Frey syndrome inowanziwo seyakasvibirira kutuka kana kugadziriswa hyperhidrosis
Mushure mekudya zvokudya zvinopisa uye zvinonhuwira, vamwe vanhu vanopika kubva pachiso-miromo, huma, mhino, uye scalp. Kune vakawanda, iyi trigeminovascular reflex yakakwana zvachose.
Zvisinei, kusvetuka kubva pachiso mushure mekudya chero rudzi rwekudya kunoratidza chiitiko chinonzi gustatory sweating, kana gustatory hyperhidrosis. Uyezve, izvi zvinoitika zvekutuka zvinogona kuuya kwete kubva pakucheka kwezvokudya asiwo kubva pane kufunga kana kutaura pamusoro pezvokudya.
Zviratidzo zvakajairika zvekunyanya kuputika zvinosanganisira kuputika, kusvetuka, kubwinya, uye kusagadzikana kwakawanda zvakanzwa pamatama. Zvisinganzwisisiki, vanhu vane chirwere ichi vanonzwa shungu kana kurwadziwa nekucheka.
Kusvetuka kunokanganisa kunogona kunge kusinganzwisisiki uye kunobatsira zvikuru hupenyu hwomunhu. Maererano neSood uye vanyori vanyori, kufungidzira kunokonzera "kunogona kukonzera kusagadzikana kwakanyanya kwevanhu kunobva pakunoda kugara uchikwanisa kuva pedyo neimba-yakasungwa." Mune mamwe mazwi, kudiwa nguva dzose kwe "kuputika" kurema kunogona kuita kuti zviome kune vamwe kubva mumba.
Yakawanda kwazvo iyo inonzi irritatory hyperhidrosis inonzi Frey syndrome. Frey syndrome inoreva kutuka uye kufambisa kuparadzirwa kwehutano hweanriculotemporal. Iyo nhengo yeanriculotemporal inopa manzwiro kune rumwe rutivi rwemusoro. Frey syndrome inonziwo gustatory hyperhidrosis ye cheek.
Chii Chinonzi Frey Syndrome?
Frey syndrome haigoni, uye vashoma vanopfuura 20 000 vekuAmerica vanoonekwa gore negore.
Chaizvoizvo, Frey syndrome inokonzerwa nekusvibiswa kwakaipa kwemitsipa inokonzera salivation, kutuka, uye kuputika. Iyo inonzi zita reFrance nyanzvi yezveuropairusi Lucia Frey, uyo akatsanangura chiitiko se "auriculotemporal nerve syndrome" muna 1923.
Frey akabudisa mushumo achireva chirwere chake chisingazivi pashure pokurapa musoja wePoland akawana ruzivo rwekunyavirira mushure mekuchengetedza ronda rakatarisana nehutachiona rinoratidzira gland parotid .
Irotiroti gland ndiyo yakakura pane zvinyorwa zvese uye iri pahutano hwetama. Iyo inovhara saliva, iyo inobatsira kugadzira uye kunya zvokudya. Kunyange zvazvo Frey akanga asiri dhiyabhorosi wokutanga kutora mamiriro ezvinhu, ndiye aiva wokutanga kufambisa mishonga inriculotemporal mukuvandudzwa kwechirwere ichi.
Kusunungurwa kwemapapiro nehanzvadzi yeparotid inopindirana nehutano hwakajeka arc iyo inosanganisira chironga cheanriculotemporal. Mune vanhu vane Frey syndrome, mushure mekukuvadzwa kune nhengo dzeanriculotemporal, mutsara uyu unodzokorora zvisiri izvo. Panzvimbo pokungopa vashandisi vasinganzwisisiki kune chirwere cheparotid, icho chizoita kuti salivation yakakwana mushure mekugadzirwa kwezvokudya, mishonga yeparasympathetic yeanriculotemporal nerve inodzoka zvakare kuti ipe rusununguko kumapfupa e sweat uye nemidziyo yeropa, iyo inokonzera kutuka uye kuputika, maererano . Kazhinji, uku kutuka uye kuputika kune pasi pekunzwira tsitsi.
Mune mamwe mazwi, mushure mehutano hweanriculotemporal hukuvadzwa, maharasi yerasympathetic regrow kuti isangotarisa chete salivation asiwo kudzora kutuka uye kuputika mushure mekunge munhu achikurudzirwa nechikafu. Uyezve, mune vamwe vanhu, iyi isymmetric pattern of sweating inogona kupfuurira mberi kwechiso zvacho uye inobata chitunha, maoko, nemakumbo.
Kana muviri wakawanda wakanyanya kubatwa, zvakanyanya kuoma zviratidzo.
Zvinokonzera
Chinhu chipi nechipi chinokuvadza chirwere cheanriculotemporal chinogona kukonzera Frey syndrome, kusanganisira zvinotevera:
- Parotid gland chirwere (chikuru chinokonzera)
- Kushungurudzika kwakashata kumatama
- Neck surgery
- Utachiona husingaperi hwemahara parotid
- Mandibular fracture
- Kuputsana kwekubatana kwema temporomandibular
- Kuvhiya kusvika kugoverwa kwema temporomandibular
- Kubviswa kwezvinyorwa zve submandibular
- Kubviswa kwetachiona gland
- Chirwere chechiremera (chirwere chinoshandiswa chinoitwa kuti chidzivirire kutuka)
- Kushungurudzika kwekuzvarwa kana kukuvadzwa nekutevera simbaps kuberekwa (mucheche)
Mumakore ekuma1940, parotid gland chirwere chakakurudzirwa muUnited Kingdom kutarisa zvinhu zvakasiyana-siyana, zvose zvekenza uye dzisina kufanana.
Gustatory sweating pamwe nemimwe mimwe miitiro yakaipisisa, kusanganisira kushungurudzika kwepfungwa, kuderera kwekunzwa kwemaziso, salivary fistula, hematoma, uye keloids zvaiwanzoonekwa pakati pevarwere vakagamuchira parotid gland chirwere. Izvozvi, vanhu vane zvipfeko zvavo zveparotidi zvakabviswa zvinowanzosangana neFrey syndrome pane avo vane chikamu chetsvina yeparotidi yakabviswa.
Frey syndrome inogona kuonekwawo nemimwe inotevera maitiro eropa:
- Facial herpes zoster
- Chorda tympani kukuvara
- Cluster headache
- Diabetes neuropathy
- Encephalitis
- Syringomyelia
- Tumha mumutsipa wekervical mutsa
Vanhu vazhinji vanoona kutuka kunokanganisa havatambudziki-chete pakati pe10 ne15 muzana yevanhu vanozviona vanotsvaka kurapwa. Uyezve, mushure mekuvhiyiwa kweparotid, 10 muzana chete yevarwere vanotaura zviratidzo zvinoratidza chiitiko ichi. Zvisinei, pakuwedzera kumubvunzurudza, 30 kusvika ku50 muzana yevarwere vanobvuma zviratidzo zvekukurumidza kuputika. Frey syndrome inowanzoonekwa pakati pemwedzi 1 ne12 mushure mekuvhiyiwa.
Frey syndrome inogona kuitika kune vanhu chero panguva ipi zvayo. Kunyange zvakadaro, hazviwanzocheche mucheche nevana vanongonyanya kukuvadzwa kunzvimbo yeparotid mushure mekusimudzira simba, uye kukuvadzwa kubva ku forceps kunowanikwa.
Muvana, zvokudya zvekudya zvinogona kukanganisa Frey syndrome. Zvisinei, zviratidzo zvekudya zvinokonzerwa nekudya zvinowanikwa mushure mekudya kwekudya kwete panguva yekucheka.
Kuziva
Nzira inonyanya kuongororwa neFrey syndrome inosanganisira kushandiswa kweiodinated starch (indicator) powder kumeso. Iyi nzira inonzi "Minor test". Murwere anobva apiwa mapepesi emonia kana zvimwe zvekudya zvinotapira zvinokurudzira kutuka. Nzvimbo dzakakanganiswa apo madonhwe ekudzikisa anogadzirisa anoshandura bhuru-dema. Mafupa acho anogona kubviswa nyore nyore kubva pachiso kuitira kuti muedzo udzoke zvakare. Uyu muedzo unogona kushandiswawo kuedza Frey syndrome kune vanhu vasina zviratidzo (kureva,, vasina zvirwere).
Kunyange zvazvo muedzo uyu wakarurama, haugoni kuratidzira kuoma kwemamiriro acho ezvinhu. Uyezve, iyi muedzo inobata pangozi yekuputika kwestarch powder. Uyu muedzo unofanirwa kutarisirwa pane ganda rakaoma, uye haufaniri kushandiswa kune vanhu vanopfugama zvikuru.
Chimwe chinodhura uye chinosanganisira kuongororwa muedzo kuti uone kana munhu ane Frey syndrome inosanganisira nzira yekushandisa zvinhu inoshandiswa inoshandisa enzymatic electrodes inoona L-lactate mazinga paganda.
Chimwe chirongwa chinowedzera ruzivo cheFrey syndrome chinosanganisira kushandiswa kwemapupa e-ply pameso kuti aongorore kutuka mushure mekunge murwere achikurudzirwa nechingwa chinotapira.
Pakupedzisira, infrared medical thermography inogona kushandiswa kufungidzira Frey syndrome. Ichi chiyero chekuongorora chinoda kuti kutonhora nemumvuri muimba yacho zvive nguva dzose. Chokutanga, mushure mekusimudzirwa, nzvimbo inopisa inotaridzirwa iyo inofananidzwa nekuwedzera kwemidziyo yeropa ine mudiki. Chechipiri, nzvimbo inotonhora inonzi visualized iyo inomiririra kufungidzira. Iko kushanduka kwakaoma kufungidzira vanhu vane ganda rakasviba.
Kurapa
Muvanhu vazhinji, Frey syndrome inopera iri yoga mumakore emakore mashanu. Vanhu vane zviratidzo zvinyoro vanofanira kupiwa chivimbo chokuti mamiriro acho achapfuura oga asina kurapwa.
Mune avo vane hutano hwakanyanya nemamiriro acho ezvinhu, kufungidzira kunokanganisa kunowanzova chiratidzo chinotambudza zvikuru uye kunoita kuti munhu atsvake rubatsiro.
Botox
Kutsvakurudza kwemazuva ano kwakagadziriswa kunotaura kuBotox therapy seyoyo nzira yakavimbiswa uye yakabudirira yekurapa kufungira nekukurumidza kweFrey syndrome. Kunyanya kunyanya, Botox therapy yakaratidza kuti ine 98 muzana inoshanda mukurapa zviratidzo zvekukutuka. Botox therapy yakaratidzawo kuti inoshanda kune vanhu vane ruzivo rwekutsvaira rwechipiri kune chirwere cheshuga chirwere cheshuga, rudzi rwehutano hwehutano hunokonzerwa nechirwere cheshuga.
Muchikamu che 2017, Lovato uye vanyori vanyori vanyora zvinotevera:
BTX [Botox] therapy inonyanya kubudirira mukurapa kwekukurumidza kuputika (Frey syndrome), uye inogona kuonekwa sekushandiswa kwegoridhe kwakagadziriswa kweiyo post-parotidectomy complication.
Panobata Frey syndrome neBotox therapy, chiremba anofanira kutanga atanga nzvimbo inobatwa nenzira dzeChidiki chekuedza. Iyi nharaunda inozogoverwa muzvikwata zvishomanana, izvo zviri pakati pe1 ne5 cm. Botox inoshandiswa mune imwe neimwe yezvikwereti izvi kuti iite kuti zvive zvakashata, zvakafanana.
Zvinonzwisisika, mamwe marapirwo eFrey syndrome akaedzwa. Pamusoro pezvikamu zvakawanda, kurapa uku kunopa zvishoma kana kusina zororo.
Antiperspirants
Chokutanga, vanhu vanopesana nemishonga vakashandiswa kunharaunda inobatwa nekukutuka. Vamwe varwere vakashuma kusunungurwa kwenguva yakati kwevhiki dzinoverengeka nekuda kwevanopesana nemagetsi. Kuti zvive nemigumisiro yakanakisisa, fomu ye gel ye antiperspirant inoshandiswa usiku kuti iome ganda uye ishambidzwe mangwanani. Bvudzi rinogona kushandiswa kuoma antiperspirant mushure mekushandiswa.
Kwemaawa gumi nemaviri mushure mekushandiswa, murwere anofanirwa kudzivisa kuveura ndeye nzvimbo yakarapwa. Nokufamba kwenguva, sezvo kusvibisa kunokonzera nzira yacho uye kunogadzirisa pachako, maitiro mashomanana evanhu vanopesana nemishonga anogona kushandiswa, uye varwere havazofaniri kushandisa antiperspirants zuva rega rega. Izvozvi, vanopikisa vanokwanisa kuita seganda rinogumbura uye rinotungamirira mukuputika. Kuchenjerera kunofanira kutorwawo kuitira kuti usapinda mukana wekudzivirira kupindira muziso.
Topical Anticholinergics
Chechipiri, zvinyorwa zvepikisi anticholinergics zvakashandiswa kurapa Frey syndrome. Iyi anticholinergics inosanganisira scopolamine, glycopyrrolate, uye diphemnanilmethylsulfate uye inogona kushandiswa se-roll-on zvinogadziriswa kana zvigadzirwa. Anticholinergics inogona kuvandudza zviratidzo zvemazuva matatu.
Zvinonyanya kukosha, anticholinergics inoputirwa neganda uye inogona kukonzera kusangana nemigumisiro yakaipisisa inosanganisira yakaoma muromo, kusvibiswa kwemaziso, maziso anocheka, kuchengetedza urinary, kuwedzera kwemwoyo, uye kuora mwoyo. Uyezve, anticholinergics haifaniri kushandiswa kune vanhu vane glaucoma, chirwere cheshuga mellitus, chirwere chetachiona, kusavhiringidzika kwehutachiona, pamwe nehupenzi, hupombwe, mwoyo kana chirwere chikuru chinotyisa.
Zvokuvhiya
Chechitatu, kurapwa kwave kusina kubudirira kuedza kubvisa zviratidzo zveFrey syndrome. Izvo zvipfeko zvinosanganisira cervical sympathectomy, tympanic neurectomy, sternocleidomastoidtransfer transfer, uye dermis-fat grafts. Uyezve, zvinhu zvakasiyana-siyana uye zvipingamupinyi zvakapindira zvakashandiswa pakubata kutuka kunokonzera.
Zvinonzwisisika, vanhu vakawanda vanoita kukurumidza kuputika kwechipiri kune kuvhiyiwa havadi kuti vawane kurapwa kwakawanda kuti vararame chirwere ichi.
> Sources:
> Kushungurudza Kwekunyengera, Muporofita, uye Mupositori Glands. Mu: Wolff K, Johnson R, Saavedra AP, Roh EK. eds. Fitzpatrick's Color Atlas uye Shanduro dzeKliniki Dermatology, 8e New York, NY: McGraw-Hill.
> Fealey RD, Hebert AA. Chitsauko 84. Kushungurudzika kweMupumbwe Kupika Glands nekupikisa. Mu: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. eds. Dermatology yeFitzpatrick muna General Medicine, 8e New York, NY: McGraw-Hill; 2012.
> Lovato, A, et al. Botulinum toxin therapy: kushanda kwakanyarara kwemazuva ano. Acta Otorhinolaryngologica Italica. 2017; 37: 168-171
> Sood S, Quraishi MS, Bradley PJ. Frey syndrome uye chirwere cheparotidi. Clinical Otolaryngology. 1998; 23: 291-301.