I-Frey syndrome yaziwa nangokuthi i-sweating gustatory noma i-hyperhidrosis
Ngemuva kokudla ukudla okushisayo nokwephuzi, abanye abantu bavuvukala ebusweni-izindebe, ebunzini, impumu, kanye ne-scalp. Kwabaningi, le reflex trigeminovascular evamile.
Noma kunjalo, ukujuluka ebusweni ngemuva kokudla noma yiluphi uhlobo lokudla kubonisa isimo esibizwa ngokuthi i-sweating gustatory, noma i-hyperhidrosis yokudla. Ngaphezu kwalokho, lokhu kuqala kokukhukhuma kungase kungabikho kuphela ekuhloleni kokudla kodwa futhi kusukela ekucabangeni noma ngokukhuluma ngokudla.
Izimpawu ezijwayelekile zokukhukhumeza okuvuthayo zihlanganisa ukujuluka, ukuqhuma, ukubomvu nokukhathazeka okuvamile kuvezwe ezingeni lehlathi. Ngokungajwayelekile, abantu abanalo simo bazizwa befudumele noma ubuhlungu ngokuhlafuna.
Ukujuluka kwe-gustatory kungathinta kakhulu futhi kuthinte kakhulu izinga lomuntu lompilo. Ngokusho kwabakwa-Sood nabambisene nabo, ukuthuthumela okuvuthayo "kungabangela ukukhubazeka okukhulu kwezenhlalakahle okuvela ekudingeni ukuba ugijime njalo ukuba uhlale uboshwe endlini." Ngamanye amazwi, isidingo esiqhubekayo sokuthi "siphumelele" ukujuluka singenza kube nzima kwabanye ukuphuma endlini.
I-iteration evamile kakhulu ye-hyperhidrosis yi-Frey syndrome. I-Frey syndrome ibhekisela ekuthunyeleni futhi ehamba ngokusakaza kwe-auriculotemporal nerve. I-auriculotemporal nerve inikeza inzwa ehlangothini yekhanda. I-Frey syndrome nayo ibizwa nangokuthi i-hyperhidrosis enomdlandla wehlathi.
Kuyini i-Frey Syndrome?
I-Frey syndrome ayidlangalaleni, engaphansi kwama-20,000 aseMelika atholakale unyaka ngamunye.
Ngokuyinhloko, i-Frey syndrome ivela ekutheni i-revering engalungile yezinzwa ezithintekayo, ukujuluka nokuqhuma. Labizwa nge-French neurologist u-Lucia Frey, owachaza lesi simo ngokuthi "auriculotemporal nerve syndrome" ngo-1923.
UFrey ushicilele umbiko obonisa ukugula kwakhe okungaziwa ngemuva kokuphatha isosha lasePoland elinezikhumba ezikhukhulayo ngemuva kokulondoloza isilonda esinegciwane lesifo esithinta igciwane le- parotid .
I-gothic parotid yiyona enkulu kunazo zonke izigcawu ze-salivary futhi itholakala ezingeni lehlathi. Ibeka umuthi, okusiza ukugaya nokudla ukudla. Nakuba uFrey engesiyena odokotela bokuqala ukuqaphela lesi simo, nguye owokuqala ukufaka impumulo emndenini we-auriculotemporal ekuthuthukiseni lesi sifo.
Ukukhululwa kwamathe nge-gland parotid kunqunywe yi-arc complex reflex efaka i-auriculotemporal nerve. Kubantu abane-Frey syndrome, ngemuva kokulimala emndenini we-auriculotemporal, le nerve ivuselela ngendlela engavamile. Esikhundleni sokuhlinzekela kuphela ukugcinwa kwe-parasympathetic kwi-parotid gland, okuzoholela ekutheni kube nokudla okuvamile ngemva kokusungulwa kokudla, izintambo ze-parasympathetic ze-auriculotemporal nerve ziphinde zivuselele ukuze zihlinzekele ukuhlanza izikhumba nemithambo yegazi engaphansi, okwenza kube nokuthuthumela nokuqhuma, ngokulandelanayo . Ngokuvamile, lokhu kuthuthumela nokuqhuma kungaphansi kokulawulwa okunomusa.
Ngamanye amazwi, ngemuva kokuba umonakalo we-auriculotemporal ulimele, imfucuza yakhe ye-parasympathetic regrow ukuze ingabi ukulawula kuphela ukuguquka kodwa futhi ilawula ukujuluka nokuqhuma ngemva kokuba umuntu evuselelwe ukudla. Ngaphezu kwalokho, kwabanye abantu, lesi sakhiwo sokujuluka singasondeza ubuso ngokuphelele futhi sithinte isiqu, izingalo nemilenze.
Lapho umzimba wesibhakabhaka unomthelela ngaphezulu, uthinteka kakhulu izimpawu.
Izimbangela
Noma yini elimaza inzwa ye-auriculotemporal ingaholela ku-Frey syndrome, kufaka phakathi okulandelayo:
- Ukuhlinzeka nge-garotid gland (imbangela enkulu)
- Ukuhlukumezeka okukhululekile esihlathini
- Ukuhlinzwa kwemikhanda
- Ukutheleleka okungapheli kwendawo ye-parotid
- I-Mandibular fracture
- Ukuqhekeka kokuhlanganiswa kwe- temporomandibular
- Ukuhlinzwa kuya kuhlangene kwe-temporomandibular
- Ukususwa kwezingqungquthela ze-submandibular
- Ukususwa kwengubo ye-thyroid
- I-syracatheticomy ye-Thoracic (ukuhlinzeka kwenziwa ukulawula ukujuluka)
- Ukulimala kokubeletha noma ukulimala ngemuva kokukhishwa kwe-forceps (ezinganeni)
Ngawo-1940, ukuhlinza nge-parotid gland kwande kakhulu e-United Kingdom ukuphatha izimo ezihlukahlukene, zombili ezibulalayo futhi ezingenangqondo.
Ukujuluka kwe-gustatory kanye neminye eminye imiphumela emibi, kuhlanganise nokulimala komzimba, ukwehla kwesifo somzimba, ukuncipha kwe-fistula, i-hematoma ne-keloids kwakuvame ukuphawula phakathi kweziguli ezathola ukuhlinzwa kwe-parotid gland. Okuphawulayo, abantu abanekhanda labo lonke elikhishwe nge-parotide basuke baningi amathuba okuzwa u-Frey syndrome kunelabo abanengxenye kuphela yesikhumba se-parotid esusiwe.
I-Frey syndrome nayo ingabonakala kanye nezinye izimo ze-neurological ezilandelayo:
- I-herpes zoster ebusweni
- Ukulimala kwe-Chorda tympani
- Amakhanda e-Cluster
- I-neuropathy ye-diabetes
- Encephalitis
- I-Syringomyelia
- Ukuthunga emzimbeni wesibeletho somlomo wesibeletho
Iningi labantu abathola ukujuluka okuvuthayo akukhathazeki yilo kuphela-phakathi kwamaphesenti angu-10 no-15 abantu abathola lona bafuna usizo lwezokwelapha. Ngaphezu kwalokho, ngemuva kokuhlinza nge-parotid, amaphesenti angu-10 kuphela weziguli abika izimpawu ezibonisa lesi simo. Kodwa-ke, ekubuzeni okuqhubekayo, iziguli ezingu-30 kuya ku-50 ezigulini zizovuma izimpawu zokukhukhumeza okunamnandi. I-Frey syndrome ivame ukuvela phakathi kwezinyanga ezingu-1 no-12 ngemva kokuhlinzwa.
I-Frey syndrome ingenzeka kubantu kunoma yimuphi ubudala. Noma kunjalo, akuyona into engavamile ezinganeni nasezinganeni eziye zahlukunyezwa ngempela endaweni ye-parotid ngemuva kokudilizwa kwe-forceps, futhi ukulimala kokukhishwa kwe-forceps akuvamile.
Ezinganeni, ukungezwani kokudla kungaphazamiseka nge-Frey syndrome. Kodwa-ke, izimpawu zokudla okungezwani kokudla kwenzeka emva kokungenisa kokudla hhayi ngesikhathi sokufuna.
Ukuxilongwa
Indlela elula yokuxilonga i-Frey syndrome ihilela ukusetshenziswa kwesimo se-isitashi (i-indicator) powder ebusweni. Le nqubo ibizwa ngokuthi i-Minor test. Isiguli sinikezwa amaswidi ama-lemon noma okunye ukudla okumnandi ukukhuthaza ukujuluka. Izindawo ezithintekayo lapho ifomu lezitho zomzimba zithuthuka liphenduka okwesibhakabhaka-omnyama. Amaconsi angasulwa kalula ebusweni ukuze ukuhlolwa kungabuyekezwa. Lokhu kuhlolwa kungasetshenziselwa ukuhlola i-Frey syndrome kubantu abangenazo izimpawu (okungukuthi, iziguli ezingenasifo).
Nakuba lokhu kuhlolwa kunembile, ngeke kubonise ubukhulu besimo. Ngaphezu kwalokho, lokhu kuvivinywa kuthatha ingozi engaba khona yokuphulukiswa kwe-starch powder. Lokhu kuhlola kufanele kwenziwe ngesikhumba esomile, futhi akufanele kusetshenziswe kubantu abaphefumula kakhulu.
Olunye uvivinyo oluvuthiwe futhi oluhilelekile lokuhlola ukuhlolisisa ukuthi umuntu unesifo se-Frey kuhilela indlela ye-biosensoring esebenzisa ama-electrode enzymatic athola amazinga e-L-lactate esikhumbeni.
Uhlolo olwengeziwe oluvuthiwe lwe-Frey syndrome luhilela ukusetshenziswa kwephepha elilodwa le-tishu ebusweni ukuze lihlole ukuthuthumela ngemuva kokuba isiguli sikhuthazwe ngokudla okumnandi.
Okokugcina, i-thermography yezokwelapha ye-infrared ingasetshenziselwa ukubona ngeso lengqondo i-Frey syndrome. Loluhlolo lokuhlola lufuna ukuthi izinga lokushisa nomswakama ekamelweni libe njalo. Okokuqala, ngemva kokuvuselela, indawo eshisayo iboniswe ngokuhambisana nokuxubana kwemithambo yegazi engaphansi. Okwesibili, indawo ebandayo iboniswe ngeso lengqondo elimele ukujuluka okugubhayo. Lezi zinguquko kunzima ukubona ngeso lengqondo kubantu abanesikhumba esimnyama.
Ukwelapha
Kubantu abaningi, i-Frey syndrome ihamba yodwa esikhathini esingaphezu kweminyaka emihlanu. Abantu abanezimpawu ezincane kufanele baqinisekiswe ukuthi lesi simo sizozidlula ngaphandle kokwelashwa.
Kulabo abathintekayo kakhulu, isimo sokukhukhuma ngokuvamile siyisifo esicindezelayo futhi sikhuthaza umuntu ukuba afune usizo.
I-Botox
Ucwaningo olususelwe ebufakazini olusanda kuphawula ku-Botox therapy njengendlela enhle kakhulu futhi ephumelelayo yokuphatha ukujuluka nokukhwabanisa kwe-Frey syndrome. Ngokuqondile, ukwelashwa kwe-Botox kufakazelwe ukuba amaphesenti angu-98 aphumelele ekunakekeleni izimpawu zokukhukhumeza okunomzimba. I-Botox therapy nayo iphumelele ekuqinisekiseni ukuthi abantu abahlangabezana nokujuluka okuvuthayo kwesifo sofuba sikashukela, uhlobo lomonakalo wezinzwa ngenxa yesifo sikashukela.
Esihlokweni sika-2017, uLovato nabalobi ababambisene nabo bhala lokhu okulandelayo:
Ukwelashwa kwe-BTX [Botox] kuyaphumelela kakhulu ekwelapheni ukujuluka kokufisa (Frey syndrome), futhi kungabhekwa ukwelashwa okujwayelekile kwegolide kwalokhu kuhlanganiswa kwe-post-parotidectomy.
Uma ukwelapha i-Frey syndrome nge-Botox therapy, udokotela kumele aqale abone indawo ethintekile ngokusebenzisa ukuhlolwa okuncane. Le ndawo ihlukaniswe yaba yizikwele eziningana ezimbalwa, eziphakathi kuka-1 no-1.5 cm. I-Botox ijojowe ngayinye kulezi zikwele ukufaka umphumela ohlukile, umfaniswano.
Ngokuphawulekayo, ezinye izifo ze-Frey syndrome ziye zazama. Ngokuyinhloko, lezi zonyango zihlinzeka ngokulinganiselwe noma akukho ukuphumula.
Abaphikisayo
Okokuqala, abantu abaphikisana nezidakamizwa basebenziselwe endaweni ezithintekayo ngokuthukumeza. Ezinye iziguli ziye zabika ukuphumula okulinganiselwe isikhathi samasonto ambalwa ngenxa yabalandeli abaphikisayo. Ukuze uthole imiphumela emihle, ifomu le-gel le-antiperspirant lisetshenziswe ebusuku ukuze lome isikhumba futhi lihlanzwe ekuseni. I-hairdryer ingasetshenziselwa ukomisa abaphikisayo ngemuva kwesicelo.
Kwaphela amahora angu-12 emva kwesicelo, isiguli kufanele sigweme ukushefa indawo ephathwayo. Ngokuhamba kwesikhathi, njengoba ukukhukhumeza okugubhayo kuqhuba inkambo yayo futhi kuzinqumela, kungasetshenziswa izilinganiso ezimbalwa zabantu abaphikisana nezidakamizwa, futhi iziguli ngeke zidingeke ukuba zisebenzise abaphikisana nezidakamizwa nsuku zonke. Okuphawulayo, abaphikisana nezidakamizwa bangasebenza njengezikhumba zesikhumba futhi baholele ekuvukeni. Qaphela kufanele futhi kuthathwe ukuze ugweme isingeniso se-antiperspirant esweni.
I-Anticholinergics yama-Topical
Okwesibili, i-anticholinergics yama-topical isetshenziselwe ukuphatha i-Frey syndrome. Le anticholinergics ihlanganisa i-scopolamine, i-glycopyrrolate, ne-diphemnanilmethylsulfate futhi ingasetshenziswa njengezixazululo noma ama-creams. I-Anticholinergics ingathuthukisa izimpawu zezinsuku ezingaba ngu-3.
Okubaluleke kakhulu, i-anticholinergics yathinteka isikhumba futhi ingabangela imiphumela emibi ye-systemic efaka umlomo owomile, umbono obonakalayo, amehlo abuhlungu, ukugcinwa kwe-urinary, izinga lokushaya kwenhliziyo, nokwehla komzimba. Ngaphezu kwalokho, i-anticholinergics ayifanele isetshenziswe kubantu abane glaucoma, isifo sikashukela, isifo se-thyroid, ukuvimbela ukuvimbela isifo sofuba, kanye ne-hepatic, renal, ne-cardiovascular or central disease nerveous disease.
Izinketho zokuhlinza
Okwesithathu, ukuhlinzwa kuye kwaphumelela ukuvimbela izimpawu ze-Frey syndrome. Lezi zihlinzeko zibandakanya i-sympathectomy yomlomo wesibeletho, i-neurctomy ye-tympanic, ukudluliselwa kwe-sternocleidomastoidtransfer, kanye nemidwebo ye-dermis-fat. Ukwengeza, izinto ezihlukahlukene kanye nezithiyo eziphambene nazo ziye zasetshenziswa ukuphatha ukujuluka okunomsoco.
Ngokuqondakalayo, iningi labantu abahlakulela ukukhukhumeza okuyisigqila ukuya ekuhlinzekeni banqika ukuthola ukuhlinzwa okwengeziwe ukuphatha lesi simo.
> Imithombo:
> Ukuphazamiseka Kwama-Glands, e-Eccrine, nase-Apocrine Glands. Ku: Wolff K, Johnson R, Saavedra AP, Roh EK. ama-eds. Umbala we-Atlas ka-Fitzpatrick kanye ne-Synopsis ye-Clinical Dermatology, 8e eNew York, NY: McGraw-Hill.
> Fealey RD, uHebert AA. Isahluko 84. Ukuphazamiseka kwe-Eprine Sweat Glands nokugwaza. Ku: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. eds. Dermatology ka-Fitzpatrick ku-General Medicine, i-8e eNew York, NY: McGraw-Hill; 2012.
> Lovato, A, et al. I-botulinum yokwelashwa kwe-toxin: ukuyeka ukusebenza kokuphazamiseka kwe-salivary. I-Acta Otorhinolaryngologica Italica. 2017; 37: 168-171
> Sood S, Quraishi MS, Bradley PJ. I-Frey syndrome nokuhlinzwa kwe-parotid. Otolaryngology Clinic. 1998; 23: 291-301.