Ukulungiswa kweCranosynostosis

Ukulungiswa kweCranosynostosis lutyando ukulungisa ingxaki ebangela ukuba amathambo okakayi lomntwana akhule kunye (fuse) kwangoko kakhulu.

Olu tyando lwenziwa kwigumbi lokusebenza phantsi kweanesthesia ngokubanzi. Oku kuthetha ukuba umntwana wakho uya kulala kwaye akazukuva zintlungu. Ezinye okanye zonke iinwele ziya kuchetywa.

Utyando oluqhelekileyo lubizwa ngokuba lulungiso oluvulekileyo. Oku kubandakanya la manyathelo:

• Indawo exhaphakileyo yokusikwa kotyando ingaphezulu kwentloko, ukusuka ngaphezulu kwendlebe enye kuye ngaphezulu kwenye indlebe. Ukunqunyulwa kuhlala ku-wavy. Apho ukusikwa kwenziwa khona kuxhomekeke kwingxaki ethile.
• Isikhumba, izihlunu, kunye nezihlunu ezantsi kwesikhumba, kwaye izicwili ezigubungele ithambo ziyakhululwa kwaye ziphakanyiswe ukuze ugqirha abone ithambo.
• Umtya wethambo uhlala ususwa apho iisutu ezimbini zidityanisiwe. Oku kubizwa ngokuba yi-strip craniectomy. Ngamanye amaxesha, iziqwenga ezinkulu zethambo kufuneka zisuswe. Oku kubizwa ngokuba yi-synostectomy. Iinxalenye zala mathambo zingatshintshwa okanye ziphinde zenziwe ngokutsha xa zisuswa. Emva koko, zibuyiselwe umva. Ngamanye amaxesha, akunjalo.
• Ngamanye amaxesha, amathambo ashiyekileyo endaweni kufuneka atshintshwe okanye asuswe.
• Ngamanye amaxesha, amathambo ajikeleze amehlo anqunyulwa aze abunjwe kwakhona.
• Amathambo aqiniswa kusetyenziswa iipleyiti ezincinci ezinezikrufu ezingena kukhakhayi. Amacwecwe kunye nezikrufu zinokuba sisinyithi okanye izinto ezinokuphinda zisebenze (inyamalale ngokuhamba kwexesha). Amacwecwe anokwanda njengoko ukakayi lukhula.

Ugqirha luhlala luthabatha iiyure ezi-3 ukuya kwezi-7. Umntwana wakho kuya kufuneka ukuba atofelwe igazi ngexesha okanye emva kotyando ukuze athabathe indawo yegazi elahlekileyo ngexesha lotyando.

Uhlobo olutsha lotyando lusetyenziselwa abanye abantwana. Olu hlobo luhlala lwenzelwe abantwana abangaphantsi kweenyanga ezi-3 ukuya kwezi-6 ubudala.

• Ugqirha wenza ukusika okukodwa okanye ezimbini kwi-scalp. Amaxesha amaninzi, oku kusikwa nganye kune-intshi enye (2.5 iisentimitha) ubude. Oku kusikwa kwenziwa ngaphezulu kwendawo apho ithambo kufuneka lisuswe khona.
• Ityhubhu (i-endoscope) idlula ngokusikwa okuncinci. Ubungakanani buvumela ugqirha ukuba abone indawo esebenza kuyo. Izixhobo zonyango ezikhethekileyo kunye nekhamera zidlula kwi-endoscope. Esebenzisa ezi zixhobo, ugqirha wotyando ususa iinxalenye zamathambo ngokusika.
• Olu tyando luhlala luthatha malunga neyure. Kuncinci ukulahleka kwegazi ngolu hlobo lotyando.
• Uninzi lwabantwana kufuneka banxibe isigcina-ntloko esikhethekileyo ukukhusela iintloko zabo kangangexesha elithile emva kotyando.

Abantwana benza ngcono xa benolu tyando xa baneenyanga ezintathu ubudala. Utyando kufuneka lwenziwe ngaphambi kokuba umntwana abe neenyanga ezi-6 ubudala.

Intloko yomntwana, okanye ukhakhayi, yenziwe ngamathambo ahlukeneyo asibhozo. Unxibelelwano phakathi kwala mathambo kuthiwa sutures. Xa umntwana ezelwe, kuqhelekile ukuba la misonto ivulwe kancinci. Ngethuba nje i-suture ivulekile, ikrele lomntwana kunye nengqondo ingakhula.

I-Craniosynostosis yimeko ebangela ukuba enye okanye nangaphezulu ye-sutures yomntwana ivale kwangoko kakhulu. Oku kunokubangela ukuba imilo yentloko yomntwana wakho ihluke kunesiqhelo. Ngamanye amaxesha inokunciphisa umda wokuba ingakhula kangakanani ingqondo.

I-x-ray okanye i-computed tomography (CT) scan ingasetyenziselwa ukufumanisa i-craniosynostosis. Ugqirha luyafuneka rhoqo ukulungisa oko.

Utyando lukhulula ii-suture ezifakelweyo. Ikwakha kwakhona ibunzi, iziseko zamehlo, kunye nokakayi njengoko kufuneka. Iinjongo zotyando zezi:

• Ukuphelisa uxinzelelo kwingqondo yomntwana
• Ukuqinisekisa ukuba kukho indawo eyaneleyo kukhakhayi ukuvumela ingqondo ukuba ikhule ngokufanelekileyo
• Ukuphucula ukubonakala kwentloko yomntwana
• Ukuthintela imiba yexesha elide ye-neurocognitive

Iingozi zalo naluphi na utyando zezi:

• Iingxaki zokuphefumla
• Usulelo, kubandakanywa nemiphunga kunye nomchamo
• Ukuphulukana negazi (abantwana abanendawo evulekileyo yokulungisa banokufuna enye okanye ngaphezulu utofelo-gazi)
• Impendulo kumayeza

Iingozi zolu tyando zezi:

• Usulelo kwingqondo
• Amathambo adibanisa kwakhona, kwaye kufuneka kwenziwe olunye utyando
• Ukudumba kobuchopho
• Umonakalo kwizihlunu zobuchopho

Ukuba utyando lucwangcisiwe, kuya kufuneka uthathe la manyathelo alandelayo:

Ngexesha leentsuku ngaphambi kotyando:

• Xelela umboneleli wakho wezempilo ukuba ngawaphi amayeza, iivithamini, okanye imifuno oyinika umntwana wakho. Oku kubandakanya nantoni na oyithengileyo ngaphandle kommiselo. Unokucelwa ukuba uyeke ukunika umntwana wakho amanye ala mayeza kwiintsuku ngaphambi kotyando.
• Buza umboneleli ukuba ngawaphi amayeza umntwana wakho anokuwathatha ngosuku lotyando.

Ngomhla wotyando:

• Nika umntwana wakho intwana yamanzi kunye nawaphi na amayeza umboneleli wakho athe wamnika wona.
• Umboneleli womntwana wakho uya kukuxelela ukuba uza kufika nini kotyando.

Buza umboneleli wakho ukuba umntwana wakho angatya okanye asele ngaphambi kotyando. Nje:

• Abantwana abadala akufuneki batye nakuphi na ukutya okanye basele naluphi na ubisi emva kobusuku bobusuku ngaphambi kotyando. Banokuba nejusi ecacileyo, amanzi, kunye nobisi lwebele ukuya kuthi ga kwiiyure ezi-4 ngaphambi kotyando.
• Iintsana ezingaphantsi kweenyanga ezili-12 zihlala zitya ubisi olungumgubo, ukutya okuziinkozo, okanye ukutya kwabantwana kude kube malunga neeyure ezi-6 ngaphambi kotyando. Banokuba nolwelo olucacileyo kunye nobisi lwebele kude kube ziiyure ezi-4 ngaphambi kotyando.

Ugqirha wakho unokukucela ukuba uhlambe umntwana wakho ngesepha ekhethekileyo ngentsasa yoqhaqho. Hlamba umntwana wakho kakuhle.

Emva kotyando, umntwana wakho uya kusiwa kwigumbi labagula kakhulu (ICU). Umntwana wakho uya kusiwa kwigumbi lesibhedlele eliqhelekileyo emva kosuku okanye ezimbini. Umntwana wakho uza kuhlala esibhedlele iintsuku ezi-3 ukuya kwezi-7.

• Umntwana wakho uya kuba nebhandeji enkulu esongelwe entloko. Kuya kubakho ityhubhu engena emthanjeni. Oku kubizwa ngokuba yi-IV.
• Abongikazi baya kujonga umntwana wakho ngokusondeleyo.
• Kuya kwenziwa iimvavanyo ukubona ukuba umntwana wakho ulahlekelwe ligazi elininzi ngexesha lotyando. Utofelo-gazi luyakwenziwa, ukuba luyimfuneko.
• Umntwana wakho uya kuba nokudumba kunye nokugruzuka ngokujikeleza amehlo nobuso. Ngamanye amaxesha, amehlo anokudumba avaleke. Oku kuhlala kusiba mandundu kwiintsuku ezintathu zokuqala emva kotyando. Kuya kuba ngcono ngemini ye-7.
• Umntwana wakho kufuneka alale ebhedini kwiintsuku zokuqala ezimbalwa. Intloko yebhedi yomntwana wakho iya kuphakanyiswa. Oku kunceda ukugcina ukudumba.

Ukuthetha, ukucula, ukudlala umculo, kunye nokubalisa amabali kunokunceda ukumthuthuzela umntwana wakho. I-Acetaminophen (iTylenol) isetyenziselwa iintlungu. Ugqirha wakho unokukunika amanye amayeza eentlungu ukuba umntwana wakho uyawafuna.

Uninzi lwabantwana abanotyando lwe-endoscopic banokugoduka emva kokuhlala esibhedlele ngobusuku obunye.

Landela imiyalelo oyinikiweyo malunga nokukhathalela umntwana wakho ekhaya.

Uninzi lwexesha, iziphumo ezivela kulungiso lwe-craniosynostosis zilungile.

Craniectomy - umntwana; I-Synostectomy; Umtya craniectomy; I-craniectomy encediswa yi-Endoscopy; I-Sagittal craniectomy; Ukuqhubela phambili kwe-orbital; FOA

• Ukuzisa umntwana wakho ukuba atyelele umntakwabo ogula kakhulu
• Ukuthintela ukwenzakala entloko ebantwaneni

UDemke JC, Tatum SA. Utyando lwe-Craniofacial lokuzalwa kunye nokufumana iziphene. Ku: IFlint PW, uFrancis HW, uHaughey BH, et al, ii-eds. I-Cummings Otolaryngology: Utyando lweNtloko kunye neNtamo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahl. 187.

UGabrick KS, Wu RT, Singh A, Persing JA, Alperovich M. Radiographic eqatha yemetopic craniosynostosis inxibelelana neziphumo zexesha elide ze-neurocognitive. Ukuqaqamba kwakhona kwePlast. Ngo-2020; 145 (5): 1241-1248. IINKCUKACHA: 32332546 pubmed.ncbi.nlm.nih.gov/32332546/.

ILin KY, Persing JA, Jane JA, kunye noJane JA. I-Nonsyndromic craniosynostosis: intshayelelo kunye ne-single-suture synostosis. Ku: Winn HR, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 193.

Proctor MR. Ukulungiswa kwe-endoscopic craniosynostosis. Guqula iPediatr. Ngo-2014; 3 (3): 247-258. IINKCUKACHA: 26835342 pubmed.ncbi.nlm.nih.gov/26835342/.