I- meningioma ukukhula okungavamile kwezicubu ezizungezile ubuchopho, ezibizwa ngokuthi ama-meninges. Ngokuvamile, i-meningiomas idinga ukuhlola ngezikhathi ezithile ngokuhlolwa kukadokotela nokuhlolwa kwe-neuroimaging, njengoba izikhumba zivame ukukhula kancane. Ngezinye izikhathi, lesi sifo singacindezela ubuchopho noma intambo yomgogodla. Kulokhu, ukwelashwa kuyadingeka.
I-Meningiomas ingelashwa ngokuhlinzwa noma imisebe. Inkambo enhle kakhulu yesenzo incike esayizi lesisu, indawo, izinga lokukhula, nokubukeka ngaphansi kwe-microscope. Ukwelashwa okufanele futhi kuxhomeke esimweni somuntu siqu sempilo yonke.
Ukuhlola okusebenzayo
Ukuqapha okusebenzayo, okubizwa nangokuthi "ukulinda okuqaphileyo," kuyindlela evamile yokuqala kubantu besilisa. Lokhu kuyiqiniso ikakhulukazi uma i-meningioma itholakale ngephutha ngesikhathi sokubamba inkinga engavumelani. Isibonelo, i-meningioma ingabonakala lapho umuntu ethola ikhanda le-CT emva kweyingozi yebhayisikili, nakuba bengakaze babone noma yikuphi uphawu lwe-tumor ngaphambi kokuskena. Le ndlela ivame kakhulu kubantu abavame ukubhekana nemiphumela emibi kusukela kokwelashwa.
Ngokuvamile, iskena se- CT noma se-MRI siphindwa izinyanga ezingu-3 kuya kwezi-6 ngemuva kokuqala. Kungenzeka kuqala kwenziwe ngonyaka kanye neminyaka embalwa yokuqala, becabanga ukuthi azikho izimpawu ezintsha futhi i-meningioma ayishintshi ngokuphawulekayo.
Kuleli phuzu, ukwelashwa kunganconywa.
Ukususwa kokuhlinzwa
Ukususwa kokuhlinzwa kwe-meningioma yindlela yokwelashwa ethandwayo ezimweni eziningi ze-meningioma. Ngenkathi umgomo ukususa sonke isisu, lokhu kungenzeka ukuthi akunakwenzeka kuncike endaweni yesikhumba nesayizi. Isibonelo, uma i-tumor isondelene kakhulu nasezindaweni ezibucayi zengqondo noma emithanjeni yegazi, ingozi yokususwa ingahle iphumelele kunoma iyiphi inzuzo ebonekayo.
Isibonelo, ukuvuselela okuphelele kuvame ukuzama uma isisu sisesimweni esiphakeme sobuchopho noma i- olfactory groove . Ukubuyisana okuyingxenye kungase kudingeke kube nzima ukuthola izifunda ezifana ne-clivus.
I-Neurosurgery inezingozi. Isibonelo, ukuvuvukala kungase kwenzeke ngokuqoqwa kwamanzi amathishu ebuchopho okuthiwa i-cerebral edema. Ukuvuvukala okunjalo kungabangela izinkinga ze-neurological njengokunganaki, ubuthakathaka noma ubunzima ngokukhuluma noma ukunyakaza. I-edema ye-cerebral ingancishiswa ngemithi efana ne-corticosteroids futhi ijwayele ukuhamba yodwa phakathi kwamasonto ambalwa. Kungenzeka ngezinye izikhathi kuvele ukuhlinzwa ngemva kokuhlinzwa; Kodwa-ke, kuyilapho ama-anticonvulsants avame ukunikezwa ukuvimbela ukugwinya, ukusetshenziswa okunjalo akuboniswa ngokuvamile futhi kuyisihloko sokuphikisana okuthile.
Ngenxa yokuthi umzimba ufuna ukuvimbela ukuphuma kwegazi ngokweqile ngemuva kokuhlinzwa, ama-clots angakha kalula, kuhlanganise nasezindaweni lapho igazi kufanele ligeleke khona ngokukhululekile. Ngenxa yalesi sizathu, imithi yokwelapha ukuvimbela i-clots yegazi isetshenziswa kakhulu. Izingozi zokuhlinza nazo zixhomeke esimweni nasendaweni yesisu. Uma i-tumor isisekelweni se-skull, isibonelo, izinzwa ezinzima endaweni zingase zibe yingozi ngesikhathi sokuhlinzwa.
I-Radiation Therapy
Ukwelashwa kwezidakamizwa ngokuvamile kuhilela ukubhekwa kwamandla aphezulu x-ray ku-tumor.
Umgomo ukunciphisa ukuvezwa kwemisebe kulo lonke ubuchopho. Ngokuvamile ama-radiation anconywa ngezicubu ezingenasidlangalaleni nezihlukumezayo, kanti nakuba kungekho ukuhlolwa okungahleliwe komkhuba, imisebe ivame ukuphakanyiswa ngemva kokuhlinzeka ngezicubu ezinonya.
Ukwelashwa kwezidakamizwa kungakhululwa ngezindlela eziningana. Enye indlela, ukwelashwa kwama-radiation fractional, inikeza izifo ezincane eziningana isikhathi eside. Le ndlela iwusizo ikakhulukazi kuma-optic nerve sheath meningiomas, futhi mhlawumbe ne-meningiomas encane engaphansi kwe-skull. Ngokuphambene nalokho, i-radiosurgery ye-stereotactic inikeza umthamo owodwa wokushisa kwemisebe endaweni ekhona kakhulu yobuchopho.
Le ndlela ingcono kakhulu ekusetshenzisweni kwezimbungulu ezincane kumasayithi akhethiwe lapho ukucabangela ukuhlinzwa kunzima kakhulu.
Imiphumela emibi ye-radiation therapy ayinzima kakhulu. Ukulahleka kwezinwele kuvame ukutholakala ekwelapheni kwama-fractionate. Ngenkathi ukulahlekelwa kungase kube unomphela, izinwele zivame ukukhula zingakapheli izinyanga ezintathu emva kokwelashwa. Ukukhathala okuncane, ukuphathwa ikhanda noma isicanucanu kungase kwenzeke.
Izifo ze-WHO ze-grade II ne-III zivame ukuphathwa ngokuhlanganiswa kokuhlinzekwa kwemishanguzo kanye nemisakazo, kanti lesi sibalo sinikezwe ama-radiation aphezulu kakhulu kune-WHO grade I meningiomas. Naphezu kwemizamo yonke, i-meningiomas ngezinye izikhathi ibuyele emuva, ngokuvamile eduze nensimu yemisebe. I-Meningioma ingase isakazeke emthonjeni wamagogasi kuze kufike emthonjeni womgogodla ("ukwehlisa imitha "). Izinqumo zokwelashwa zenziwa kangcono ngokubambisana ne-neurosurgeon, nezinqumo ekulandiseni kanye nezindlela zokuletha imisebe eholwa yi-oncologist yemisebe.
Imithombo:
U-Arvold ND, Lessell S, uBussiere M, et al. Imiphumela ebonakalayo kanye nokulawulwa kwesisu emva kokuhambisana ne-radiotherapy yeziguli ezine-optic nerve sheath meningioma. I-Int J Radiat Oncol Biol Phys 2009; 75: 1166.
UMarosi C, uHassler M, uRoessler K, et al. Meningioma. Crit Rev Oncol Hematol 2008; 67: 153.
Minniti G, Amichetti M, Enrici RM. I-Radiotherapy ne-radiosurgery ye-benign skull base meningiomas. I-Radiat Oncol 2009; 4:42.
Pamir N, Black P, Fahlbusch R. Meningiomas: Umbhalo ophelele, u-Elsevier, 2009.
Yano S, Kuratsu J, Kumamoto Brain Tumor Research Group. Izinkomba zokuhlinzwa ezigulini ezinezinkinga ezingenangqondo ezixhomeke ekuhlangenwe nakho okubanzi. J Neurosurg 2006; 105: 538.