Ingabe ingane yakho ivame ukuminyana lapho iphuza noma idla? Noma ingabe yenza umsindo ongajwayelekile lapho iphefumula, noma ingabe ivame ukuba nobunzima bokuphefumula? Ngezinye izikhathi, njengomama noma ubaba, kuyinto evamile ukuthi uzizwe wesaba kakhulu futhi ukhathazekile uma ubona lezi zinto. Namuhla sizokhuluma ngesimo sokuzalwa esingabonisa izimpawu ezifanayo, kodwa esingavamile kakhulu kubantu abaningi. Lesi simo sibizwa ngokuthi i-laryngeal cleft . Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, masiliqonde kalula.
Kuyini i-Laryngeal Cleft?
Kalula nje, i-laryngeal cleft iyindawo encane noma umngxuma esicutshini okufanele ube phakathi kwemiphimbo yezingane zethu, okungukuthi, ibhokisi lezwi (i-larynx) kanye nepayipi lokudla (umphimbo). Cabanga ngakho, ibhokisi lethu lezwi lingaphezu kwepayipi lomoya (i-trachea). Ipayipi lokudla lingemuva kwaleli bhokisi lezwi. Ngakho-ke, uma kukhona igebe elingavamile phakathi kwalaba ababili, izinto ezidliwa yingane, okungukuthi, ubisi, amanzi, nokudla kungadlula kulelo gebe liye epayipini lomoya esikhundleni sokungena esiswini. Yilapho izinkinga ziqala khona. Lesi yisimo esingavamile kakhulu sokuzalwa . Lesi simo senzeka cishe koyedwa kwabayi-10,000 kuya kwabayi-20,000 abazalwa bephila. Sivame kakhulu kubafana.
Kubalulekile ukuhlonza nokwelapha umntwana onalesi simo ngokushesha okukhulu, ngoba uma ukudla noma isiphuzo kuya endaweni engafanele, kungabangela izinkinga eziningi. Kodwa-ke, ubucayi balo mfantu we-laryngeal buxhomeke kubukhulu bomfantu nendawo okuyo.
Yiziphi izinhlobo eziyinhloko zemifantu ye-laryngeal?
Odokotela bahlukanisa imifantu ye-laryngeal ibe izinhlobo ezine eziyinhloko, kuye ngokuthi ibucayi kangakanani. Ake sibheke ukuthi iyini:
- Uhlobo I: Lolu uhlobo oluthambile kakhulu . Ukuqhekeka kusezintanjeni zezwi lomntwana kuphela. Lolu hlobo ngokuvamile alubangeli izimpawu ezinkulu. Ngakho-ke, lungase lungabonakali ngokushesha.
- Uhlobo II: Lapha uqhekeko ludlulela ngaphansi kwezintambo zezwi lomntwana.
- Uhlobo III: Uqhekeko lukhulu kancane. Lungase ludlulele ngale kwebhokisi lezwi lomntwana (i-larynx) luye e-trachea (umphimbo womoya).
- Uhlobo IV: Lolu uhlobo olubi kakhulu . Lapha, ukuqhekeka kwenabela phansi kakhulu embhobheni womntwana. Ngezinye izikhathi, ukuqhekeka kunganwebeka kulo lonke umbhobho womoya.
Manje usuyaqonda ukuthi igebe lithinte kangakanani lokhu kuhlukaniswa.
Ziyini izimpawu zokuqhekeka kwe-laryngeal?
Uma ingane yakho inomqhekezo womphimbo, kungenza kube nzima ngayo ukudla nokuphefumula. Izimpawu ezivamile zifaka:
- Ukukhwehlela nokuminyana ngesikhathi uncelisa noma uncelisa: Lokhu kuvame ukuba uphawu lokuqala olubonayo. Kufana nalapho ingane encane inikwa ubisi bese iqala ukuminyana, ukuqunjelwa, futhi ngezinye izikhathi ubisi luphuma emakhaleni ayo.
- Ubunzima bokugwinya: Ingane iyenqaba ukudla, noma ibonakala inenkinga enkulu yokugwinya.
- Isikhumba esiluhlaza okwesibhakabhaka (i-Cyanosis): Lokhu kushintsha kombala okuluhlaza okwesibhakabhaka (i-cyanosis) kubonakala kalula ezinsinini, ezindebeni, ezinzipho, nasemaceleni kwamehlo, ikakhulukazi ezinganeni ezinesikhumba esimnyama. Lokhu kwenzeka lapho umzimba ungatholi umoya-mpilo owanele.
- Umsindo oshisayo, omanzi, nobuhlungu lapho uphefumula: Kungazwakala sengathi uketshezi lunamathele emphinjeni.
- Ukukhala njalo, ukungahlaliseki, nokungalali kahle ngenxa yendlala: Ingane ingase izizwe ilambile ngaso sonke isikhathi ngoba ukudla akungeni kahle esiswini.
- Ukwehluleka ukukhuluphala, ukukhula okulibazisekile: Uma ingane ingakhuli noma ingakhuli ngesivinini esifanayo nezinye izingane ezineminyaka efanayo, kungakhathaliseki ukuthi inikezwa ubisi noma ukudla okungakanani, lokhu kufanele kubhekwe njengokusolisayo.
- Ukufutha ukudla noma isiphuzo epayipini lomoya: Lokhu kungaholela ekuthelelekeni kwamaphaphu njalo.
- Ukwenzeka njalo kwe-pneumonia: Lokhu kwenzeka ngenxa yesimo sokufutha okukhulunywe ngaso ngenhla.
Uma ingane yakho inesinye salezi zimpawu noma ngaphezulu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.
Yini ebangela ukuqhekeka kwe-laryngeal?
Abacwaningi abakayazi imbangela eqondile yalesi simo. Kodwa-ke, kucatshangwa ukuthi yinto eyenzeka ezinyangeni ezimbalwa zokuqala zokukhula komntwana esibelethweni. Ingazenzekela yodwa, noma ingahlotshaniswa nezifo ezithile zofuzo. Isibonelo:
- Isifo se-Opitz-Frias
- Inhlangano ye-VACTERL
- Isifo sikaPallister-Hall
- Isifo Sokushaja
Izingane ezingaphezu kwengxenye ezinezimfa ze-laryngeal nazo zingase zibe nezinye izinkinga zokuzalwa. Ezinye zalezi zinkinga zifaka:
- I-Tracheobronchomalacia - ubuthakathaka bombhobho womoya
- Umlomo oqhekekile kanye/noma ulwanga
- Ukuphazamiseka kwenhliziyo nemithambo yegazi
- I-Pulmonary agenesis - ukwehluleka kokukhula kwephaphu elilodwa
- I-Esophageal atresia - ukwakheka okungaphelele kwe-esophagus
- I-Tracheoesophageal fistula - ukuxhumana okungavamile phakathi komphimbo kanye ne-esophagus
Ngenxa yokuthi lo mfantu we-laryngeal ungabonakala nakwezinye izimo ezinjengalesi, odokotela bayakunaka nalokhu.
Itholakala kanjani i-laryngeal cleft?
Izinhlobo ezincane ze-laryngeal clefts, izinhlobo I no-II, ngezinye izikhathi zingase zingatholakali iminyaka eminingi ngoba izimpawu azizimbi kangako. Kodwa-ke, izimpawu zezinhlobo III no-IV zimbi kakhulu kangangokuthi zivame ukutholakala ezinsukwini ezimbalwa zokuqala ngemva kokuzalwa.
Uma ingane yakho inezimpawu ezishiwo ngenhla, udokotela we-otolaryngologist (uchwepheshe we-ENT) uvame ukuncoma ukuhlolwa kwe-endoscopic. Kulokhu, isivivinyo esiyinhloko sokuthola ukuthi kukhona yini ukuqhekeka kwe-laryngeal yi -microlaryngoscopy kanye ne-bronchoscopy . Ungakhathazeki, lokhu kwenziwa ngemuva kokuba ingane inikezwe i-anesthesia futhi ilele ngokuphelele. Ngemuva kwalokho uchwepheshe ufaka ipayipi elinekhamera encane emphinjeni womntwana bese ehlola ngokucophelela ukuthi kukhona yini ukuqhekeka.
Ngaphezu kwalokho, ingane yakho ingathunyelwa ku-Speech-Language Pathologist (SLP). Lochwepheshe uzobheka ukuthi lesi simo sithinta kanjani ikhono lengane yakho lokukhuluma nokugwinya.
Iphathwa kanjani i-laryngeal cleft?
Ngokuvamile, ukuqhekeka kwe-laryngeal kudinga ukuhlinzwa . Lokhu kubizwa ngokuthi ukulungiswa kwe-laryngeal cleft. Ukuhlinzwa kuyadingeka kakhulu ezinhlotsheni ze-II, III, kanye ne-IV. Kodwa-ke, ezinye izingane ezine-type I cleft encane zingase zivaleke zodwa njengoba zikhula. Izingane ezinjalo zingadinga kuphela imithi yokuvimbela ukudla nokuphuza ukuthi kungabuyeli emphinjeni (reflux) kanye nezinyathelo ezithile zokuvimbela ukudla ukuthi kungangeni emqaleni (aspiration).
Isikhathi nendlela yokuhlinzwa iyahlukahluka kuye ngohlobo lwe-laryngeal cleft. Odokotela abahlinzayo basebenzisa izindlela ezilandelayo ukulungisa i-cleft:
- Ukufakwa komjovo okungenamjovo kakhulu: Lapha, udokotela ohlinzayo ufaka i-filler yesikhashana endaweni lapho kukhona khona isilonda. Lokhu kungasiza ekunciphiseni izimpawu (ngokuvamile cishe izinyanga ezintathu). Lokhu kunikeza impumuzo kuze kube yilapho ingane isilungele ukuhlinzwa. Ngezinye izikhathi, lokhu kukodwa kunganele.
- Ukuhlinzwa kwe-endoscopic okungenangozi kangako: Lapha, udokotela ohlinzayo uvame ukusebenzisa i-laser ukususa izicubu ezingavamile endaweni yokusikwa, bese evala indawo yokusikwa nge-sutures.
- Ukuhlinzwa okuvulekile: Lapha, udokotela ohlinzayo wenza i-incision encane entanyeni yomntwana futhi ulungisa i-cleft. Le ndlela ivame ukusetshenziswa ezinganeni ezine-type IV laryngeal clefts.
Into ebaluleke kakhulu ukuthi ngaphambi kokuba ingane yakho ihlinzwe, ithimba lezokwelapha lizonikeza ingane umuthi wokubulala izinzwa. Ngakho ingane ngeke izwe ubuhlungu . Ungakhathazeki ngakho.
Ingabe kukhona izinkinga noma imiphumela emibi yokwelashwa kwe-laryngeal cleft?
Njenganoma yikuphi ukuhlinzwa, ukuhlinzwa kwe-laryngeal cleft kungaba nezingozi ezithile. Ezinye zazo yilezi:
- Ukuqina okungavamile komphimbo womntwana.
- Izithungo ziyaphuka noma ziyavuleka.
- Ukuphefumula okunomsindo noma i-laryngomalacia.
- Ukulimala kwemizwa exhunywe ebhokisini lezwi lomntwana (i-larynx).
- Ukuvuvukala kwendawo ephakathi kwamaphaphu esifubeni (i-Mediastinitis).
- Ukuqongelela komoya ngaphansi kwesikhumba ngemva kokuhlinzwa (i-Surgical emphysema).
- Ukucinana komphimbo lapho uphefumula (i-Tracheomalacia).
Amathuba okuba le nkinga yenzeke ancike ezintweni eziningi, okuhlanganisa uhlobo lokuhlinzwa olwenziwe, uhlobo lwesibazi, kanye nempilo yengane iyonke. Udokotela wengane yakho uzoxoxa nawe ngalokhu ngokuningiliziwe ngaphambi kokuhlinzwa.
Kuzothatha isikhathi esingakanani ukuthi ingane yami ilulame ngemva kokwelashwa kwe-laryngeal cleft?
Ngemva kokuhlinzwa, ingane yakho kuzodingeka ihlale esibhedlela okungenani usuku olulodwa noma ezimbili. Njengoba izitishi zifakwa ukuze kuvalwe imbobo, kungathatha amasonto noma izinyanga eziningana ukuthi ingane ilulame ngokuphelele . Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngokucophelela phakathi nalesi sikhathi.
Iyini ikusasa lalesi simo?
Uma kutholakale futhi kwelashwa kusenesikhathi , umbono wezingane ezinezimbobo ze-laryngeal muhle kakhulu . Ngokusho kocwaningo lwamuva nje, izingane ezingu-9 kwezingu-10 ezihlinzwa ukulungiswa kwe-laryngeal cleft zibona ukuthuthuka kwezimpawu zazo zingakapheli amasonto ayisithupha. Kodwa-ke, okuningi kuncike ekutheni imbobo inzima kangakanani. Izingane ezine-type IV cleft zinamathuba amaningi okuhlinzwa okungaphezu kokukodwa futhi zihlale esibhedlela isikhathi eside.
Udokotela wengane yakho uzokhuluma nawe ngesimo sengane yakho kanye nokunakekelwa kwayo esikhathini esizayo.
Ingabe i-laryngeal cleft ifinyeza isikhathi sokuphila?
Kwabaningi bezingane, ukuba ne-laryngeal cleft akuthinti isikhathi sokuphila kwazo. Kodwa-ke, ezinye izingane ezine-laryngeal cleft yohlobo lwe-IV enzima kakhulu kanye nezinye izinkinga zokuzalwa ezingathi sína zingaba yingozi empilweni. Kodwa-ke, ukufa ngenxa ye-laryngeal cleft - ngisho nasezimweni ezimbi kakhulu - kuyinto engavamile kakhulu .
Uma kwelashwa kahle futhi kulandelwa iseluleko sezokwelapha, ukuvuleka kwe-laryngeal akufanele kufinyeze isikhathi sokuphila kwengane noma kunciphise izinga lokuphila kwayo.
Kufanele ngimbone nini udokotela wengane yami?
Ngemva kokuhlinzwa, udokotela wengane yakho cishe uzokucela ukuthi uze ukuzobona udokotela njalo ezinyangeni eziyisithupha, kuze kube unyaka. Inani lokuvakasha phakathi naleso sikhathi lizoncika entuthukweni yengane yakho.
Phakathi nalezi zivivinyo, udokotela angenza izivivinyo zezithombe futhi akubuze ngezimpawu zomntwana wakho. Lungela ukukhulumela ingane yakho. Khuluma nodokotela nganoma yiziphi izinguquko ozibonayo ezimpawu zomntwana wakho kanye nempilo yakhe iyonke.
Yimiphi imibuzo okufanele ngiyibuze udokotela wengane yami?
Nazi ezinye zemibuzo ebalulekile okufanele uyibuze udokotela wengane yakho:
- Kungani uncoma lokhu kwelashwa noma ukuhlinzwa?
- Yini engingayenza ukuze ngisize ingane yami ikhululeke kakhudlwana ngaphambi nangemva kokuhlinzwa?
- Ziyini izingozi zokuhlinzwa kwengane yami?
- Kuzothatha isikhathi esingakanani ukuthi ingane yami ilulame?
- Yini engingayilindela ngempilo yengane yami yesikhathi eside?
Buza imibuzo efana nale bese uchaza konke onakho.
Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)
Uma ingane yakho izalwa ine-laryngeal cleft, kuzodingeka ubone ochwepheshe abahlukahlukene. Bonke bazosebenzisana ukuze banikeze ingane yakho ukunakekelwa okungcono kakhulu. Khumbula, ngezinye izikhathi i-cleft ingase iphole yodwa. Uma kunjalo, ukuqaphela ingane yakho eduze kungase kwanele. Uma i-cleft inzima, ingane yakho ingadinga ukuhlinzwa. Into ebalulekile ukukhumbula ukuthi kunezindlela zokwelapha ezingasiza. Okwamanje, buza udokotela wengane yakho ngezinto ongazenza ukusiza ingane yakho ibhekane nalokhu kuxilongwa. Awuwedwa, futhi ithimba lezokwelapha lihlala likhona ukukusiza wena nengane yakho.
👩🏽⚕️ Imibuzo eyengeziwe (ama-FAQ)
💬 Ingabe i-Laryngeal Cleft iyisifo se-Cleft Lip?
Cha! Umlomo oqhekekile uyabonakala ngaphandle, kodwa lona awubonakali. Umphimbo wethu unodonga oluhlukanisa ipayipi lokudla (umphimbo) kanye nepayipi lomoya (umphimbo). Kodwa-ke, kulesi sici sokuzalwa, lolo donga alwakhi kahle, lushiya 'imbobo' noma uqhekeko phakathi kwepayipi lokudla kanye nepayipi lomoya.
💬 Uyibona kanjani le nkinga uma uncelisa umntwana?
Uma kukhona le mbobo, ubisi olungena epayipini lokudla lapho umntwana ephuza lungena ngqo ngesikhala luye emaphashini (i-aspiration). Lokhu kubangela ukuthi umntwana akhwehlele kakhulu lapho ephuza, abe nobunzima bokuphefumula, aphenduke abe luhlaza okwesibhakabhaka ebusweni, futhi abe nezifo zamaphaphu ezivame ukutheleleka (i-pneumonia).
💬 Uyondla futhi uphuze kanjani ingane uma kukhona umgodi onje?
Lokhu kumele kuvalwe ngokuhlinzwa. Uma ukudabuka kuncane kakhulu, ukulawula okuthile kungafinyelelwa ngokunikeza ukudla okumanzi (ubisi) okujiyile kancane (okujiyile). Kodwa-ke, uma ukudabuka kukhulu, ipayipi (i-G-tube) kungadingeka lifakwe ngqo esiswini (esiswini) kuze kube yilapho ukuhlinzwa kungenziwa.
Ukuqhekeka kwekhala , ulwanga oluqhekekile, ukuminyana kwengane, ubunzima bokuphefumula, ukukhubazeka kokuzalwa, impumulo egobhozayo, impilo yengane
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