Ingaba uhlala unentlungu entanyeni, emagxeni, okanye ezingalweni zakho? Le meko isenokuba yiThoracic Outlet Syndrome (TOS)!

Ngaba ngamanye amaxesha uziva intlungu engaqhelekanga okanye ukuba ndindisholo okuphuma entanyeni nasemagxeni akho kuyehla ngeengalo zakho? Mhlawumbi le ntlungu iyanda xa uphakamisa ubunzima okanye uphakamisa ingalo yakho. Ukuba uneempawu ezinje, unobangela usenokuba yimeko enegama elintsonkothileyo. Namhlanje sithetha ngemeko enjalo, ebizwa ngokuba yiThoracic Outlet Syndrome (TOS) . Nangona igama lisenokuvakala lisoyikisa kancinci xa uliva, ukuba unolwazi olufanelekileyo ngalo, unganciphisa iingxaki ezininzi.

Yintoni iThoracic Outlet Syndrome?

Ngamafutshane, i-Thoracic Outlet Syndrome (TOS) yingqokelela yeempawu ezibangelwa kukucinezelwa kwemithambo-luvo okanye imithambo yegazi entanyeni yakho esezantsi nakwisifuba esingaphezulu. Elinye igama lale nto yi-"thoracic outlet."

Khawuthelekelele ukuba kukho indawo encinci, efana nomnyango, phakathi kwentamo yakho nesifuba sakho. Le yinto oogqirha abayibiza ngokuba yi "Thoracic Outlet." Kule ndawo kungena imithambo-luvo ebalulekileyo eya engalweni yakho, kunye nemithambo-luvo ethwala igazi engalweni yakho kunye nemithambo-luvo ebuyisela igazi elivela engalweni yakho entliziyweni yakho. Ezona zibalulekileyo kwezi yi-brachial plexus, inethiwekhi yemithambo-luvo eya engalweni yakho, kunye nomthambo we-subclavian kunye nomthambo.

Ngokwesiqhelo, le ndawo ibizwa ngokuba yi "thoracic outlet" inkulu ngokwaneleyo ukuba le mithambo-luvo kunye nemithambo yegazi zidlule ngaphandle kokuphazanyiswa. Nangona kunjalo, ngamanye amaxesha le ndawo inokuba mxinwa ngenxa yokutshintshatshintsha okuthile komzimba wethu okanye ngenxa yokwenzakala entanyeni okanye esifubeni. Kulapho ingxaki iqala khona. Xa le ndawo iba mxinwa, imithambo-luvo okanye imithambo yegazi edlula kuyo iqala ukucinezelwa ngamathambo okanye izihlunu ezingezantsi. Olu xinzelelo lubangela iimpawu ezifana nentlungu kunye nokungaziva kakuhle engalweni yakho, egxalabeni, nasentanyeni. Ezi mpawu zinokunganxulumani kwaye zahluke, ngoko ngamanye amaxesha kungathatha ixesha ukuqaphela oku njengemeko ye-TOS .

Kodwa ungakhathazeki. Abantu abaninzi banokufumana isiqabu ngonyango olulula olufana nonyango lomzimba kunye neepilisi zokudambisa iintlungu. Nangona kunjalo, ukuba ezo azincedi okanye ukuba kukho ukuvaleka okukhulu kwegazi, utyando lunokufuneka.

Ngaba kukho iintlobo ze-TOS?

Ewe, oogqirha bahlula i-TOS kwiintlobo ezintathu eziphambili, kuxhomekeke kwinto ebangela oku kuqaqamba:

I-Neurogenic TOS (ii-Tos ezibangelwa kukucinezelwa kwemithambo-luvo)

Olu lolona hlobo luqhelekileyo lwe-TOS . Malunga ne-95% yazo zonke izigulana ze-TOS zinolu hlobo. Okwenzekayo apha kukuba i-"Brachial plexus", uthungelwano lwemithambo-luvo ephuma entanyeni yakho idlule ekhwapheni ukuya engalweni, icinezelwe. Ihlala isenzeka kubantu abakwiminyaka yabo yama-30. Ukulimala okuphindaphindwayo koxinzelelo - ngakumbi kwezemidlalo - kunye nokwenzakala ngequbuliso entanyeni, okufana ne-"Whiplash" ngenxa yengozi yemoto, zezona zizathu ziphambili.

I-TOS ebangelwa kukuxinana kwemithambo yegazi (i-Venous TOS)

Kulapho kungena khona "umthambo wakho we-Subclavian". Lo ngumthambo wegazi oyintloko othwala igazi elingcolileyo ukusuka engalweni ukuya entliziyweni. Uhlala usenzeka kumadoda , ngesiqhelo phakathi kweminyaka engama-20 nama-30. Iimpawu zihlala zibonakala engalweni esetyenziswa kakhulu ('ingalo elawulayo').

I-TOS ebangelwa kukucinezelwa kwemithambo yegazi (i-Arterial TOS)

Olu lolona hlobo lungaqhelekanga lwe-TOS . Luchaphazela malunga ne-1% yazo zonke izigulana ze-TOS. Nangona kunjalo, yeyona nto ixhaphakileyo yokuqhekeka kwegazi ngequbuliso ezingalweni kubantu abangaphantsi kweminyaka engama-40 ubudala. Olu hlobo lwe-TOS lwenzeka kumthambo wakho wegazi ongaphantsi kwe-subclavian, umthambo wegazi oyintloko othwala igazi elineoksijini ukusuka entliziyweni yakho ukuya ezingalweni zakho. Ludla ngokubangelwa kukungaqheleki kokuzalwa. Umzekelo lubambo olongezelelweyo entanyeni (ubambo lomlomo wesibeleko). Malunga nama-70% abantu abanebambo lomlomo wesibeleko ngabafazi, ngoko ke olu hlobo lwe-TOS luxhaphake kakhulu kubafazi.

Oogqirha ngamanye amaxesha badibanisa iintlobo ezimbini ze-venous kunye ne-arterial TOS baze bazibize ngokuba yi-"Vascular Thoracic Outlet Syndrome." Zombini ezi ntlobo zihlala zifuna utyando ukuze kuncitshiswe iimpawu kwaye kuthintelwe iingxaki. Uhlobo lwe-TOS olunxulumene nemithambo-luvo (i-Neurogenic TOS) lusabela kakuhle kunyango lomzimba kunye nokuzilolonga, kodwa abanye abantu banokufuna utyando.

Ixhaphake kangakanani le meko?

Ngokutsho kwabaphandi, minyaka le:

• I-TOS ye-neurogenic iyenzeka kumntu omnye kwabangama-40,000.
• I-VOS yemithambo yegazi yenzeka kumntu omnye kwi-1.25 yezigidi zabantu.

Nangona kunjalo, ngenxa yobunzima bokuxilonga ngokuchanekileyo le meko, inani labantu abanesifo linokuba phezulu kakhulu.

Zithini iimpawu ze-TOS?

Iimpawu ze-TOS zihlala zivela kwelinye icala lomzimba wakho ongaphezulu (intamo, isifuba esingaphezulu, igxalaba, ingalo, okanye iminwe). Usenokuhlangabezana nezinto ezifana nezi:

• Intlungu: Le ntlungu inokwanda xa uphakamisa ingalo yakho.
• Ukuba ndindisholo okanye ukuziva "uphambene".
• Ukuba ndindisholo, ukuziva kungekho nto esandleni .
• Ubuthathaka besandla.
• Ukudumba okanye ubunzima esandleni.
• Utshintsho lombala wolusu (ulusu luba mthubi okanye lube luhlaza okwesibhakabhaka).
• Ukuziva ubanda xa uchukumisa ulusu.
• Amanxeba eminwe athatha ixesha elide ukuphola.

Ezi mpawu zinokwahluka ngokuxhomekeke kuhlobo lwe-TOS onayo. Kuba iimpawu zixhomekeke kwinto ecinezelweyo (umthambo okanye umthambo wegazi). Ukuchaneka, zezi zilandelayo:

• I-"Brachial plexus" yakho kulapho ingalo yakho ifumana khona intshukumo kunye nemvakalelo. Ngoko ke, xa olu nxibelelwano lwemithambo-luvo lucaphukile, izinto ezifana nentlungu kunye nokungaziva.
• Umthambo wakho we-subclavian ngulowo uthwala igazi elivela engalweni yakho ulibuyisele entliziyweni yakho. Ngoko ke, xa lo mthambo uvalekile, igazi elingalweni yakho alikwazi ukuphuma kakuhle, nto leyo ebangela ukuba ingalo yakho idumbe kwaye ivakale inzima.
• Umthambo wakho we-subclavian unika igazi elinomoya-mpilo engalweni yakho. Ngoko ke, xa lo mthambo uvaliwe, ukuhamba kwegazi engalweni yakho nakwiminwe yakho kuyancitshiswa. Oku kunokubangela ukungaziva, ukurhawuzelelwa, iintlungu, kunye nokubanda engalweni yakho.

Injani intlungu ye-TOS? Ingaba ididaniswa ne-angina?

I-TOS ingabangela intlungu entanyeni, esifubeni esingaphezulu, egxalabeni, nasengalweni. Oku kungaba yintlungu engathandekiyo, njengentlungu engapheliyo, kwaye kunokuba mandundu xa ushukumisa ingalo yakho.

Abanye abantu babhidanisa intlungu ye-TOS ne -angina , imeko yentliziyo. I-Angina yintlungu yesifuba ebangelwa kukuba izihlunu zentliziyo azifumani ioksijini eyaneleyo. Kodwa kukho umahluko obalulekileyo phakathi kwezi zimbini:

• Intlungu ye-TOS ayiveli okanye ibe mandundu ngokuhamba. Nangona kunjalo, intlungu ye-angina idla ngokuba njalo. I-angina inokuhamba nezinye iimpawu ezifana nokuphefumla okufutshane, ukubetha kwentliziyo ngokukhawuleza, kunye nesiyezi.
• Iintlungu ze-TOS zihlala zisanda xa ingalo echaphazelekayo iphakanyisiwe. Oku akwenzeki nge-angina.

Kubalulekile: Musa ukubhidanisa i-TOS nokuhlaselwa yintliziyo okanye istroke!

Le yinto ekufuneka uyikhumbule . Ezinye zeempawu ze-TOS zinokufana nezo zeemeko ezinzulu ezifana nokuhlaselwa yintliziyo kunye nestroke, ezifuna unyango olungxamisekileyo. Umzekelo:

• Intlungu yesifuba , ingakumbi ukuba ivele ngequbuliso kwaye ingalindelwanga, inokuba luphawu lokuhlaselwa yintliziyo. Nangona kunjalo, xa uhlaselwa yintliziyo, kunokubakho ezinye iimpawu, ezinje ngokuphefumla kancinci, iintlungu zesisu, ukubila, kunye noloyiko lokufa.
• Ubuthathaka kwelinye icala lomzimba bunokuba luphawu lokungakhuli kakuhle. Nangona kunjalo, ukungakhuli kakuhle kungaba neempawu ezongezelelweyo, ezifana nokuthetha okungacacanga, ukugoba kwelinye icala okanye omabini amacala obuso, kunye nokulahlekelwa ngumbono ngequbuliso.

Ukuba uneempawu zokuhlaselwa yintliziyo okanye isifo sohlangothi, funa uncedo lwezonyango ngokukhawuleza. Ezi ziimeko ezingxamisekileyo ezisongela ubomi. Ukulibazisa unyango kunokuba yingozi.

Zithini izizathu ze-TOS?

Oogqirha bahlula izizathu ze-TOS zibe ziindidi ezintathu eziphambili:

Izizathu zokuzalwa

Ezi zezinye zeendlela ezitshintshayo ezenzeka emzimbeni wakho xa uzalwa. Umzekelo, ungazalwa unembambo eyongezelelweyo ('imbambo yomlomo wesibeleko') entanyeni yakho. Oku kukufutshane, mhlawumbi kudibene nembambo yokuqala. Okanye usenokuba neengxaki kwiimbambo zakho, kwimisipha yentamo, okanye kwimisipha. Ezi nguqu zinokubangela uxinzelelo kwimithambo-luvo okanye kwimithambo yegazi 'kwindawo yokuphuma kwesifuba'.

Ngenxa yeengozi (Ezenzeka kabuhlungu)

Ezi zizinto ezenzakeleyo ngequbuliso entanyeni yakho nakwisifuba sakho esingaphezulu. Izinto ezenzakeleyo ezibangelwa ziingozi zeemoto, ingakumbi i-whiplash, ngumzekelo obalaseleyo woku. Khawuthelekelele, ukuba ubukhwele imoto enamavili amathathu waza wafumana ingozi waza intamo yakho yaphuka ngequbuliso, oku kungenzeka.

Ngenxa yemisebenzi eqhubekayo (Esebenzayo)

Oku kuthetha ukuba xa usenza into efanayo ngokuphindaphindiweyo, izinto ezikwi "thoracic outlet" ziyamoshakala. Le yimbangela eqhelekileyo yoku phakathi kwabadlali (ingakumbi abadlali bekriketi - ababhowuli, ababhethi, kunye nabadada) ngenxa yokunyakaza ngokukhawuleza kweengalo. Omnye umzekelo kukuphakamisa izinto ngaphezulu kwentloko rhoqo kwimisebenzi ethile. Kwanomntu osebenza phambi kwekhompyutha imini yonke enesimo esibi somzimba unokuba sengozini.

Nangona abanye abantu bezalwa benezinto ezibangela umhlaza, basenokungabi nazo iimpawu de babe nengozi engxamisekileyo entanyeni okanye basoloko besenza uhlobo olufanayo lomsebenzi kwaye yonakale.

Ngubani osengozini enkulu yokufumana i-TOS?

Usenokuba sengozini enkulu yokufumana i-TOS ukuba:

• Ukuba udlala imidlalo edla ngokubandakanya iintshukumo eziphindaphindayo zeengalo okanye zamagxa. Imizekelo: ikhilikithi, ukudada, igalufa, ivolibholi.
• Ukuba wenza ukuphakamisa iintsimbi.
• Ukuba uhlala uphakamisa iingxowa ezinzima emagxeni akho okanye uphakamisa izinto ngaphezulu kwentloko yakho. (umz., abantu abasebenza kwishishini lokwakha, abantu abalayisha iimpahla)
• Ukuba wenzekele entanyeni okanye emqolo, umzekelo `(Whiplash)`.
• Ukuba unezimila okanye ii-lymph nodes ezinkulu kwisifuba esingaphezulu okanye ekhwapheni.
• Ukuba indlela ohlala ngayo okanye omi ngayo ayilunganga. (Umzekelo: abantu abasebenza kwikhompyutha begobile umqolo imini yonke)

Ingaba i-TOS yimeko embi kakhulu? Ziziphi iingxaki ezinokubakho?

Ukuba ayinyangwa, i-Thoracic Outlet Syndrome inokukhokelela kwiingxaki ezinkulu. Ezinye zazo ziquka:

• Ukuqhekeka kwegazi ekhwapheni nakwimithambo enxulumene nayo (`i-Axillo-subclavian vein thrombosis`).
• Ukudumba okungapheliyo kunye nentlungu esandleni, ingakumbi kwabo bane-venous TOS (`Venous TOS`).
• Ukufa kwezicubu (`Gangrene`).
• Izilonda ze-Ischemic zenzeka kwiminwe ngenxa yokuncipha kokuhamba kwegazi.
• Ukonakala kwemithambo-luvo okungapheliyo.
• I-Pulmonary embolism – Le yimeko eyingozi kakhulu.

Ngoko ke, uyabona, ayingombono ulungileyo ukucinga ukuba le yingxaki nje encinci. Kubaluleke kakhulu ukuyixilonga nokuyinyanga kwangethuba.

Ungazi njani ngokuqinisekileyo ukuba une-TOS? (Ukuxilongwa)

Ugqirha uza kukuxilonga aze akubuze ngembali yakho yezonyango ukuze abone ukuba une-TOS na. Ngexesha lovavanyo lomzimba, ugqirha wakho uza kukucela ukuba wenze uvavanyo lokushukuma. Umzekelo:

• `Uvavanyo lokuxinana kwamalungu angasentla` (uvavanyo lokujonga ukuba ilungu eliphezulu lichaphazelekile na)
• `Uvavanyo loxinzelelo lwengalo oluphezulu`

Ngexesha lovavanyo, ugqirha wakho uza kukucela ukuba wenze izinto ezilula ezifana nokuphakamisa ingalo yakho, ukujika intloko yakho, nokushukumisa isandla sakho. Emva koko uza kujonga ukuba zeziphi iintshukumo ezibangela iintlungu okanye ezinye iimpawu. Iziphumo zinokunceda ekuxilongeni imeko.

Ukongeza, ugqirha wakho unokuyalela iimvavanyo zelebhu kunye novavanyo lwemifanekiso ukuqinisekisa ukuxilongwa kwe-TOS kunye nokuthintela ezinye izizathu zeempawu zakho.

Zeziphi ezinye iimvavanyo ozenzayo?

Kusenokufuneka wenze olunye okanye ngaphezulu kwezi vavanyo:

• Uvavanyo lwegazi .
• I-X-ray yesifuba .
• I-CT scan yesifuba kunye/okanye umqolo .
• Uvavanyo lwe-EMG (`Electromyography (EMG)`) – Olu vavanyo lujonga ukusebenza kwezihlunu kunye nemithambo-luvo.
• I-Magnetic resonance angiography (MRA) yemithambo yegazi yakho .
• I-Magnetic resonance imaging (MRI) yesifuba kunye/okanye umqolo .
• Uphononongo lokuqhuba imithambo-luvo – Oku kulinganisa isantya imiyalezo ehamba ngaso kwimithambo-luvo.

Olu vavanyo lunokunceda ugqirha afumanise oku:

• Jonga iingxaki zokuzalwa (umz., ubambo lomlomo wesibeleko).
• Jonga indlela igazi elihamba ngayo kwimithambo yakho yegazi kunye nemithambo yegazi.
• Zisuse ezinye iimeko ezinokubangela ezi mpawu.
• Jonga indlela ezisebenza ngayo izihlunu zakho kunye nemithambo-luvo yakho.
• Fumanisa ngqo apho uxinzelelo lukhoyo.

Ziziphi iindlela zonyango ze-TOS?

Unyango lwe-TOS luyahluka ngokuxhomekeke kuhlobo lwe-TOS onalo kunye neempawu zakho. Injongo ephambili yonyango kukunciphisa iimpawu nokuthintela iingxaki ezinokubakho. Ugqirha wakho uya kugqiba ukuba loluphi unyango olulungele wena.

Nazi ezinye iindlela zonyango ezinokwenzeka:

• Unyango lomzimba: Olu lolona nyango lokuqala lwe-TOS ebangela i-neurogenic. Ingcali yonyango lomzimba inokukunceda wonyuse uluhlu lwakho lokushukuma entanyeni nasemagxeni akho, iqinise izihlunu zakho, kwaye igcine ukuma okufanelekileyo. Oku kunceda kakhulu abantu abaninzi abane-TOS ebangela i-neurogenic.
• Izithomalalisi zentlungu: Ugqirha wakho unokukunika amayeza okuthomalalisa iintlungu, anjengee-NSAID (iziyobisi ezichasene nokuvuvukala ezingezizo ii-steroidal), onokuzithenga kwikhemesti.
• Amayeza athintela okanye anyibilikisa amahlwili egazi:Abantu abane-arterial TOS okanye i-venous TOS banokuncedwa yi-'thrombolytic therapy' (unyango lokunyibilikisa amahlwili egazi). Oku kubandakanya ukunika amayeza nge-IV line okanye i-catheter ukunyibilikisa amahlwili egazi akhoyo kunye nokuthintela ukwakheka kwamahlwili amatsha. Ugqirha wakho unokukunika ne-'anticoagulant medication'.
• Utyando: Abantu abaninzi abane-TOS ecinezela imithambo yegazi okanye imithambo yegazi badinga utyando. Abanye abantu abane-TOS ecinezela imithambo yegazi banokufuna utyando ukuba ezinye iindlela zonyango azincedi. Oogqirha basebenzisa iindlela ezahlukeneyo zotyando kuxhomekeke kuhlobo lwe-TOS kunye nohlobo lomzimba wakho. Umzekelo, utyando lokunciphisa uxinzelelo lususa ithambo okanye izicubu ezingaqhelekanga ezibangela uxinzelelo. Ezinye iindlela zotyando zinokuphucula ukuhamba kwegazi ngokulungisa iingxaki zesakhiwo kwimithambo yegazi. Ugqirha wakho uya kukuchazela ukuba uyaludinga na utyando, ukuba lwenziwa njani, kunye neengozi zalo.

Ngaba i-TOS iya kuba ngcono ngokwayo ?

Hayi, musa ukulinda ukuba iimpawu zibe ngcono zodwa. Ukuba uneempawu ze-TOS , funa uncedo lwezonyango ngoko nangoko. Nangona izinto ezilula ezifana nonyango lomzimba zinokunceda ekunciphiseni iimpawu, abanye abantu banokufuna utyando okanye olunye unyango ukuthintela iingxaki ezinkulu. Ugqirha wakho uza kukuxelela ukuba loluphi ucwangciso lonyango olulungele wena.

Ngaba ii-TOS zinokuthintelwa?

I-TOS ayinakuthintelwa rhoqo. Ngenxa yokuba uninzi lwezinto ezibangela oku zingaphaya kwamandla ethu (umz., izinto zemfuza), kukho izinto onokuzenza ukunciphisa umngcipheko wakho:

• Ukuba udlala umdlalo ofuna iingalo ezinde rhoqo, thetha nomqeqeshi wakho okanye umqeqeshi wakho malunga nokuzilolonga okunokuqinisa izihlunu ezijikeleze amahlombe akho.
• Ukuba umsebenzi wakho ufuna ukuphakamisa iintsimbi okanye usebenze ngaphezulu kweeyure zomsebenzi, thetha nogqirha malunga nokuzilolonga okunokunciphisa umngcipheko wokwenzakala.
• Gcina ukuma okufanelekileyo. Gcina umqolo wakho uthe nkqo xa uhleli, umile, kwaye usebenza.
• Sukuhlala ukwindawo enye ngalo lonke ixesha. Sukuma uhambe-hambe ubuncinane kanye ngeyure, wolula umzimba wakho kancinci.

Ukuba une-TOS, yintoni omele uyilindele? / Ungazinyamekela njani?

Imbono yomntu one-TOS iyahluka ngokuxhomekeke kuhlobo lwe-TOS anayo. Ugqirha wakho angakuxelela ngcono ngembono yakho.

Ukuba une-TOS, landela imiyalelo kagqirha wakho yendlela yokuzinyamekela. Ugqirha wakho angakuxelela izinto ezifana nezi:

• Nciphisa okanye uyeke ukuthwala iingxowa ezinzima phezu kwamagxa akho kwaye uphakamise izinto phezu kwentloko yakho kangangoko unako.
• Sebenza nogqirha wezonyango. Yenza umthambo akunika wona.
• Yenza umthambo onokuwenza ekhaya ukuze uqinise izihlunu zakho kwaye uphucule indlela oma ngayo.
• Nciphisa okanye uphephe iintshukumo ezithile ezibangela iimpawu.Tshintsha indlela oqhele ukwenza ngayo imihla ngemihla.

Ufanele uye nini kugqirha? / Imibuzo yokubuza ugqirha

Ukuba ubonakalisa iimpawu ezintsha okanye ukuba iimpawu zakho ziyatshintsha, thetha nogqirha wakho. Uza kukuxelela ukuba kufuneka uye kangaphi kugqirha wakho kwaye nokuba kufuneka wenze naluphi na uvavanyo.

Ukuba usandul’ ukufunyanwa une-Thoracic Outlet Syndrome, nantsi eminye imibuzo onokuyibuza ugqirha wakho:

• Luhlobo luni lwesifo seThoracic Outlet endinaso?
• Yintoni isizathu soku?
• Loluphi unyango olucebisayo? Lufanele lwenziwe nini?
• Singazi njani ukuba unyango luphumelele?
• Zithini iingozi zonyango?
• Zeziphi iinguqu ekufuneka ndizenze kwimisebenzi yam yemihla ngemihla okanye imikhwa yam?
• Ndingenza ntoni ekhaya ukunciphisa iimpawu?
• Injani imbono yam?

Izinto ekufuneka uzikhumbule kweli nqaku (Umyalezo Wokuya Ekhaya)

Isifo seThoracic Outlet Syndrome (TOS) sinokuphazamisa ubomi bakho obuqhelekileyo. Kunokuba yinto ecaphukisayo ukuba kufuneka uthathe ikhefu kwimidlalo okanye emsebenzini wakho. Kodwa yiba nomonde. Ngokuzinyamekela ngonyango lomzimba okanye olunye unyango, unokuphinda ufumane amandla akho kwaye uhlale uphilile ekuhambeni kwexesha.

Eyona nto ibalulekileyo kukufuna iingcebiso zonyango ukuba uneempawu, endaweni yokuzityeshela. Ukufunyaniswa kwangoko kwenza unyango lube lula kwaye kunciphisa umngcipheko weengxaki.

Ukuba unemibuzo malunga nemeko yakho, isicwangciso sonyango, okanye indlela ocinga ngayo, thetha nogqirha wakho.

Isifo seThoracic Outlet, i-TOS, iintlungu zentamo, iintlungu zengalo, iintlungu zamagxa, ukungaziva, ukucinezelwa kwemithambo-luvo