Endoscopic Sinus Surgery
Maxillary Antrostomy
Iyo inozivikanwawo sekuti: endoscopic pakati pepakati meatal maxillary antrostomy, antrostomy pakati pepakati
Maitiro anonzi Maxillary antrostomy ndiyo nzira yekuvhiya kuti ikudze kuzarura (ostium) yemasasa akawanda. Izvi zvinobvumira kupindira kwakapfurikidza kwokupindira mukati mejasipirasi yemasipirasi pamwe nekuvandudzwa kwemvura. Chirwere chinonzi Maxillary chakave chichiitwa kubva pakati pe1980 uye ndiyo inogona kunge yakagadzirwa yekuvhiya kana iwe uine sinusitis isingaperi iyo isingateereri kune dzimwe kurapa.
Muchiitiko ichi chirongwa chacho chikamu chekugadzirwa kwechivi chekusoscopic chingave chiri chako chinotevera chakanakisisa. Mishonga yemishonga yakazara inosanganisira kuongororwa kwemishonga inorwisa mabhakitiriya (masvondo matatu kusvika ku6), nasal steroids, uye irrigations ye saline.
Kunyatsoongorora Chronic Sinusitis
Usati waita chirwere chekuvhiya, chiremba wako achada kusimbisa sinusitis isingaperi ne CT scan. X-rays haisi seanowanzodiwa, sezvavanokwanisa kuratidza zvirwere zvechi sinus uye zvishoma nezvehumwe humwe hunoenderana nezvimwe zvinetso zvepine sinus. The CT scan kwete chete icharatidza kuoma kwemaximillary sinus kuvhiringidza, asi ichapawo chiremba wako nezvimwewo ruzivo rwakakosha:
- nzvimbo yechipfuva chine nasolacrimal
- uncinate - iyo inokosha chikamu chekuvhiya
- kuwedzerwa kwemucus membranes
- mhepo inopesana nemvura yakadzika mumatanda ematanda
- polyps
- Osteomeatal complex obstruction - inodzivirira mvura ye maxillary sinus
Kunyange zvazvo ichi chiri chizhinji chekurapa kwemashoko ekurapa, mashoko aya ose achapa chiremba wako ruzivo rwakakosha kuti rwakanyatsogadzirirwa kugadzirisa kwako.
Icho chinonzi osteomeatal chinoumbwa nezvikamu zvina zvinotevera:
- uncinate - inonzi bone yakaita somunhu uyo ichabviswa
- maxillary ostium (kuvhura kwemaximillary sinus)
- infundibulum - rakapoteredzwa mumakumbo
- ethmoid bulla - chimwe chezvitema zvechitimu
Kugadzirira Endoscopic Sinus Kuvhiya uye Maxillary Antrostomy
Usati wavhiyiwa, iwe uchave wakarayirwa kuti urege kuva nechinhu chokudya kana kunwa kubva pakati peusiku zuva rekuvhiyiwa kusvikira mushure mekuvhiyiwa kwaitwa.
Izvi zvingabatsira kudzivirira dambudziko rako rekuvhiringidza zviri mukati momuviri (aspiration). Munzvimbo inotangira nzvimbo, iwe unogona kupiwa Afrin nasal spray kuti uwedzere kuderedza mapepa ako kuitira kuti uwedzere nzvimbo yekuonekwa panguva yekuvhiyiwa kwako. Kana uchinge watemwa, iwe unogonawo kuva nechayi yakakonzerwa neAfrin kana sopicia cocaine yakashandiswa mumhino dzako kuti urambe uchiwedzera kuonekwa kana zvichidikanwa.
Panguva yeMaxillary Antrostomy
Pane zvinangwa zvitatu izvo chiremba wako achaedza kuita munguva yaAlexillary Antrostomy
- Bvisa unicate process
- Kuwana kuvhura kwechisikiro muchivi chema maxillary
- Kuwedzera kuzarura mukati memadhora maxillary
- Bvisa polyps kubva mukati me maxillary sinus cavity
Zvakakosha kuti chiremba wako abvise basa reuncinate pakutanga kwegadziriro kuitira kuti uone zviri nani mavhiriillary sinus kuvhura. Kana sarudzo ye sinus isiripo uye mukova mutsva unogadzirwa, unogona kugadziridza zvakare mvura yakasviba, apo kunyura kunobuda muvheti rimwe uye kunopindazve muchero wechivi kuburikidza nedzimwe svhura.
Mushure mekunge maMalasilla Antrostomy
Mushure mekuvhiyiwa kwako kwapera, iwe uchamuka mukati eh post-anesthesia care unit (PACU). Ikoko iwe uchange uchitarirwa kubuda ropa, nausea (iyo inogona kuitika kana ropa ikamedzwa), kana zvimwe zvinetso zvingangodaro kubva pakuvhiyiwa.
Iwe uchazozotevera-uine chiremba wako pakati pemazuva matatu nemashanu kuti uve nejasi rako rinenge rabviswa. Zvichienderana nekubudirira uye kana iwe uine zviratidzo zvinoramba zvichiratidza kuti mamwe mazano ekurapa anoedzwa sei mushure mekuvhiyiwa.
Ngozi Dzinosangana naMaxillary Antrostomy
Kunze kwezviitiko zvinowanzoenderana nekuvhiya chero kupi zvayo kunoda kuti aneshehesia inowanzogadzirwa, antirosstomy maxillary inewo zvinotevera zvinokonzera ngozi:
- kuvhiringidza kunzvimbo yakakomberedza ziso (kukuvara kwebumbiro)
- bofu
- nasolacrimal duct kurira
- nosebleed (epistaxis)
- cerebrospinal fluid (CSF) rhinorrhea
- meningitis
Kunze kwezvenyeredze , dzakawanda zvepakutanga zvinongororwa zvinokonzera hazviwanzoitiki.
Maitiro anowanzoitwa Maxillary antrostomy, asi, izvi ndizvo zvinokonzera ngozi. Zvizhinji zvezvikonzero izvi zvine chokuita nemichina yekuvhiya inoshandiswa seyi microdebrider , iyo inowanzochengeteka uye ine zvishoma zvingagadzirisa. Zvisinei, zvinokonzera njodzi dzakanyorwa pamusoro apa zvakanyanya asi zvisingawanzoiti, saka fadza iwe nguva dzose sarudza anyanzvi ENT kuti aite iyo nzira.
Sources:
Chiu, AG & Palmer, JN (2013). Atlas of Endoscopic Sinus uye Skull Base Surgery, Chitsauko 8: Maxillary Antrostomy. Mapeji 65-74.
Patel, A., Vaughan, WC & Meyers, AD (2015). Kurapa Kwokurapwa Kwemazuva Ekupedzisira Maxillary Sinusitis Kutsvaga Mazano.