Nasal Sinus Ukuhlinzwa Complication
Eyaziwa nangokuthi : i-cerebrospinal fluid (CSF) evuza
I-cerebrospinal fluid (CSF) i-rhinorrhea yigama lezokwelapha esimweni esingavamile lapho umfutho ovame ukhiphe ubuchopho nentambo yomgogodla, i-cerebrospinal fluid, iphuma emakhaleni. Ukuze lokhu kwenzeke indlela engavamile phakathi kwesikhala esinqunyiwe sebuchopho kanye namasongo / isisindo samasimali adalwe ngokungalungile.
Lesi sikhala esingavamile singabangelwa ngu:
- isifo sokusulwa kwesono esiswini
- ezinye izinkinga zokuzalwa
- i-obnetive obnetive sleep apnea eyenza ukwanda komfutho we-intracranial (ICP)
- ukuhlukumezeka ekhanda nasobusweni obangela ukuhlukana kwe-naso-orbito-ethmoid nokulimaza epulazini ye-cribriform (ingxenye ye-lobe yangaphambili eyenza "uphahla" lwesinasi)
Isimo esiqondile se-CSF rhinorrhea akaziwa kodwa ezinye izifundo zishicilele ukuthi izinga lezinkinga ze-CSF rhinorrhea kusukela ekuhlinzekeni kwesono ngu-0.5%. Ngokujabulisayo, kusukela ekusetshenzisweni kwemithetho yekhanda, izimo ze-CSF i-rhinorrhea eyabangelwa ukuhlukumezeka iye yenqatshwa.
Izimpawu ze-CSF Rhinorrhea
I-rhinorrhea (impumu egijima) ecacile futhi amanzi angase abe uphawu lokuqala lwe-rhinorrhea ye-cerebrospinal fluid. Ezinye izibonakaliso nezimpawu zingabandakanya:
- ikhanda
- amanzi emanzini anambitheka enosawoti noma ensimbi
- umsele ukwanda ngenkathi ugxila phambili ngekhanda phansi
- ukungabi nesikhutha (i-anosmia)
- ukunyanyiswa kwamanzi
Kubalulekile ukuqaphela ukuthi lezi zimpawu zenzeka nakweminye eminingi, ejwayelekile, futhi kufanele zihlolwe yi- otolaryngologist (indlebe, impumu, umphimbo we-throat noma i-ENT). Kodwa uma unayo izimpawu ezibalwe ngenhla, akufanele ukulibazise ukuhlolwa kusukela i-CSF i-rhinorrhea ingaholela ezinkingeni ezinkulu.
Okufanele Ukwenze Uma Usola I-Cerebrospinal Fluid Rhinorrhea
Uma unayo izimpawu ezibalwe ngenhla, kufanele ufune ukuhlolwa ngu-otolaryngologist. Uma ngabe uhlinzwa, kufanele uhambe kudokotela ohlinzayo owenza inqubo yakho. Kodwa-ke, uma ungakaze ube nokuhlinzwa kwesasus, kufanele uthole noma yiziphi izinkomba ze-CT noma ezinye izithombe ze-sinographic okungenzeka wazithola esikhathini esidlule bese uziyisa kumchwepheshe we-ENT wokuhlola.
Phakathi nalesi sikhathi sokuqokwa ungase ucelwe ukuba wenze ukuhlolwa kwe-Smell Identification ukuze unqume ukuthi kukhona yini ukungasebenzi komzimba (iphunga). Lokhu kuhlolwa kufanele kwenziwe ngaphambi kokwelashwa ukuze kunqume umsebenzi oqalayo. Udokotela wakho angenza i- endoscopy , lokhu kuhilela udokotela esebenzisa ikhamera encane ukuze abone ngeso lengqondo noma yikuphi okungajwayelekile ku-plate cribriform. Okunye ukuhlolwa okungahle kulandelwe udokotela wakho kuhlanganisa:
- CT scan
- I-MRI
- I-B-2 transferrin assay (i-laboratory test on water drainage)
- Ukuskena kwesevisi yomsakazo
- I-fluorescein ye-intrathecal
Izinketho zokwelashwa ze-Cerebrospinal Fluid Rhinorrhea
Uma une-rhinorrhea ye-cerebrospinal fluid kubalulekile kuwe ukuthi uthole ukwelashwa okufanelekile ukuvimbela i-meningitis noma i-pneumocephalus (umoya emoyeni we-cranial).
Ukwelapha i-cerebrospinal rhinorrhea, kuzodingeka ukuhlinzwa. Uhlobo lokuhlinzekwa oludingekayo luzoxhomeka esibangele isimo sakho (ukuhlinzeka, ukuhlukumezeka, ukuphefumula kwe-apnea ...). Izinga lokuphumelela lokuhlinzeka lihle, kodwa izinkinga zingase zenzeke nganoma iyiphi inqubo yokuhlinzeka, ikakhulukazi lezo ezibandakanya i- anesthesia ejwayelekile . Kufanele uxoxe ngengozi kanye nezinzuzo zokuthola ukuhlinzwa nodokotela wakho futhi ulandele noma yiziphi iziqondiso abakunikezayo ngokuzila ukudla ngosuku nosuku lokuhlinzwa kwakho nanoma yiziphi iziqondiso zokuthi kufanele uzizinake kanjani emva kwenqubo.
Ngenkathi i-rhinorrhea ye-cerebrospinal isimiso esingavamile, izinkinga (isib. I-meningitis) ingaba yingozi futhi akufanele ithathwe kalula.
Imithombo:
Goldenberg, D. & Goldstein, BJ (2011). I-Handbook ye-Otolaryngology - Inhloko Nokuhlinzwa Kwezinyosi. I-New York City, NY: Thieme Medical Publishers, Inc.
UVuzniar, TJ, Gruber, B. & Gokhan, MM (2005). I-Cerebrospinal Fluid Leak nge-Meningitis ehambisana no-Nasal Okuqhubekayo Okuphikisanayo Nokucindezela Kwama-Airway Pressure. Isifuba. Kufinyelelwe: Mashi 11, 2012 kusukela http://journal.publications.chestnet.org/article.aspx?articleid=1083773