Ingabe izimila zingakhula emithanjeni yakho? Ake sixoxe ngama-Nerve Sheath Tumors ngamagama alula!

Imizwa egijima emizimbeni yethu ifana nenethiwekhi yezintambo ezithwala imiyalezo kagesi. Zithwala ulwazi lubuya lubuye lubuye lusuke ebuchosheni luye kuwo wonke umzimba, futhi lusuka emzimbeni luye ebuchosheni. Cabanga ukuthi la maseli emizwa, amaqoqo awo, ahlanganiswe ngama-membrane akhethekile okuvikela, njenge-sheath yepulasitiki ezungeze intambo, ukuze awavikele futhi asize izimpawu zikagesi zihambe ngokushesha. Kukulezi zingqimba ezivikelayo lapho lezi zimila ezibizwa ngokuthi ama-nerve sheath zikhula khona ngezinye izikhathi.

Ziyini izimila ze-nerve sheath?

Kalula nje, la mathumba akheka “ezimbotsheni” ezivikelayo ezizungeze izinzwa zethu. Lo “mgobo” noma isembozo sakhiwe ngezendlalelo eziningana:

• Amaseli eSchwann: Lawa amaseli azungeza i-axon, okuyingxenye ende yeseli yemizwa. Njengokushiswa komoya ozungeze ucingo.
• I-Endoneurium: Lesi yizicubu ezixhumanisayo ezizungeze i-fibre ngayinye yezinzwa, njenge-sheath ezungeze intambo eyodwa yethusi entanjeni.
• I-Perineurium: Yilokhu okuzungeze izinqwaba zemicu yezinzwa.

Uhlelo lwethu lwezinzwa lungahlukaniswa izingxenye ezimbili:

• Isimiso sezinzwa esiyinhloko: Lokhu kuhlanganisa ubuchopho bethu kanye nomgogodla.
• Isimiso sezinzwa esingaphandle: Lena inethiwekhi yezinzwa ezisuka ebuchosheni nasemgogodleni ziye kuzo zonke izingxenye zomzimba.

Esikhathini esiningi, lawa ma-neurofibroma akheka ohlelweni lwezinzwa oluseceleni .

Yiziphi izinhlobo zamantongomane ezikhona?

Kunezinhlobo eziningana eziyinhloko zama-neuromas. Ake sibheke ukuthi ziyini.

AmaSchwannoma

Lezi zimila zikhula emaseli aseSchwann okukhulunywe ngawo ngaphambili. Cishe ama-60% ama-schwannoma akhula emthanjeni we-vestibular endlebeni yethu yangaphakathi . Lo mthambo usiza umzimba wethu ukuthi ugcine ibhalansi. Amanye ama-schwannoma ngezinye izikhathi angakhula ngaphansi kwesikhumba sethu, noma ngaphakathi kwezicubu nezitho zomzimba. Izindawo ezivame kakhulu lapho lezi zimila zibonakala khona yilezi:

• Ezingalweni nasemilenzeni
• Ekhanda
• Esiqwini (okungukuthi, indawo ephakathi kwamahlombe nezinqe)

Ama-Schwannoma amathumba avame ukuvalelwa engqimbeni encane yezicubu, ebizwa ngokuthi i-capsule. Ngokuvamile awawona umdlavuza (angabi yingozi)**. Kodwa-ke, akuvamile kakhulu ukuthi isimila esihlale isikhathi eside sibe yingozi (umdlavuza).

Ama-Neurofibromas

Lolu hlobo lwesimila luhilela izinhlobo eziningana zezicubu ezibizwa ngokuthi amaseli e-Schwann, i-endoneurium, kanye ne-perineurium ezimboza imizwa. Lezi zivame ukubonakala njengezigaxa ngaphansi kwesikhumba, kodwa ngezinye izikhathi zingakhula emithanjeni ejulile emzimbeni.

Ngokungafani nama-schwannoma, ama-neurofibroma awahlanganisiwe. Akhula ngaphakathi kwama-nerve bundles. Ama-neurofibroma e-Plexiform awuhlobo lwesimila esisakazeka njenge-mesh, sizungeze ama-nerve bundles amaningi futhi singasakazeka ezicutshini ezizungezile.

Iningi lama-neurofibroma aliwona umdlavuza. Kodwa-ke, cishe u-5% kuya ku-10% walezi zimila zingaba umdlavuza . Zibizwa ngokuthi ama-malignant peripheral nerve sheath tumors (MPNST) . Cishe ingxenye yabantu abanalezi zimila ezibulalayo isivele isakazekele kwezinye izingxenye zomzimba ngesikhathi zitholakala.

Sivame kangakanani lesi sithelo?

Izimila ze-nerve sheath ezingezona umdlavuza azivamile.

• Ama-Schwannoma avame ukubonakala kubantu abaneminyaka ephakathi kuka-50 no-60.
• Ama-neurofibroma avame ukwenzeka kubantu abaneminyaka ephakathi kuka-20 no-40.
• Ama-neurofibroma e-Plexiform avame ukukhula ngaphambi kweminyaka emi-5.

I-Malignant Peripheral Nerve Sheath Ama-tumors awuhlobo lomdlavuza olungavamile kakhulu , athinta cishe umuntu oyedwa kwabayizigidi eziyi-10 minyaka yonke.

Kungani izimila zifana nalezi? Ziyini izimbangela?

Izinguquko zofuzo zinomthelela omkhulu ekuthuthukisweni kwalezi neurofibromas.

• Ukuthuthukiswa kwamaSchwannomas kuhlotshaniswa nezinguquko ku-gene ebizwa ngokuthi i-NF2.
• Ama-neurofibroma ahlotshaniswa ne-gene ebizwa ngokuthi (NF1).

Esikhathini esiningi, lezi zinguquko zofuzo zenzeka ngezikhathi ezithile, ngaphandle kwesizathu esibonakalayo . Kodwa-ke, inani elincane lama-schwannoma nama-neurofibromas libangelwa yisimo esingavamile sofuzo esibizwa ngokuthi i-neurofibromatosis , esingaba semindenini.

Izinhlobo ze-Neurofibromatosis

Kunezinhlobo ezintathu eziyinhloko zalesi sifo:

• Uhlobo lwe-Neurofibromatosis 1 (NF1): Abantu abane-NF1 bakha inani elikhulu lama-neurofibromas. Baphinde babe nengozi eyengeziwe yokuthola ama-neuromas e-plexiform kanye nama-malignant peripheral nerve sheath tumors (MPNST). Ezinye izimo ezibonakala kubantu abane-NF1 zifaka phakathi i-macrocephaly , i-scoliosis, kanye nokukhubazeka kokufunda .

• Uhlobo lwe-Neurofibromatosis 2 (NF2):Cishe wonke umuntu one-NF2 uba nama-schwannoma e-vestibular ezindlebeni zombili ngaphambi kokuba abe neminyaka engu-30. Ngaphezu kwalokho, ezinye izinhlobo zama-schwannoma nama-tumors nazo zingakhula esikhumbeni, emehlweni, nasesimisweni sabo sezinzwa esiyinhloko.

• I-Schwannomatosis: Kulesi simo, ama-schwannoma amaningi akhula emthanjeni we-vestibular (ezindlebeni zombili) kunasemthanjeni we-vestibular.

Ziyini izimpawu zalezi zimila?

Iningi labantu abanezimila ze-neuromastoid abazizwa ubuhlungu noma ezinye izimpawu . Kodwa-ke, uma isimila sikhula sibe sikhulu noma sicindezela imizwa, izimpawu ezinjengalezi:

• Isigaxa noma isimila ngaphansi kwesikhumba (kungaba buhlungu uma sicindezelwa).
• Ubuthakathaka bemisipha .
• Ukuba ndikindiki .
• Ubuhlungu, izinhlungu, noma ubuhlungu obubukhali .
• Umuzwa wokuthuthumela, njengokushaywa ugesi .

Kuye ngokuthi isimila sikuphi, kungase kuvele nezinye izimpawu ezithile. Nazi izibonelo ezimbalwa:

• Isimila semizwa ye-sciatic: Ubuhlungu obuhamba kusukela emhlane kuya phansi emlenzeni (sciatica).
• Isimila esihlakaleni: Izimpawu ezifana nezeCarpal Tunnel Syndrome.
• Isimila semithambo ye-Vestibular: Ukulahlekelwa ukuzwa, i-tinnitus, izinkinga zokulinganisela.

Ngokuvamile, uma umuntu ene-neurofibromatosis, kuba yi-tumor eyodwa. Kodwa-ke, kubantu abane-neurofibromatosis okukhulunywe ngayo ngaphambilini, kungabonakala izimila eziningi (ngokuvamile esikhumbeni).

Wazi kanjani ukuthi unalezi zinongo?

Udokotela wakho uzokuhlola ngokomzimba kuqala bese ehlola impilo yakho iyonke. Lokhu kuzofaka phakathi ukubuza ngomlando wakho wezokwelapha, umlando wezokwelapha womndeni, kanye nanoma yiziphi izimpawu ongase ube nazo.

Ukuze uphenye kabanzi ngesimila esivele sibonakala noma isimila esisolwayo, udokotela wakho angase ancome ukuhlolwa okulandelayo:

• Ukuhlolwa kwezithombe zezokwelapha: Lokhu kufaka phakathi ukuskena kwe-MRI, ukuskena kwe-ultrasound, kanye nokuskena kwe-PET ukuze kubonakale kahle isimila.
• I-Biopsy: Kuthathwa ingxenye encane yezicubu esiqwini bese ihlolwa ngaphansi kwe-microscope ukuze kutholakale ukuthi hlobo luni lwamaseli akhona. Yilokhu okungakutshela ngokuqinisekile ukuthi isiqwili sinomdlavuza noma cha.

Uma unezimila eziningi, udokotela wakho angase futhi ancome ukuhlolwa kwezakhi zofuzo ukuze abone ukuthi unezimo ezibizwa ngokuthi (NF1), (NF2), kanye neSchwannomatosis.

Yiziphi izindlela zokwelapha lokhu?

Uma ungenazo izimpawu ezivela ku-neuromastoid, udokotela wakho angase akuncome ukuthi "uqaphele bese ulinda."Ungakhetha indlela ebizwa ngokuthi "ukuqapha." Lokho kusho ukuhlola isimila njalo ukuze ubone ukuthi siyakhula noma siyashintsha.

Uma unezimpawu zezimila, noma uma ufuna ukususa isimila ngenxa yezizathu zobuhle, ukuhlinzwa ngokuvamile kuyindlela kuphela ongayikhetha .

Amanye ama-neurofibroma, ikakhulukazi lawo abizwa ngokuthi ama-plexiform neurofibroma, kunzima ukuwasusa ngokuphelele ngoba akhula ngaphakathi kwe-nerve naphakathi kwezingqimba zesembozo. Uma isimila singenakususwa ngokuphelele ngemva kokuhlinzwa, udokotela wakho uzokuqapha eduze, njengoba isimila singakhula futhi.

Ukwelashwa kwe-schwannomas ekhanda

Ama-Schwannoma akheka ekhanda, njenge-vestibular schwannomas, angathinta imizwa elawula imisebenzi ebalulekile emzimbeni wethu. Kulezi zimo, odokotela basebenzisa inqubo ebizwa ngokuthi i-stereotactic radiosurgery (isib., i-Gamma Knife®) ukuvimbela ukulimala kwemizwa.

Lokhu akuyona indlela yokuhlinzwa yendabuko ehilela ukwenza i-incision. Kuhilela ukuthumela imisebe eqondiswe ngqo esikhumbeni ukuze kubhujiswe noma kuncishiswe isimila.

Ukwelashwa kwezimila ze-nerve sheath ezinomdlavuza

Ngaphezu kokuhlinzwa, ukwelashwa komdlavuza njengokwelashwa ngemisebe kanye ne -chemotherapy nakho kungasetshenziswa ukwelapha izimila ze-nerve sheath eziyingozi.

Yiziphi izinkinga ezingaba khona ngenxa yokuhlinzwa?

Njenganoma yikuphi ukuhlinzwa, kunezinkinga eziningana ezivamile ezingase zenzeke ngalezi zinqubo zokuhlinzwa:

• Ukopha
• Ukutheleleka kwenxeba
• Ubuhlungu
• Izibazi

Ngaphezu kwalokho, ukuhlinzwa kwemizwa kuthwala ingozi yokulimala kwemizwa kanye nokukhubazeka okuhlala njalo . Ithimba lakho lezokwelapha lizokusiza ukuphatha noma yikuphi ukukhubazeka kwesikhathi eside okungase kuvele ngemva kokuhlinzwa. Izindlela zokwelapha ezahlukahlukene (ukwelashwa ngokomzimba, ukwelashwa ngokomsebenzi, kanye nokwelashwa ngenkulumo) zingakusiza ukuthi ululame.

Ingabe la mathumba angavinjelwa ukwakheka?

Ayikho indlela eyaziwayo yokuvimbela ukwakheka kwalezi zimila. Kodwa-ke, udokotela wakho angancoma ukuhlolwa kwezakhi zofuzo uma:

• Uma kukhona emndenini wakho onomlando wokuthuthukisa ama-neurofibromas.
• Uma unezimila eziningi ze-nerve sheath (lokhu kungaba uphawu lwesifo se-neurofibromatosis).

Yini okufanele siyicabange ngalezi zinto ezingenangqondo esikhathini esizayo? (I-Outlook)

Iningi lama-neurofibroma alinawo umdlavuza . Angelapheka ngokuhlinzwa futhi awavamile ukubuya. Kodwa-ke, uma isimila sakho singenakususwa ngokuphelele ngokuhlinzwa, kuzodingeka uqhubeke uqashwe udokotela.

Cishe abantu abathathu kwabayi-4 abathola ukwelashwa kwe-vestibular schwannoma bayakwazi ukugcina ukuzwa kwabo .

Ingozi yokuthi isimila se-nerve sheath sibe umdlavuza iphansi kakhulu. Ingozi enkulu kakhulu ingeyabantu abanesifo (NF1) abathola i-Plexiform neurofibroma. Ukubikezela kwesifo se-malignant peripheral nerve sheath tumors (MPNST) akukuhle kangako, ikakhulukazi uma lesi simila sikhulu kune-intshi ezimbili. Abantu abangaphansi kwengxenye abanalesi simo baphila iminyaka emihlanu ngemva kokuxilongwa.

Kufanele ubonane nini nodokotela?

Uma ubona iqhubu ngaphansi kwesikhumba sakho, noma uhlangabezana nanoma yiziphi izimpawu ocabanga ukuthi zingaba yi-neurofibromatosis , bona udokotela ngokushesha . Futhi, tshela udokotela wakho uma kukhona emndenini wakho oke waba nalezi zinhlobo zamathumba.

Umyalezo Wokugcina Wokuya Nasekhaya

Khumbula, iningi lezimila ze-neuroendocrine ziyizimila ezingenabungozi, ezingezona umdlavuza ezikhula kancane . Uma ungenazo izimpawu, udokotela wakho angase anqume ukukubheka nje. Uma isimila sidinga ukususwa, ukuhlinzwa kuvame ukuphumelela kakhulu. Akuvamile kakhulu ukuthi kube nezinkinga (njengokungakwazi ukususa ngokuphelele isimila, ukulimala kwemizwa) noma ukuthi isimila sibe umdlavuza. Udokotela wakho uzokusiza ukuthi wakhe uhlelo lokwelashwa kanye nesheduli yezivivinyo zesikhathi esizayo ukuze akusize uphathe isimo sakho. Ngakho-ke ungesabi ukukhuluma nodokotela wakho nganoma yini.

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