Kungcono Ukubamba Lezi Khansela Ekuqaleni
Sibutsetelo
Ngenhlanhla, ama-neoplasms amahle, noma izicubu zesifo somdlavuza, isigxobo somzimba namasinasi e-paranasal awanqabile.
Amaphesenti angaba ngu-3 ama-cancer ebulalayo ekhanda nasentanyeni asithinta isigxobo semisipha nama-sinus paranasal. Ngokuvamile, lezi zomshukela zakha cishe amaphesenti angu-0.5 yazo zonke izinhlobo zomdlavuza ezibulalayo. Ngaphezu kwalokho, amadoda angase agula ngalezi zomshukela, futhi abantu abane kwabathintekayo baneminyaka engama-55 nangaphezulu.
Ngenxa yokuthi into engavamile, noma kunjalo, akusho ukuthi akubalulekile. Kulabo abaneziphuzo ezimbi eziyinkimbinkimbi yezinyosi nezono ze-paranasal - cishe abangaba-2000 baseMelika basanda kutholakala njalo ngonyaka - kanye nabo bonke abathandekayo babo, lezi zicubu zomdlavuza zinzima kakhulu.
Ngokuyinhloko ngokusho kweMelika Cancer Society, amazinga okusinda kweminyaka emihlanu, noma amaphesenti abantu abaphila eminyakeni emihlanu emva kokuxilongwa kokuqala, umdlavuza wesasal noma we-paranasal wesusus uphakathi kwama-35 kuya kwangu-63 amaphesenti asekelwe esiteji noma esiqine.
Iyini isigxobo esiyinkinga?
Iphunga lakho lixhunywe emlonyeni wakho ngesigxobo somzimba .
Yiziphi iziphambeko zeParanaal?
Izikhala zindawo noma izindawo ezingenalutho emzimbeni wethu. Isigxobo somswakama sivula ama-sinus amane ahlanganiswe ngamaphanana, ajikeleza isikhumba semisipha.
Izono zama-maxillary yizoni ezinkulu kakhulu ezihlala endaweni yamahlathi. Isono ngasinye sama-maxillary sinamathela ekhaleni ngokwayo futhi silale phansi.
Izono zangaphambili ziphezu kwamashiya.
Izono ze-ethmoid ziyinkimbinkimbi yezono ezincane ezithintanayo ezakhiwe ngamathishu omzimba namathambo amancane. Lezi zono zilele phakathi kwamehlo akho.
Izono ze-sphenoid zijulile emmpeni futhi zimehlo.
Izono zenza izinto eziningi kubandakanya okulandelayo:
- isihlungi nomoya ofudumele
- unikeze ukusekela i-skull
- ukhanyisa i-skull
- siza ukukhiqiza izwi lakho
Ngokujwayelekile, izoni ze-paranasal zigcwele umoya. Kodwa uma usulelekile futhi uvutha, lezi zono zingagcwalisa ngegazi, i-pus, kanye ne-mucus-konke okubangelwa ukungahambi kahle nobuhlungu.
Kuphi I-Nasal Cavity ne-Paranasal Sinus Cancers Ekhulayo?
Amapulangwe amanengi namasinasi e-paranasal akhona ezingeni le-sinus maxillary. Ngokuvamile, lezi zomshukela zishaya umcengezi womzimba, izindlu ezingasese (ezisekungeneni kwempumphu) kanye nezono ze-ethmoid. Ngokuvamile lezi kansa zithinta izono zangaphambili noma ze-sphenoid.
Amaphi Amaseli Ayenzela I-Canal Cavity ne-Paranasal Sinus Cancers Ephakama?
I-sinus ne-canal canal zihlanganiswe nezinhlobo eziningi ezahlukene zamaseli nezakhiwo zamaselula kuhlanganise okulandelayo:
- amangqamuzana angama-squamous
- amangqamuzana anomzimba nama-gland amancane
- amangqamuzana angenalutho
- ama-melanocytes
- i-lymphocytes (amangqamuzana omzimba omzimba)
- amangqamuzana omzimba
- amathambo amathambo
- amangqamuzana omzimba
Noma yiliphi lala maseli lingabangela umdlavuza, okuchaza ukuthi kungani kokubili umdlavuza we-nasal and paranasal ungase ube ne-histology ehlukahlukene, noma ukwakheka kwamaselula, kanye nokwelashwa.
Ngokwesibonelo, i-melanoma (uhlobo lomdlavuza wesikhumba); i-sarcoma (bone, imisipha noma umdlavuza wesikhumba); I-lymphoma (umdlavuza wegazi ohlanganisa i-lymphocytes); futhi i-esthesioneuroblastoma (noma umdlavuza ovela emanzini ashukumisayo) kungabangela umdlavuza we-nasal kanye ne-paranasal.
Kodwa-ke, eziningi zalezi zinhlobo zomdlavuza ezihlukahlukene azivamile neze. Esikhundleni salokho, umdlavuza wamangqamuzana wesifo yisisusa esivame kakhulu sezinsana zamascans nasasana. Amaphesenti angaphezu kwangu-50 alawa kansala atholakala kumangqamuzana angcolile. Uhlobo lwesibili oluvame kakhulu lomzimba womzimba noma umdlavuza we-paranasal sinus yi-adenocarcinoma, evela kumangqamuzana angama-glandular.
Izimpawu
Amakhansela emithanjeni yamazinyo nama-sinus e-paranasal afana kakhulu nezimo ezingenakuqhathanisa ezithinta le ndawo (cabanga ukuthi izifo eziphakeme zokuphefumula zifana nokubandayo noma umkhuhlane noma isifo se-sinusitis). Kodwa ekugcineni, izicubu zikhula, futhi zenza umthelela omkhulu , zithinta izakhiwo eziseduze ezifana nezamehlo nobuchopho.
Nazi ezinye izimpawu zokuqala zesikhumba semisipha kanye ne-paranasal sinus izifo:
- ikhala eligijima
- ukuxubana
- ukuvimbela
- ukugcwele kwesono
- ububele besono
Ngemuva kokuba i-tumor ikhule futhi idle ezakhiweni ezizungezile, okulandelayo kungenzeka:
- ukuphuma kwempumu;
- ubuhlungu bombuso;
- izinhlungu zamazinyo (uma i-tumor ikhula ngokwanele ukuze icindezelwe ngokumelene nephunga, amazinyo aphezulu angalimaza);
- izinkinga zamehlo (isibonelo, umbono ophindwe kabili, ukunyakaza kwamehlo nokukhubazeka)
Ngeshwa, abantu abaningi abethulayo noma ekugcineni babhekiselwa kuchwepheshe we-ENT (indlebe, impumulo nomphimbo) onomzimba ongasese kanye ne-paranasal isifo se-sinus benza kanjalo kamuva, ngemva kokuba baqale ukuthola izimpawu ukuthi noma bona odokotela abanakekelwa ngokuyinhloko bangakwazi yini ukufakazela kubanda, umkhuhlane, isifo (sinus ukutheleleka) noma okunye.
Empeleni, izikhathi eziningi laba bantu baye bazama izifundo eziningana zama-antibiotic. Ekugcineni, ngesikhathi esiningi kakhulu ngalezi zomshukela, ukuqina kakhudlwana kwandisa futhi ukubikezelwa, noma umbono, kugcinwa kakhulu.
Izimbangela
Amakhansela emithanjeni yamasalane nama-sinus e-paranasal abangelwa ukuhlanganiswa kwezakhi zofuzo (cabanga ukuguquka kwezithandwa) nokuvezwa kwemvelo.
Kunezici eziningana zokubeka ingozi emakhanda nasezintweni zomdlavuza, kufaka phakathi umthambo wezinyosi namagciwane we-paranasal sinus, ziye zacaciswa. Lezi zici eziyingozi zingenza kube lula ukuthi umuntu ahlakulele lesi sifo.
Nazi ezinye izici zokufaka ingozi kulezi zomshukela:
- ukubhema;
- ukusetshenziswa kotshwala;
- uthuli lwe-inhalation (i-Nickel, isikhumba, izindwangu, imbali kanye nezinkuni);
- imisebe (njenge-radium etholakala emidwebo yokudweba noma ama-radon ukuchayeka);
- i-glues;
- i-formaldehyde;
- igesi lwesinaphi;
- ukusika amafutha;
- amaminerali;
- i-chromium;
- ukudla okugcinwe;
- I-HPV (i-papilloma yesandulela ngculazi eyabangela izintambo zangasese);
- I-Epstein-Barr virus;
- I-Paan (uhlobo lwe-stimulant elitholakala eNdiya);
- impilo encane yomlomo (inselele ebuthakathaka);
- Okhokho base-Asia.
Eziningana zalezi zingozi ezibangelwa ingozi zivela ngenxa yokutholakala komsebenzi. Ngokwesibonelo, abantu abasebenza emafektheri abakha izikhumba, izinsimbi, amafutha nokunye kukhona engozini ikakhulukazi ekuvezweni okubangelwa ukungena.
Kuze kube manje, izingozi ezivame ukwedlula zonke ezenza umfutho wezinyosi kanye ne-paranasal sinus khancer zibhema futhi ziphuza kakhulu - ikakhulu uma zihlangene.
Ukuxilongwa
Ngenxa yokuthi izimpawu zesikhumba sangasese kanye ne-paranasal yesusus cancers ingaba yinto engcono kakhulu - ikakhulukazi ekuqaleni - i-ENT (udokotela, umphuzi nomphimbo) udokotela, noma i-otolaryngologist, kuzodinga ukubona ngeso lengqondo futhi i-biopsy, noma isampula, i-tumor, noma mass, ukuthola ukuthi yini.
Ngaphambi kokwenza noma ukuyala ukuhlolwa kokuhlola, udokotela uzoqala ukuhlola ikhanda nentamo. Uma kukhishwa isisu, kunakekelwa okukhethekile emiphumela yokuhlola iso, njengokunyakaza kwamehlo e-extraocular.
Ngaphezu kwalokho, amasinasi kanye nesigxobo se-nasal bahlolisiswa ngokubili, kokubili ngokubheka ngeso lengqondo kanye nokuthinta noma ukuthinta. Ngokucacile, ukucindezela ezindaweni ze-sinus kungabangela ubuhlungu uma kwenzeka ukugula noma izifo.
Nazi izivivinyo ezahlukene zokuxilonga ezingenziwa ukuze usize ukuxilonga lezi kansela bese uhlela ukwelashwa okufanele:
- i-endoscopy yama-nasal (ithubhu eguquguqukayo enekhamera nokukhanya okusetshenziselwa ukubheka ngaphakathi kwesikhumba sangasese)
- CT
- I-MRI
- X-ray
- Iskena se-PET
Kulezi zivivinyo, ama-X-ray nama-CT ahlose kahle ekunqumeni ukuthi umdlavuza usakaze yini ezakhiweni eziseduze nasemgodini wesisu. Nakuba, i-PET scan isetshenziselwa ukuthola ukuthi lezi zansana ziye zasakazeka yini noma zenziwe kabusha. Ngokusobala, kubi kakhulu isiguli lapho lezi zansana zisabalalisa kwezinye izingxenye zomzimba.
Isiteji
Ngokuvamile, amakhemikhali emisindo yomzimba namasinasi e-paranasal yizinhlobo zekhanda lezinwele zekhanda nentamo. Njengamanye izinhlobo zesifo somdlavuza, ikhanda lezinwele zekhanda zitholwa ukuthi zisebenzisa izigaba: Isigaba 0, I, II, III no-IV. Lezi zigaba zihlukaniswa ngokusekelwe ezimweni ezithile zesisu. Isiteji esikhulu, isifo somdlavuza sibi kakhulu. Ngaphezu kwalokho, lezi zigaba zenziwa ngokusetshenziswa kwe- TNM .
I-T e-TNM imelela isisu esikhulu futhi ibhekisela ebukhulu besisu.
I-N ku-TNM imele ukubandakanyeka kwe-lymph node.
I-M ku-TNM imele imithemitha noma ukusabalala okude.
Akuvamile ukuba umdlavuza wezintambo zomzimba noma izidakamizwa ze-paranasal zisakaze emagqumeni angama-lymph noma zihlanganise futhi zisakaze kwenye isayithi elikude. Noma kunjalo, lezi zicubu zingasakazeka ezakhiweni ezungezile, futhi uma zingena ebuchosheni, ukufa kungaholela.
Ake sihlolisise lezi zigaba ezihlukahlukene zomdlavuza wekhanda nentamo.
- Isiteji 0 umdlavuza i- carcinoma in situ futhi ikhona kuphela endaweni owaqala ngayo. Uma uthathwa ekuseni, umdlavuza we-Stage 0 uvame ukuphulukiswa.
- Umdlavuza we-Stage 1 usakazeke kulo lonke i-mucosa, noma ungqimba lwangaphandle lwesigxobo noma amasinasi, kodwa awungena phakathi kwethambo. Ngaphezu kwalokho, akukho ukubandakanyeka kwe-lymph node noma ama-metastases okwamanje. Ngokusho kweMelika Cancer Society phakathi kuka-1998 no-1999, isilinganiso seminyaka engu-5 sokusinda kwabantu abaneSigaba 1 somswakama nesifo somdlavuza we-paranasal kwaba ngamaphesenti angu-63.
- Umdlavuza wesigaba sesi-2 uye wangena emathanjeni. Kodwa-ke, isifo se-Stage 2 asizange sisakaze kuma-lymph nodes noma sisetshenziswe ezindaweni ezikude zomzimba. Izinga lokusinda iminyaka emihlanu labantu abanesifo sangasese se-Stage 2 kanye ne-paranasal sinus cancers ngamaphesenti angu-61.
- Isigaba somdlavuza wesi-3 singabhekisela ku-tumor ekhulile ibe yithambo kanye nezinye izakhiwo futhi sishaye ama-lymph nodes. Isilinganiso sokusinda iminyaka emihlanu yesigxobo se-Stage 3 nasal andasalus sinus ngamaphesenti angu-50
- Isigaba somdlavuza wesi-4 singabhekisela esiqhumeni esasakaze kakhulu ezakhiweni ezizungezile kanye nezakhi zamakhansela kanye nokulahlwa ngaphandle kwe-metastases. Inani lokusinda iminyaka engu-5 yesiteji se-Stage 4 esiswini kanye namagciwane we-paranasal sinus amaphesenti angu-35.
Ngokuvamile ukwenza ikhanda nekhanda kanomdlavuza - kufaka phakathi amathuna emisipha kanye nezidumbu zesineus ze-paranasal - zibandakanya ama-lymph nodes noma zilahle izidakamizwa ezikude. Kodwa-ke, amaphesenti angama-20 kuya kwangu-40 abantu abanalo la kansela futhi abaphenduli emibonweni ejwayelekile yokwelashwa embukisweni.
Okuphawulayo, amagciwane e-maxillary sinus - izinhlobo ezivame kakhulu zesikhumba esiswini kanye ne-paranasal sinus khancer - zinezibalo ezithile eziqondile. Amagciwane e-Maxillary sinus angathula isikhathi esincane ngoba isono esikhulu sama-maxillary sikhulu, futhi kuthatha isikhathi umdlavuza ukhiphe indlela yalesi sikhala esikhulu kakhulu.
Ngaphandle kokufakwa kwesiteji, izicubu zibuye zenziwe, noma zihlelwe ngezigaba ngokweqile, zisebenzisa izicubu namasampuli eseli kusuka ku-biopsy. Izicubu ezincane ezisezingeni eliphansi zihlukanisiwe kahle futhi izikhwama eziphakeme kakhulu zihlukaniswa kancane noma zingenamkhawulo. Izikhumba ezingapheliyo zithwala ama-prognose ezimbi kakhulu ngoba zihlukanisa futhi zisakazeka ngokushesha kunokwenza izicubu ezihlukanisiwe kahle.
Ukwelapha
Ukwelashwa kwemisipha yamazinyo kanye ne-paranasal sinus khancer kuncike esiteji noma ubunzima bomdlavuza kanye nesimo sakho sezokwelapha jikelele.
Ngokwesibonelo, umuntu onempilo onomdlavuza we-Stage 1 angaphulukiswa ngokuhlinzwa kuphela. Kodwa-ke, umuntu onesifo esiphezulu kakhulu angadinga ukuhlinzwa, i-chemo, ne-radiation therapy. Okokugcina, kubantu abanezifo eziphambili kakhulu ezingenakuphulukiswa, ukuhlinzwa kungase kusebenze ukukhuphuka kokukhula kwesisu futhi kwandise ukusinda. Ngamanye amazwi, ukunakekelwa kwabantu abanesifo esongela impilo kungaba yinto enamandla.
Nazi ezinye izinketho zokwelapha kubantu abanezikhamera:
- ukuhlinzwa
- i-chemotherapy
- ukwelashwa kwemisebe
- ukwelashwa okuhlosiwe
- ukunakekelwa okunomsoco
Abantu abanezifo ezithuthukisiwe bangadinga izinhlobo eziningana zezobuchwepheshe ukuze banikeze ukwelapha, njenge-ENT, i-neurosurgeon, i-oncologist yezokwelapha kanye ne-oncologist yemisebe.
Uma wena noma othandekayo esho umdlavuza wezinsipho zomzimba noma izidakamizwa ze-paranasal, kubalulekile ukuba ubonane nodokotela bese uxoxisana nokukhathazeka kwakho. Ekuqaleni kwesikhathi phakathi nalezi zomshukela, uma izimpawu zingenasidingo, udokotela wakho cishe uzobonisa inkomba encane yokumangalisa lowo mdlavuza - ikakhulukazi ngoba lezi zomshukela azivamile.
Kodwa-ke, uma unomlando womndeni walowo mdlavuza, uye wabhekana nezici eziyingozi, uye waba nezimpawu ezifana nephunga eliphuthumayo noma isisindo somzimba esingahambi ngisho nangemva kwemijikelezo yama-antibiotic noma abhekene nezinguquko ezibukwayo noma ezinye izinkinga ezibonisa ukusabalala kwesisu , kubalulekile ukuthi ubone i-ENT noma utshele udokotela wakho wokunakekela oyinhloko ukuthi ufuna ukubona i-ENT.
Imithombo
I-Fischman ML, i-Rugo HS. I-Cancer Occupational. Ku: LaDou J, Harrison RJ. ama-eds. UKUHLOLA OKUPHAKATHI Nokwelashwa: Imithi yokuSebenzi nokuMvelo, 5e . ENew York, NY: McGraw-Hill; 2013.
I-Mandpe AH. Isahluko 17. I-Paranasal Sinus Neoplasms. Ku: Lalwani AK. ama-eds. Ukuqaphela Kokuqala Nokuphathwa Kwe-Otolaryngology-Inhloko Nokukhishwa Kwezinyosi, 3e . ENew York, NY: McGraw-Hill; 2012.