Laryngomalacia

Umxholo

• Ushwankathelo
• Ziintoni iimpawu zelaryngomalacia?
• Yintoni ebangela ilaryngomalacia?
• Ichongwa njani i-laryngomalacia?
• Iphathwa njani i-laryngomalacia?
• Utshintsho onokulwenza ekhaya
• Ngaba inokuthintelwa?
• Yintoni imbonakalo?

Ushwankathelo

ILaryngomalacia yimeko exhaphake kakhulu kwiintsana. Yinto engaqhelekanga apho izihlunu ezingaphezulu nje kwemicu yelizwi zithambe ngokukodwa. Oku kuthamba kubangela ukuba iphaphazele ingene kwindlela yomoya xa uphefumla. Oku kunokubangela ukuvalwa kwendlela yomoya, ekhokelela ekuphefumlweni okunengxolo, ngakumbi xa umntwana esemqolo.

Iintambo zezwi zizibini ezisongelayo kwingqula, ekwabizwa ngokuba yibhokisi yelizwi. Ingqula ivumela umoya ukuba udlulele emiphungeni, kwaye ikwanceda ukwenza izandi zezwi. Ingqula inepiglottis, esebenza nayo yonke ingqumbo ukugcina ukutya okanye ulwelo lungangeni kwimiphunga.

ILaryngomalacia yimeko yokuzalwa, okuthetha ukuba yinto abantwana abazalwa nayo, kunokuba imeko okanye isifo esiya sikhula kamva. Malunga neepesenti ezingama-90 zamatyala e-laryngomalacia asombulula ngaphandle konyango. Kodwa kwabanye abantwana, amayeza okanye utyando kunokuba yimfuneko.

Ziintoni iimpawu zelaryngomalacia?

Olona phawu laryngomalacia kukuphefumla okunengxolo, okwaziwa ngokuba yi-stridor. Sisandi esiphakamileyo esivakalayo xa umntwana wakho ephefumla. Kumntwana ozelwe ene-laryngomalacia, i-stridor inokubonakala ngokuzalwa. Ngokomndilili, imeko ibonakala kuqala xa iintsana zineeveki ezimbini ubudala. Ingxaki inokuba mandundu xa umntwana esemqolo okanye xa ekhathazekile elila. Ukuphefumla okunengxolo kuthambekele ekubeni kubengaphezulu kwiinyanga zokuqala emva kokuzalwa. Iintsana ezine-laryngomalacia zinokutsala zijikeleze intamo okanye isifuba xa zingena ngaphakathi (zibizwa ngokuba ziirhoxiso).

Imeko eqhelekileyo enxulumene noko sisifo se-reflux se-gastroesophageal (GERD), esinokubangela uxinzelelo olukhulu kumntwana omncinci. I-GERD, enokuthi ichaphazele nawuphina umntu nakweyiphi na iminyaka, yenzeka xa i-asidi yokugaya inyuka ukusuka esiswini iye kwi-esophagus ebangela iintlungu. Ukutsha, ukuziva ucaphukisa kuyaziwa ngokuxhaphakileyo njengokutshisa kwentliziyo. I-GERD inokubangela ukuba umntwana abuye kwakhona kwaye agabhe kwaye abe nengxaki yokufumana ubunzima.

Ezinye iimpawu ze-laryngomalacia eziqatha zibandakanya:

• kunzima ukondla okanye ukonga
• ukutyeba kancinci, okanye ukwehla kobunzima
• ukukrwitsha xa uginya
• umnqweno (xa ukutya okanye ulwelo lungena emiphungeni)
• ukunqumama ngelixa uphefumla, okwaziwa ngokuba yi-apnea
• ukujika luhlaza okwesibhakabhaka, okanye i-cyanosis (ebangelwa ngamanqanaba eoksijini asezantsi egazini)

Ukuba ubona iimpawu ze-cyanosis okanye ukuba umntwana wakho uyeka ukuphefumla ngaphezulu kwemizuzwana eli-10 ngexesha, yiya esibhedlele kwangoko. Kwakhona, ukuba uqaphela umntwana wakho ukuba aphefumle- umzekelo, ukutsala esifubeni nasentanyeni- yiphathe le meko ngokungxamisekileyo kwaye ufumane uncedo. Ukuba ezinye iimpawu zikhona, yenza idinga kunye nogqirha wabantwana bomntwana wakho.

Yintoni ebangela ilaryngomalacia?

Akucaci kakuhle ukuba kutheni abanye abantwana beba ne-laryngomalacia. Imeko icingelwa njengokukhula okungaqhelekanga kwe-cartilage ye-larynx okanye nayiphi na enye indawo yebhokisi yelizwi. Oko kunokuba sisiphumo semeko yemithambo-luvo echaphazela imithambo-luvo yeentambo zezwi. Ukuba i-GERD ikhona, inokwenza ukuphefumla okungxolayo kwe-laryngomalacia kubi.

ILaryngomalacia inokuba luphawu oludlalwe, nangona ubungqina bungomelelanga kule theory. I-Laryngomalacia ngamanye amaxesha inxulunyaniswa neemeko ezithile ezizuzwe njengelifa, njenge-gonadal dysgenesis kunye ne-Costello syndrome, phakathi kwabanye. Nangona kunjalo, amalungu osapho ane-syndrome ethile akunyanzelekanga ukuba abe neempawu ezifanayo, kwaye akanayo yonke i-laryngomalacia.

Ichongwa njani i-laryngomalacia?

Ukuchonga iimpawu, ezinjenge-stridor, kunye nokuqaphela xa zisenzeka kunokunceda ugqirha womntwana wakho enze uxilongo. Kwiimeko ezinobulali, uvavanyo kunye nokulandelwa kufutshane kunokuba yiyo yonke into eyimfuneko. Kwiintsana ezineempawu ezingaphezulu, iimvavanyo ezithile zinokufuneka ukuba zichonge imeko ngokusemthethweni.

Uvavanyo oluphambili lwe-laryngomalacia yi-nasopharyngolaryngoscopy (NPL). I-NPL isebenzisa umda omncinci kakhulu ofakwe ikhamera encinci. Ubungakanani bukhokelwa ngobunono phantsi kwenye yeempumlo zomntwana wakho emqaleni. Ugqirha unokujonga kakuhle impilo kunye nolwakhiwo lweengqula.

Ukuba umntwana wakho ubonakala ngathi une-laryngomalacia, ugqirha unokuyalela ezinye iimvavanyo, ezinjengentamo nesifuba iX-reyi kunye nolunye uvavanyo olusebenzisa umda omncinci, okhanyisiweyo, obizwa ngokuba yifluoroscopy yomoya. Olunye uvavanyo, olubizwa ngokuba luvavanyo olusebenzayo lokugwinya (FEES), ngamanye amaxesha lwenziwa ukuba kukho iingxaki zokuginya kunye nomnqweno.

I-Laryngomalacia inokufunyaniswa ukuba ithambile, imodareyitha okanye inzima. Phantse iipesenti ezingama-99 zeentsana ezizalwe nge-laryngomalacia zineentlobo eziphakathi okanye eziphakathi. I-laryngomalacia emnene ibandakanya ukuphefumla okunengxolo, kodwa azikho ezinye iingxaki zempilo. Ihlala ikhulile ngaphakathi kwiinyanga ezili-18. I-laryngomalacia emodareyithiyo ihlala ithetha ukuba kukho iingxaki ngokondla, ukuphinda ubuye, i-GERD, kunye nokubuyisa isifuba kancinci okanye ngokulinganayo. I-laryngomalacia enamandla inokubandakanya ukondla ingxaki, kunye ne-apnea kunye necyanosis.

Iphathwa njani i-laryngomalacia?

Uninzi lwabantwana luza kuphuma laryngomalacia ngaphandle konyango ngaphambi kokuzalwa kwabo kwesibini, ngokweSibhedlele saBantwana saseFiladelfia.

Nangona kunjalo, ukuba i-laryngomalacia yomntwana wakho ibangela iingxaki zokondla ezithintela ukutyeba okanye ukuba i-cyanosis yenzeka, kunokufuneka kwenziwe utyando. Unyango oluqhelekileyo lonyango luqala ngenkqubo ebizwa ngokuba yi-laryngoscopy ngqo kunye ne-bronchoscopy. Yenziwe kwigumbi lokusebenza kwaye ibandakanya ugqirha usebenzisa izikali ezikhethekileyo ezibonelela ngokusondeleyo kwilarynx kunye netrachea. Isinyathelo esilandelayo ngumsebenzi obizwa ngokuba yi-supraglottoplasty. Kungenziwa ngesikere okanye i-laser okanye enye yeendlela ezimbalwa. Olu tyando lubandakanya ukwahlula intlala yomqala kunye neepiglottis, izicwili ezisemqaleni ezigqume umqala xa usitya. Utyando lubandakanya ukunciphisa kancinci izihlunu ngaphezulu nje kwemisipha yezwi.

Ukuba i-GERD yingxaki, ugqirha wakho unokumisela amayeza e-reflux ukunceda ukulawula ukuveliswa kwesisu esiswini.

Utshintsho onokulwenza ekhaya

Kwiimeko ezinobulali okanye eziphakathi zelaryngomalacia, wena nomntwana wakho akufuneki nenze naluphi na utshintsho olukhulu ekondleni, ekulaleni, okanye nakuwuphi na omnye umsebenzi. Kuya kufuneka ujonge umntwana wakho ngononophelo ukuze aqiniseke ukuba bondla kakuhle kwaye abafumani naziphi na iimpawu ezinzulu ze-laryngomalacia. Ukuba ukondla ngumceli mngeni, kuya kufuneka uyenze rhoqo, kuba umntwana wakho usenokungafumani iikhalori ezininzi kunye nezakhamzimba ngokutya ngakunye.

Kuya kufuneka uphinde uphakamise intloko kumatrasi wosana lwakho ukubanceda baphefumle lula ebusuku. Nokuba une-laryngomalacia, iintsana zisalele ngokukhuselekileyo emqolo ngaphandle kokuba kucetyiswe ngugqirha wabantwana.

Ngaba inokuthintelwa?

Ngelixa ungenako ukuthintela i-laryngomalacia, unganakho ukunceda ukuthintela ukungxamiseka kwezonyango okunxulumene nemeko. Cinga ngezi ndlela zilandelayo:

• Yazi ukuba yeyiphi imiqondiso ekufuneka uyijongile xa isiza kokondla, ukutyeba, kunye nokuphefumla.
• Kwimeko engaqhelekanga yokuba umntwana wakho apnea enxulunyaniswa ne-laryngomalacia yabo, thetha nogqirha wakho malunga nokusebenzisa unyango oluqhubekayo loxinzelelo lomoya (CPAP) okanye olunye unyango lwe-apnea.
• Ukuba i-laryngomalacia yomntwana wakho ibangela iimpawu ezinokuthi zifumane unyango, fumana ingcali enamava okunyanga i-laryngomalacia. Kuya kufuneka uye kwi-Intanethi ukufumana amaqela enkxaso anokunceda okanye uzame isikolo sezonyango esikufutshane. Ingcali ehlala kude nawe inokwazi ukudibana nogqirha wabantwana ukude.

Yintoni imbonakalo?

Kuze kube yilapho i-larynx yomntwana ikhula kwaye ingxaki iphela, kuya kufuneka ujonge nayiphi na inguqu kwimpilo yomntwana wakho. Ngelixa abantwana abaninzi besenza into engaphaya kwelaryngomalacia, abanye bafuna utyando, kwaye oko kusoloko kusenziwa phambi komhla wokuzalwa komntwana wokuqala. I-apnea kunye ne-cyanosis zingasongela ubomi, ngoko unganqikazi ukubiza i-911 ukuba umntwana wakho uhlala exinzelelo.

Ngethamsanqa, uninzi lweemeko ze-laryngomalacia azidingi kutyando okanye nantoni na ngaphandle komonde kunye nokhathalelo olongezelelekileyo lomntwana wakho. Ukuphefumla okungxolayo kungacaphukisa kancinci kwaye kuxinzelele uxinzelelo de uyazi ukuba kuqhubeka ntoni, kodwa ukwazi umba kufuneka uzisombulule kungenza kubelula.