Ingabe uthole ukwelashwa ngemisebe yomdlavuza wekhanda nentamo? Ingabe kuyawathinta amathambo akho? Ake sifunde nge-(Osteoradionecrosis - ORN)!

Wake waba nobuhlungu, ukuvuvukala, noma isilonda emlonyeni wakho noma emhlathini ngemuva kokwelashwa ngemisebe yomdlavuza wekhanda noma wentamo? Kungase kube yisikhathi sokuba ufunde ngesimo esibizwa ngokuthi i-osteoradionecrosis. Ungakhathazeki, sizoxoxa ngakho ngokuningiliziwe nangendlela elula kakhulu.

Kuyini i-Osteoradionecrosis (ORN)?

Kalula nje, i-osteoradionecrosis (ORN) ukufa kwamangqamuzana amathambo ngenxa yokuchayeka emisebeni. Kuyisimo esingaba khona njengomphumela ongemuhle wokwelashwa ngemisebe yomdlavuza, ikakhulukazi umdlavuza wekhanda nentamo. Khumbula, imisebe esetshenziselwa ukubulala amangqamuzana omdlavuza ngezinye izikhathi ingalimaza namangqamuzana amathambo aphilile. Ingenzeka ezinyangeni noma ngisho neminyaka ngemva kokuthola ukwelashwa ngemisebe.

Lesi simo sivame ukuthinta ithambo lomhlathi ongezansi (i-mandibular osteoradionecrosis). Kodwa-ke, singavela kunoma yiliphi ithambo eliye lavezwa imisebe, njengethambo lomhlathi ongaphezulu (i-maxillary osteoradionecrosis) noma ingxenye engaphambili yomgogodla (i-vertebral osteoradionecrosis). Akuvamile kakhulu, lesi simo singathinta ugebhezi, kodwa singaba sibi kakhulu.

Ukwelashwa ngemisebe kanye nempilo yamathambo - kungani lokhu kwenzeka?

Manje, ake sibone ukuthi kungani lokhu kwenzeka. Imisebe ilimaza imithambo yegazi ethambile ehambisa igazi emathanjeni. Njenganoma iyiphi enye ingxenye yomzimba wethu, amathambo adinga ukuhlinzekwa kwegazi okuhle ukuze ahlale ephilile futhi alulame ngokushesha uma onakele.

Cabanga nje, njengoba nje umuthi ubuna ngaphandle kwamanzi, uma ithambo lingatholi igazi elanele, nalo lizolahlekelwa ukuphila kwalo bese liqala ukufa.

Kwenzekani uma lokhu kuphakelwa kwegazi kuphazamiseka?

• Amathambo nezicubu ezizungezile kulula ukuzithola zingenwa yizifo.
• Akunakwenzeka ukuphulukiswa kahle.
• Iqala ukufa kancane kancane.

Indawo yethu yomhlathi isengozini enkulu yalokhu. Lokhu kungenxa yokuthi kunzima ukuvimbela imisebe ukuthi ingafiki emathanjeni omhlathi ngesikhathi sokwelashwa ngemisebe yomdlavuza wekhanda nentamo. Futhi, ingozi yalokhu `(ORN)` iyanda kakhulu ngenxa yamagciwane ahlala ngokwemvelo emilonyeni yethu.

Ukulimala kwemisebe emlonyeni kungabangela izinto ezifana nalezi:

• Ukuchayeka emathanjeni (okusho ukuthi ithambo lichayeka ezinsinini).
• Ubuhlungu nokuvuvukala emhlathini ngezikhathi ezithile.
• Ukuba nesilonda esingapholi .

Sivame kangakanani lesi simo?

Ngokusho kwe-American Head & Neck Cancer Society, i-osteoradionecrosis ingenzeka phakathi kuka-4% no-8% wabantu abanomdlavuza wekhanda nentamo.

Ziyini izimpawu ze-osteoradionecrosis (ORN)?

Manje ake sibone ukuthi yiziphi izimpawu ongase uzizwe kulesi simo. Uma unesinye noma ngaphezulu kwalezi, kungcono ukufuna iseluleko sezokwelapha.

• Isilonda noma isilonda ngaphandle kwezinsini, entanyeni, noma emhlathini.
• Ubuhlungu.
• Ukuvuvukala.
• Ukutheleleka (njengobomvu).
• Amazinyo angahlangani kahle (i-malocclusion).
• Umuzwa wokuthuthumela noma wokukhafula .
• Izingcezu zamathambo eziphuma ngaphakathi emlonyeni.
• Ngezinye izikhathi, ngaphansi kwesilevu, isikhumba siyaphuka bese ithambo liphuma (lokhu kubizwa nangokuthi "i-fistula").
• Ukuphuka komhlathi.
• Ukuqina kwemisipha yomhlathi okuvimbela umlomo ukuthi uvuleke kahle (i-trismus).

Kungani kwenzeka i-osteoradionecrosis (ORN)?

Imbangela eyinhloko ukwelashwa ngemisebe ekhanda nasentanyeni. Lesi simo sivame kakhulu kubantu abathole imithamo yemisebe engaphezu kwamayunithi angu-60 eGrey (Gy). (I-Gy iyiyunithi yokulinganisa imisebe).

Izici Zengozi ze-Osteoradionecrosis `(ORN)` - Ubani onamathuba amaningi okuba nayo?

Abanye abantu basengozini enkulu yokuthola lesi simo kunabanye. Bona ukuthi la maqiniso ayasebenza yini kuwe:

• Ukungahlanzeki komlomo (ukungaxubhi amazinyo akho kahle, ukunganakekeli ukuhlanzeka komlomo wakho).
• Uma izinkinga zamazinyo (ezifana nezimbobo kanye nesifo sezinsini) zingaxazululwanga kahle ngaphambi kokuqala ukwelashwa ngemisebe.
• Uma unesifo somlomo owomile (xerostomia) ngemva kokwelashwa ngemisebe.
• Uma kukhona ingozi noma ukulimala emhlathini ngemva kokwelashwa ngemisebe, ikakhulukazi phakathi nonyaka wokuqala.
• Uma izinyo likhishwa endaweni eke yashiswa imisebe ngaphambilini.

Khumbula, lesi simo se-osteoradionecrosis singase senzeke ngisho nangemva kweminyaka eminingi yokwelashwa ngemisebe yomdlavuza wekhanda nentamo.

Kutholakala kanjani lokhu?

I-Osteoradionecrosis (ORN) ivame ukwenzeka eminyakeni eminingana ngemva kokwelashwa ngemisebe. Uma udokotela wakho esola lokhu, uzokwenza ukuhlolwa okujulile kwekhanda nentamo yakho. Uzoxhumana nodokotela wezifo zomdlavuza wemisebe okunikeze ukwelashwa ngemisebe ukuze athole umthamo ophelele wemisebe oyitholile.

Yiziphi izivivinyo ezisiza ekuxilongweni?

Ukuqinisekisa ukuxilongwa, udokotela wakho angase ancome ukuhlolwa okufana nalokhu:

• Ama-X-ray amazinyo.
• Kwenziwa i-CT scan yomhlathi (CT - computed tomography scan).
• Kungenziwa i-biopsy ukuze kuhlolwe ukuthi umdlavuza uphinde wabuya yini.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kwe-osteoradionecrosis (ORN) kuncike ebangeni kanye nobucayi besimo sakho. Into ebaluleke kakhulu ukuqala ukwelashwa ngokushesha okukhulu.Uma uqala ukwelashwa ngokushesha, amathuba akho okululama ayanda. Kukhona kokubili ukwelashwa kokuhlinzwa kanye nokwelashwa okungahlinzwa.

Ukuphathwa kokuhlinzwa

Kunezindlela eziningana zokuhlinzwa ezenzelwe lesi simo:

• Ukususwa kwesikhumba ngokuhlinzwa: Lokhu kwenzeka lapho udokotela ohlinzayo esusa amathambo nezicubu ezifile noma ezinegciwane, njengokuhlanza indawo embi.
• Ukuhlinzwa kokuvuselela i-flap kwamahhala: Lokhu ukuhlinzwa okuyinkimbinkimbi kancane. Kuhilela ukuthatha imithambo yegazi, izicubu, kanye nengxenye yethambo kwenye ingxenye yomzimba wakho (isibonelo, umlenze noma ingalo) bese uyifakela endaweni yomhlathi eyonakele.
• I-ALTFL (i-Anterolateral Thigh Fascia Lata Rescue Flap): Lolu futhi uhlobo lwe-free flap. Kule nqubo, kuthathwa ucezu lwezicubu ezixhumeneyo (i-fascia) ngemuva kwethanga bese kufakelwa. Lesi zicubu sinomfutho wegazi ophezulu, okuvumela indawo eyonakele ukuthi ithole umoya-mpilo nezakhamzimba. Izifundo zamuva zibonise ukuthi le ndlela isebenza kahle kakhulu kubantu abane-ORN.
• Ukufakelwa amathambo ngokuphelele: Le nqubo yokuhlinzwa yendabuko isetshenziswa uma kunethambo elifile eliningi, ikakhulukazi emhlathini ongezansi. Kule nqubo, ithambo elonakele lisuswa ngokuphelele bese kufakwa i-free flap equkethe ithambo endaweni yalo. Nakuba lokhu kuyinqubo ephumelelayo, kuwukuhlinzwa okukhulu. Kungabangela ukuhlala isikhathi eside esibhedlela kanye nesikhathi eside sokululama. Ngakho-ke, odokotela bazama ukuxilonga nokwelapha lesi simo ngokushesha okukhulu.

Ukuphathwa okungahlinzwa

Kukhona futhi ukwelashwa okungekona ukuhlinzwa:

• Ama-antibiotic: Uma kukhona ukutheleleka emathanjeni noma ezicutshini ezizungezile, udokotela wakho uzokunikeza ama-antibiotic.
• I-PENTOCLO: Lokhu kuyinhlanganisela yemithi eminingana: i-pentoxifylline, i-tocopherol (ivithamini E), kanye ne-clodronate. I-Pentoxifylline isebenza ngokwandisa ukugeleza kwegazi ethanjeni elonakele. I-Tocopherol (ivithamini E) isiza ukuqinisa amasosha omzimba nokuvimbela amahlule egazi. I-Clodronate isiza ukuvimbela ukulahleka kwamathambo okuqhubekayo. Ngezinye izikhathi i-pentoxifylline kanye ne-tocopherol kunikezwa ngaphandle kwe-clodronate (lokhu kubizwa ngokuthi i-PENTO).
• Ukwelashwa nge-hyperbaric oxygen (i-hyperbaric oxygen - HBO - ukwelashwa):Abanye odokotela basebenzisa lokhu kwelashwa ukusheshisa inqubo yokuphulukiswa komzimba. Kulokhu, ufakwa ekamelweni elikhethekile futhi wenziwa ukuthi uphefumule umoya-mpilo ohlanzekile. Izinga lomoya-mpilo ngaphakathi ekamelweni liphakeme ngokuphindwe kathathu kunasendaweni evamile. Umgomo oyinhloko ukwengeza umoya-mpilo owanele egazini ukulungisa izicubu ezonakele. Kodwa-ke, kunemibono ehlukene phakathi komphakathi wezokwelapha mayelana nalokhu kwelashwa "kwe-Hyperbaric oxygen". Nakuba kusetshenziswa njengokwelashwa okujwayelekile kwezinye izikhungo, azikho izifundo ezilawulwayo eziqinisekisile impumelelo yayo.

Ingabe i-osteoradionecrosis (ORN) ingavinjelwa?

Lesi simo singase singavinjelwa ngaso sonke isikhathi, kodwa ngaphambi kokuba uqale ukwelashwa ngemisebe ekhanda noma entanyeni yakho, udokotela wakho uzokhuluma nawe ngezindlela zokunciphisa le ngozi.

Ngaphambi kokuqala ukwelashwa ngemisebe, kufanele wenze okulandelayo:

• Vakashela udokotela wamazinyo , hlanza umlomo wakho kahle, bese uhlolwa ngokuphelele .
• Thola noma yikuphi ukwelashwa kwamazinyo (njengokugcwalisa amazinyo, ukukhipha amazinyo).
• Qala ukwelashwa nge-fluoride nsuku zonke.

Kufanele wenze lezi zinto ngesikhathi nangemva kokwelashwa ngemisebe:

• Gcina inhlanzeko yomlomo ilungile (xubha amazinyo akho kabili ngosuku, hlanza phakathi kwamazinyo akho).
• Nciphisa ukudla okunoshukela kanye neziphuzo .
• Bona udokotela wamazinyo njalo ukuze akuhlole futhi uhlanze umlomo wakho.
• Thola ukwelashwa kwanoma yiziphi izinkinga zamazinyo ezintsha ngokushesha .
• Qhubeka nokwelashwa nge-fluoride nsuku zonke.

I-osteoradionecrosis (ORN) isakazeka ngokushesha kangakanani?

Ezimweni eziningi, i-osteoradionecrosis (ORN) ikhula kancane. Kungathatha iminyaka eminingana ukuthi ube nezimpawu.

Ingabe i-osteoradionecrosis (ORN) ingelapheka?

Nakuba odokotela abahlinzayo bengenakukwazi ukuvuselela ithambo elifile, ukwelashwa okufanele kungamisa ukuqhubeka kwe-osteoradionecrosis (ORN). Kuthiwa uma ukwelashwa kuqalwa kusenesikhathi, lesi simo singamiswa ezimweni ezingama-96% .

Ngakho-ke, uma une-osteoradionecrosis (ORN), ukuqala ukwelashwa kusenesikhathi kuyithuba lakho elihle kakhulu lokuphumelela. Ukuhlinzwa kwakho kungase kube kufushane, futhi ungase ululame ngokushesha. Uma welapha ngokushesha (ORN), kungcono.

Ukubikezela kwe-Osteoradionecrosis (ORN)

I-Osteoradionecrosis (ORN) yisimo esingelapheka kakhulu. Uhlobo lokwelashwa oludingekayo luncike endaweni yethambo elonakele, izinga lokufa kwethambo, kanye nokuthi yiziphi izindlela zokwelapha ozizamile ngaphambilini.

Ngokuvamile, uma indawo yomonakalo wethambo incane, kuba ngcono amathuba okululama ngaphandle kokuhlinzwa okukhulu. Amanye amacala e-ORN angase angasabeli ekwelashweni okuncane futhi angaqhubekela ekuthelelekeni kwamathambo (i-osteomyelitis) noma ukuphuka kwamathambo. Ezimweni ezinjalo, odokotela abahlinzayo kungadingeka benze ukuhlinzwa okukhulu (okungavuleki).

Kufanele ngimbone nini udokotela?

Uma uke welashwa ngemisebe ekhanda noma entanyeni yakho ngaphambilini futhi uqala ukuzwa izimpawu ezifana nobuhlungu, ukuvuvukala, noma ukuklwebheka, bona udokotela wakho ngokushesha. Bangaqinisekisa ukuthi une-osteoradionecrosis (ORN) futhi baqale noma yikuphi ukwelashwa okudingekayo ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma wena noma othandekayo wakho nitholakale ninesifo i-osteoradionecrosis (ORN), ungase ufune ukuzibuza le mibuzo:

• Lokhu kusabalala kwamathambo kusabalale kangakanani?
• Yiziphi izindlela zokwelapha enginazo?
• Ingabe ngizodinga ukuhlinzwa?
• Uyini umbono wami (ukuphulukiswa)?

Okokugcina, khumbula (Umyalezo Wokuya Ekhaya)

I-Osteoradionecrosis (ORN) ingumphumela omubi kakhulu wokwelashwa ngemisebe ekhanda nasentanyeni. Kungathatha iminyaka ukuthi izimpawu zivele. Nakuba i-ORN ingenakwelashwa ngokuphelele, ingalawulwa ngokwelashwa. Imiphumela incike endaweni yethambo elonakele, izinga lokufa kwethambo, kanye nobunzima balo.

Uma unobuhlungu, ukuvuvukala, ukuchayeka emathanjeni, noma ezinye izimpawu ze-osteoradionecrosis, bona udokotela ngokushesha. Bangancoma ukwelashwa okufanele futhi bakusize uphathe isimo sakho. Ukugcina inhlanzeko yomlomo enhle nokubona udokotela wamazinyo njalo kubalulekile ekuvimbeleni nasekutholeni lesi simo kusenesikhathi.

I- Osteoradionecrosis, i-ORN, imiphumela emibi yokwelashwa ngemisebe, isifo samathambo omhlathi, ukwelashwa komdlavuza, ukufa kwamathambo, impilo yomlomo