I-Maxillary Antrostomy

I-Endoscopic Sinus Surgery

I-Maxillary Antrostomy

Eyaziwa nangokuthi: i- endoscopic mediater maxillary antrostomy, i-antrostomy ephakathi

I-antillastomy yama-Maxillay iyindlela yokuhlinzekwa ukukhulisa ukuvula (ostium) yesiniso se-maxillary. Lokhu kuvumela ukungenelela okwengeziwe okuhlinzekwa ngaphakathi kwe-maxillary sinus cavity kanye nomsele wamanzi wesimo. I-maxillary antrostomy iye yaqhutshwa kusukela maphakathi nawo-1980 futhi kuyindlela yokuhlinzwa eningi kakhulu okumele yenziwe uma unesifo esingapheli esingasabeki kwezinye izidakamizwa zokwelashwa.

Kulesi simo inqubo iyingxenye yokuhlinzwa kwesono okungapheli okungase kube okulandelayo okukhethwa kukho okulandelayo. Imithi yokwelashwa ejwayelekile ihlanganisa ukuhlolwa kwe-antibiotic (amasonto amathathu kuya kwangu-6), i-steroids yama-nasal, namanzi okunisela.

Ukubona i-Chronic Sinusitis

Ngaphambi kokuba uhlinzekwe ngesinus, udokotela wakho uzofuna ukuqinisekisa isifo esingapheli sinus nge-CT scan. I-X ray ayifuni ngaso sonke isikhathi, njengoba ingabonisa kuphela isifo se-sinus nolwazi oluncane oluthile mayelana nezinye izinkinga zesinus zomzimba. I-CT scan ngeke nje ibonise ubukhulu be-maxillary sinus inflammation, kodwa izophinde inikeze udokotela wakho ngolunye ulwazi olubalulekile:

• isikhundla somgwaqo ongenawo
• uncinate inqubo - okuyinto ebalulekile ingxenye yokuhlinzwa
• ukuqina kwamangqamuzana e-mucus
• umoya ngokumelene namazinga ahlanzekile emithini yesinus
• ama-polyps
• isithiyo esiyinkimbinkimbi ye-osteomeatal - ivimbela ukugeleza kwe-sinus maxillary

Nakuba lokhu kuningi lwezokwelapha zezokwelapha, lonke lolu lwazi luzohlinzeka udokotela wakho ngolwazi oludingekayo ukuze alungele kahle indlela yakho yokuhlinzwa.

Isakhiwo se-osteomeatal sakhiwa ngezakhiwo ezine zomzimba:

• uncinate inqubo - isifuba esifane no-L esizosuswa
• i-maxillary ostium (ukuvulwa kwesiniso se-maxillary)
• I-readfundibulum - isiteshi esiphundu ekhaleni
• i-ethmoid bulla - enye yesono se-ethmoid

Ukulungiselela ukuhlinzwa kwe-Endoscopic Sinus ne-Maxillary Antrostomy

Ngaphambi kokuhlinzwa, uzobe ufundiswe ukuba ungadli lutho noma uphuze kusukela phakathi kwamabili ngosuku lokuhlinzwa kuze kube yilapho sekuhlinzwa.

Lokhu kuzokusiza ukuvimbela ingozi yakho yokuvuselela okuqukethwe kwesisu (isifiso). Endaweni yangaphambili, cishe uzonikezwa i- Afrin nasal spray ukuze unciphise amavesi akho angasese ukuze usize ukwandisa indawo yokubonakala phakathi nokuhlinzwa kwakho. Uma usu-anesthetized, ungase ube ne-gauze efakwe ku-Afrin noma i-cocaine yama-topic esetshenziswa ekhaleni lakho ukuze uthuthukise ukubonakala uma kunesidingo.

Ngesikhathi se-Maxillary Antrostomy

Kunezinhloso ezintathu eziyinhloko udokotela wakho azama ukuzenza ngesikhathi se-Antrostomy maxillary

1. Susa inqubo ye-uncinate
2. Ukuthola ukuvulwa kwemvelo kwisiniso se-maxillary
3. Ukwandisa ukuvula kwisiniso se-maxillary
4. Susa ama-polyps ngaphakathi kwe-maxillary sinus cavity

Kubalulekile ukuthi udokotela wakho asuse inqubo ye-uncinate ekuqaleni kwenqubo ukuze ubone kangcono ukuvula i-maxillary sinus. Uma ukuvulwa kwesono kungatholakali futhi kuvulwa ukuvula okusha, ungaba nokuvuselelwa kwemithombo yesinisi, lapho amanzi okuphuma ephuma evulekile futhi angena ngaphakathi kwesinye isivalo.

Ngemva kokuba ne-Antrostomy yama-Maxillary

Ngemuva kokuhlinzwa kwakho sekuphelile, uzovusa i-unit eh post-anesthesia ukunakekelwa unit (PACU). Lapho uzobe uhlolwe ngokukhipha igazi, i-nausea (okungenzeka uma igazi ligwinya), noma ezinye izinkinga ezivela ekuhlinzekeni.

Uzobe ulandelana nodokotela wakho phakathi kwezinsuku ezingu-3 kuya kwezingu-5 ukuze ususwe ukupakisha kwakho kwe-nasal. Kuye impumelelo futhi uma unayo izimpawu ezisele kuzonquma ukuthi yiziphi ezinye izindlela zokwelapha ezenziwa ngemuva kokuhlinzwa.

Izingozi Ezihlobene no-Maxillary Antrostomy

Ngaphandle kwezingozi ezijwayelekile ezihambisana nanoma yikuphi ukuhlinzwa okudinga ukuhlinzeka i-anesthesia jikelele, i-maxillary antrostomy nayo inezici ezilandelayo zengozi:

• ukulimala endaweni ezungeze iso (ukulimala kwe-orbital)
• ubumpumputhe
• ukulimala kwe-duct okungavamile
• i-nosebleed (i-epistaxis)
• i-cerebrospinal fluid (CSF) i-rhinorrhea
• i-meningitis

Ngaphandle kokuphefumula , eziningi zezici ezibekwe ohlwini eziyingozi azivamile.

I-Maxillary antrostomy iyindlela evamile, kodwa, lezi yizici ezibangelwa ingozi. Eziningi zalezi zici zihlobene nezindlela zokuhlinza ezisetshenziswa njenge- microdebrider , ebuye futhi iphephile futhi inezinkinga ezimbalwa. Kodwa izici eziyingozi ezibalwe ngenhla zilukhuni kakhulu, ngakho-ke sicela njalo ukhethe i-ENT enekhono ukwenza inqubo.

_Imithombo:

_{I-Chiu, i-AG & Palmer, i-JN (2013). I-Atlas of Endoscopic Sinus ne-Skull Base Surgery, Isahluko 8: i-Maxillary Antrostomy. Amakhasi 65-74.}

_{Patel, A., Vaughan, WC & Meyers, AD (2015). Ukwelapha Okuhlinzekwa Kwama-Maxillary Sinusitis Okujwayelekile Okuphepheni Wokuhlinzeka.}