Ukuqonda Izimpawu Nezici Zengozi
Umdlavuza we-Laryngeal uhlobo lomdlavuza oluthinta i-larynx, isitho esaziwa ngokuthi ibhokisi lezwi. Abantu abangaba ngu-13 000 baseMelika batholakala benesifo somdlavuza unyaka ngamunye, okungenani abangu-3 500 bazofa ngesifo.
Anatomy
I-larynx iqukethe izintambo zezwi futhi ihlukaniswe izingxenye ezintathu:
- i-glottis, iminyango yamazwi eqiniso, lapho amaphesenti angama-60 ekhansela athuthuka khona
- i-supraglottis, engasenhla kwe-glottis, lapho amaphesenti angu-35 ekhansela ekhona
- i-subglottis, esezansi nje kwe-glottis
Indawo yesikhumba ingaveza izimpawu ezehlukene futhi idinga izindlela ezahlukene zokwelashwa.
Izingozi Zezingozi
Nakuba singazi imbangela eqondile yomdlavuza we-laryngeal, siyazi ukuthi yiziphi izinto eziyingozi kakhulu ezivamile. Umdlavuza we-Laryngeal ungenye yezinhlobo eziningi zomdlavuza ohlobene nokubhema .
Nakuba kungenzeka kubantu abangabhemi, ubufakazi bubeke kakhulu ugwayi njengengxenye eyodwa, engozini enkulu yesifo. Ukubhema nokuphuza ngokweqile ukusetshenziswa kwandisa ingozi ngisho nangaphezulu.
Phakathi kwezinye izici eziyinhloko:
- ubudala (45 nangaphezulu)
- ubulili besilisa (ngenxa yezingxenye eziphezulu zokubhema emadodeni)
- umlando womdlavuza wekhanda nentamo (kufaka phakathi ukuvezwa kwekhanda noma imisebe yentamo)
- ukusetshenziswa kotshwala obunzima
- ukutholakala komsebenzi ku-asbestos, amalahle, noma i-formaldehyde
- ukudla okudliwayo enyama kanye / noma inyama enziwe
- izakhi zofuzo nomlando womndeni
- ukuxoshwa kwamagciwane, kuhlanganise nabamukeli begciwane kanye nabantu abane-HIV
- umncintiswano (nabaningi base-Afrika baseMelika basebenzisa umdlavuza womzimba kunabamhlophe)
I-GERD, i-HPV, ne-Laryngeal Cancer Risk
Ezinye izifundo ziye zaxhuma umdlavuza we-laryngeal kuya kwesifo somzimba se-reflux esiswini (GERD) . Ngenkathi inhlangano isabhekwa njengengxabano, ngisho ne-American Cancer Society iye yahlukana nomthelela we-acid ophikisayo we-reflux emdlalweni we-laryngeal.
Ngokufanayo, i- papillomavirus yomuntu (i-HPV) , igciwane elixhunywe ezingaphezu kwamaphesenti angama-95 omdlavuza wesibeletho somlomo womlomo wesibeletho, lingase likhulise ingozi yomdlavuza we-laryngeal. Ngenkathi amanye amaqembu acabanga ukuthi ubungozi buphansi, ezinye izifundo ziye zabonisa ukuthi amaphesenti angu-25 we-laryngeal carcinomas i-HPV ukutheleleka (kuhlanganise nezinhlobo eziphezulu ze-HPV izinhlobo ezingu-16 no-18).
Izimpawu
Esinye sezibonakaliso ezivame kakhulu zomdlavuza we-laryngeal yizwi eliphikisayo lezwi . Ukwesaba okungahambi ngemuva kwamasonto amabili kumele kubikwe kudokotela wakho. Ngenkathi isimo singabangelwa yizinto ezivela emithonjeni yesikhashana kuya kwe-laryngitis, ukuphikelela kokwesaba kufanele kuhlale kukukhathazeka noma yikuphi imbangela.
Ezinye izimpawu zingabandakanya:
- ubunzima bokugwinya (dysphagia)
- ubuhlungu noma ukuvutha uma kugwinya
- ukuzwa kokudla okunamathela emqaleni wakho
- ukukhwehlela okuqhubekayo okungahambisani nokubandayo noma ukungezwani komzimba nokuhlala isikhathi esingaphezu kwamasonto ayisishiyagalombili
- inhlama entanyeni ezungeze ibhokisi lezwi
- Umphimbo obuhlungu
- izindlebe
- ukuchofoza ukudla
- umoya ophikisayo oqhubekayo (halitosis)
- ukulahlekelwa kwesisindo esingenasisekelo samaphesenti angaphezu kwamahlanu phakathi nenyanga eyi-12
Usayizi we-tumor kanye nendawo yizici ezinkulu kakhulu ekunqumeni ukuthi yiziphi izimpawu umuntu angase azizwe. Uma i-tumor iqala ezintanjeni zamagama, ushintsho ngezwi nokuthuthumela luvame.
Uma izicubu zikhula ngenhla noma ngezansi kwezingcingo zamagama, izimpawu ezehlukene ezifana ne-earache noma ubunzima bokuphefumula kungenzeka.
Ukuxilongwa
Umdlavuza we-Laryngeal utholakala ngokuqala ukuhlola ngokomzimba ukuzwa noma yiziphi izimbungulu noma ukungavamile emqaleni. Ukuze uthole ukubukeka okungcono ngaphakathi, udokotela angase ancoma noma engaqondile noma i-laryngoscopy ngqo:
- An I-laryngoscopy engacacile ihilela isilwane esinezinsimbi eside esibukweni esifakwa emlonyeni wakho ukuze sibheke ngokuqondile i-larynx yakho.
- E-laryngoscopy eqondile, i-spray isetshenziselwa kuqala ukuphazamisa umphimbo, emva kwalokho umthamo we-fiberoptic ukondliwe ngaphakathi ukuze ubheke kangcono ngemuva komphimbo wakho, i-larynx, ne-vocal cords. Isampula yamathambo (i-biopsy) ingathathwa uma kukhona okusolisayo.
Amanye amasu okuphenya ahlanganisa ukucabanga kwe-resonance magnetic (MRI), ikhompyutha ye-tomography (CT scan), i-X-ray ye-barium swallow, noma i-positron emission tomography (i-PET scan).
Isiteji
Uma umdlavuza utholakala, udokotela wakho uzohlose ukukhomba ubukhulu nobukhulu bomdlavuza. Lena inqubo ebizwa ngokuthi isiteji. Isiteji somdlavuza we-laryngeal sizosiza ekutholeni indlela yokwelashwa efanele kakhulu kuwe njengomuntu ngamunye.
Odokotela benza lokhu ngokuqala ukusebenzisa uhlelo lwe-TNM. Kulesi simiso:
- I-T imelela isisu futhi imelela usayizi we-tumor yakho kusukela ku-T1 (echaphazela ingxenye encane ye-larynx) eya ku-T4 (isakaza ngaphesheya kwe-larynx).
- I-N imele i- lymph node futhi imele ukuthi umdlavuza ukhona kangakanani emitholampilo yakho evela ku-N0 (akukho mdlavuza) ku-N3 (okusakazeka ngaphesheya kwe-lymph nodes).
- I-M imelela imetastasis futhi imelela ukuthi umdlavuza usakaze kangakanani ( okuhlanganisiwe) ezithombeni ezikude ezivela ku-M0 (akukho metastasis) ukuya ku-M1 (i-metastasis).
Ngokusekelwe kuloluhlolo, umdlavuza wakho uzonikezwa isiteji:
- Isigaba 0 (noma i- carcinoma in situ ) ama-khansela acatshangelwa ukuthi awunasidingo.
- Isigaba Mina ngilamdlavuza akhiwe endaweni eyodwa yomzimba.
- Isigaba sesi-2 yi-khansela esendaweni yangasese kodwa iqhubekile.
- Isigaba sesi-3 ngamagciwane angamakhemikhali abuye asungulwe futhi asuselwe phambili kodwa acatshangelwa ukuthi angathà sina.
- Isigaba sesi-4 yi-kansela eye yasungulwa.
Ukwelapha
Ukwelapha kanye nokwelashwa kwemisebe yindlela ejwayelekile yokwelashwa yomdlavuza we-laryngeal. Lezi zingabandakanya izinqubo ezilandelayo zokuhlinzwa:
- i-laryngectomy yenani, ukususwa kokuhlinzwa kwe-larynx yonke (okungase kumshiye umuntu ongakwazi ukukhuluma ngaphandle kwedivaysi yomshini)
- i-laryngectomy eyingxenye ehilela ukususwa kokuhlinzwa kwendawo ethintekile ye-larynx
- i-laryngectomy ephakeme ehlanganisa ukukhishwa kwe-larynx ngaphansi kwezingcingo zamagama
- i-cordectomy ehilela ukukhishwa kokuhlinzwa komunye noma womabili izintambo zezwi
Ezinye izinqubo zihlanganisa:
- ukwelapha imishanguzo kunikezwa njengokwelashwa okuyisisekelo noma esetshenziswe ngemuva kokuhlinzwa ukuze kuqedwe noma yiliphi ilungu lomdlavuza
- I-lymph node dissection ehilela ukukhishwa kwe-lymph nodes eduze nesayithi le-malignancy
- i-chemotherapy ngokuvamile isetshenziswa njenge-neoadjuvant therapy (yokwehlisa isisu ngaphambi kokuhlinzwa) noma ukwelashwa kwe-adjuvant (ukususa noma yimaphi amangqamuzana omdlavuza ngemva kokuhlinzwa)
Imiphumela ingahluka kusuka komunye nomuntu. Umbuso jikelele wesithupha ungukuthi ngaphambili uthola ukuthi uphathwe futhi uphathwe, amathuba okuba uzoba nokuphulukiswa. Izifo zakuqala zifaka isigaba 1, 2, kanye no-3 kansela.
Izwi elivela
Ukutholwa ukuthi unomdlavuza kungenza impilo yakho igxile ngisho nasesiteji sokuqala sesifo. Cela usizo, futhi uvumele abantu ukukusiza. Finyelela kwabanye. Cabanga ngokujoyina iqembu lokusekela umdlavuza noma ngabe kukhona emphakathini noma ku-intanethi.
Imithi iyashintsha ngokushesha futhi ukuba ummeleli wakho akusizi nje ukuthi uzizwe ukhululekile ekulawuleni, ingakusiza wenze izinqumo ezingcono mayelana nempilo yakho. Lokhu kuhlanganisa izinhlobo zokwelashwa ozikhethayo.
Ukunquma ukuthi ngabe ukuhlinzwa - noma ngisho nokuhlinzwa kwakho - kuyisinqumo somuntu siqu. Ikhwalithi yokuphila ingathinteka, ngakho-ke kubalulekile ukuthi uchithe isikhathi esiningi sokufunda ngesifo sakho nokuthi kwenzekani ukuze uyiphulukise. Into ebaluleke kakhulu ukwenza ukhetho olunolwazi ngokusekelwe ekuqondeni kwakho okungcono kokukhethwa kwakho.
Imithombo
- UBlanchard, P., Volk, R., Ringash, J., Peterson, S., Hutcheson, K., noSper Frank. "Ukuhlola iNhloko Nekhanda Lomkhuhlane Izintandokazi Nokulindela Iziguli: Ukubuyekezwa Okuhlelekile." I-Oral Oncology . 2016. 62: 44-53.
- I-National Cancer Institute. "I-PDQ Cancer Summarie s." I-Laryngeal Cancer Treatment (PDQ): I-Health Professional Version. Bethesda, Maryland: 2002 (ibuyekeziwe ngo-December 2016).
- USalvador-Coloma, uC., NoChohen, E. "Ukunakekelwa Kwamanye Amanxeba I-Laryngeal Cancer". I-Journal ye-Oncology Practice . 2016; 12 (8): 717-24.