Uvulopalatopharyngoplasty (UPPP)

I-Uvulopalatopharyngoplasty (UPPP) ngotyando lokuvula umoya ophezulu ngokukhupha izicwili ezongezelelweyo emqaleni. Kungenziwa ukunyanga i-apnea yokulala ethintelayo (OSA) okanye ukurhona kakhulu.

I-UPPP isusa izicwili ezithambileyo emva komqala. Oku kubandakanya:

• Yonke okanye inxalenye yokuvula (i-flap soft of tissue ejinga phantsi emlonyeni womlomo).
• Amacandelo enkalakahla ethambileyo kunye nezicubu emacaleni omqala.
• Iitoni kunye neeadenoids, ukuba zisekhona na.

Ugqirha wakho unokulucebisa olu tyando ukuba une-apnea yokulala ethintelayo (OSA).

• Zama ukutshintsha indlela ophila ngayo kuqala, njengokunciphisa umzimba okanye ukutshintsha indawo olele kuyo.
• Uninzi lweengcali zincoma ukuzama ukusebenzisa i-CPAP, ukwanda kwempumlo, okanye isixhobo somlomo ukuphatha i-OSA kuqala.

Ugqirha wakho unokulucebisa olu tyando ukunyanga ukurhona okunzima, nokuba awunayo i-OSA. Ngaphambi kokuba uthathe isigqibo malunga nolu tyando:

• Jonga ukuba ukwehla kobunzima kunceda ukurhona kwakho.
• Cinga ngendlela ekubaluleke ngayo kuwe ukunyanga ukurhona. Olu tyando alusebenzeli wonke umntu.
• Qinisekisa ukuba i-inshurensi yakho iyakuhlawula olu tyando. Ukuba awunayo i-OSA, i-inshurensi yakho ayinakukugubungela utyando.

Ngamanye amaxesha, i-UPPP yenziwa kunye nolunye unyango olungaphaya lokunyanga i-OSA eqatha.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza okanye kwiingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Iingozi zolu tyando zezi:

• Ukonakala kwezihlunu zomqala kunye nenkalakahla ethambileyo. Unokuba neengxaki ezithile zokugcina i-liquids ukuba ingangeni ngeempumlo xa usela (ebizwa ngokuba yi-velopharyngeal insufficiency). Rhoqo, oku kuyisiphumo secala lethutyana.
• Iifinya emqaleni.
• Utshintsho kwintetho.
• Ukuphelelwa ngamanzi emzimbeni.

Qiniseka ukuba uxelela ugqirha okanye umongikazi:

• Ukuba ukhulelwe okanye unokukhulelwa
• Zeziphi iziyobisi ozithathayo, kubandakanya iziyobisi, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo
• Ukuba ubusele utywala obuninzi, ngaphezu kwesiselo esinye okanye ezi-2 ngosuku

Ngexesha leentsuku ngaphambi kotyando:

• Unokucelwa ukuba uyeke ukuthatha abacoci gazi abanjengo aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Buza ugqirha wakho ukuba zeziphi iziyobisi omele uzithathe ngosuku lotyando lwakho.
• Ukuba uyatshaya, zama ukuyeka. Ukutshaya kunokuthoba ukunyanga. Buza umboneleli wakho ngoncedo lokuyeka.
• Yazisa umboneleli wakho malunga nako nakuphi na ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isigulo onokuba naso ngaphambi kotyando lwakho. Ukuba uyagula, utyando lwakho lunokufuna ukuba limiswe elinye ixesha.

Ngomhla wotyando:

• Uya kucelwa ukuba ungaseli okanye ungatyi nantoni na iiyure ezininzi ngaphambi kotyando.
• Thatha nawaphi na amachiza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Landela imiyalelo ukuba ufike nini esibhedlele. Qiniseka ukuba ufika ngexesha.

Olu tyando luhlala ludinga ukuhlala esibhedlele ubusuku bonke ukuqinisekisa ukuba ungaginya. Utyando lwe-UPPP lunokuba buhlungu kwaye ukubuyisa ngokupheleleyo kuthatha iiveki ezi-2 okanye ezi-3.

• Umqala wakho uya kuba buhlungu kakhulu ukuya kuthi ga kwiiveki ezininzi. Uya kufumana amayeza eentlungu zentlungu ukunciphisa ukudakumba.
• Unokuba neentsimbi emva komqala wakho. Ezi ziya kunyibilika okanye ugqirha wakho azisuse kutyelelo lokuqala olulandelayo.
• Yitya ukutya okuthambileyo kunye nolwelo kwiiveki ezimbini zokuqala emva kotyando. Kuphephe ukutya okutyayo okanye ekunzima ukukuhlafuna.
• Kuya kufuneka uhlambe umlomo wakho emva kokutya ngesisombululo samanzi anetyuwa kwiintsuku zokuqala ezisi-7 ukuya kwezi-10.
• Kuphephe ukuphakamisa okunzima okanye ukuxinana kwiiveki ezimbini zokuqala. Unokuhamba kwaye wenze imisebenzi elula emva kweeyure ezingama-24.
• Uya kuba notyelelo olulandelayo kunye nogqirha wakho kwiiveki ezi-2 okanye ezi-3 emva kotyando.

I-apnea yokulala iphucula ekuqaleni malunga nesiqingatha sabantu abenza olu tyando. Ixesha elingaphezulu, isibonelelo siyaphela ebantwini abaninzi.

Olunye uphononongo lubonisa ukuba utyando lufaneleke kuphela kubantu abaneempawu ezingaqhelekanga kwilwanga elithambileyo.

Utyando lwePalate; Inkqubo ye-Uvulopalatal flap; UPPP; I-laser incediswa yi-uvulopalaplasty; Radiofrequency palatoplasty; Ukungonelanga kweVelopharyngeal - UPPP; Ukuthintela ukuphefumla xa ulala - uvulopalaplasty; OSA - uvulopalaplasty

IKatsantonis GP. I-uvulopalatopharyngoplasty yesiqhelo. Ku: UFriedman M, uJacobowitz O, ii-eds. Ukulala Ukuphefumla kunye Ukurhona. Ngomhla wesi-2. IPhiladelphia, PA: Elsevier; 2020: isahluko 32.

Qaseem A, Holty JE, Owens DK, et al; IKomiti yeZikhokelo zeKlinikhi yaseMelika yaseMelika yoGqirha. Ulawulo lokuthintela ukuphefumla kubantu abadala: isikhokelo sonyango esivela kwiKholeji yaseMelika yoGqirha. UAnn Intern Med. Ngo-2013; 159 (7): 471-483. IINKCUKACHA: 24061345 www.ncbi.nlm.nih.gov/pubmed/24061345.

I-Wakefield TL, uLam DJ, uIshman SL. Ukulala kunye nokulala. Ku: Flint PW, Haughey BH, Lund V, et al, ii-eds. I-Cummings Otolaryngology: Utyando lweNtloko kunye neNtamo. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2015: isahl 18.