Ukuqonda iZimpawu kunye Neziphumo zobungozi
Umdlavuza weLaryngeal uhlobo lomhlaza ochaphazela i-larynx, iqumrhu esiyazi ngokubanzi njengebhokisi lezwi. Abangama-13,000 aseMerika bafumaneka ukuba banomdlavuza wonyaka we-laryngeal, oqikelelwa ukuba u-3 500 uya kufa kwesi sifo.
Anatomy
I-larynx iqulethe iintambo ze-vocal kwaye ihlulwe ibe ngamacandelo amathathu:
- i-glottis, i-vocal folds folds, apho iipesenti ezingama-60 ze-khansa zikhula
- i-supraglottis, engasentla kwe-glottis, apho iipesenti ezingama-35 ze-cancer zenzeka
- i-subglottis, ephantsi nje kwe-glottis
Indawo yokuxhamla ingakwazi ukuvelisa iimpawu ezahlukileyo kwaye ifuna iindlela ezahlukeneyo zonyango.
Izinto zobungozi
Ngelixa singayazi isizathu esona sizathu somhlaza we-laryngeal, siyazi ukuba zeziphi izinto eziqhelekileyo zobungozi. Umhlaza weLaryngeal ungomnye weentlobo ezininzi zomdlavuza ohlobene nokutshaya .
Ngoxa kungenzeka kubantu abangabhemi, ubungqina bayibeke ngokugqithiseleyo i-cigarettes njengenye yeyona nto, ingozi enkulu kwisifo. Ukutshaya nokuxilisa utywala kunye kunye nokwandisa ingozi ngakumbi.
Phakathi kwezinye izinto eziphambili:
- ubudala (45 nangaphezulu)
- ngokwesini (ngenxa yenxalenye yamanani aphezulu okutshaya kumadoda)
- imbali yomhlaza nomsi weentamo (kuquka ukuvezwa kwintloko okanye intanyeni yomsindo)
- kutywala utywala
- ukubonakaliswa kwe-asbestos, amalahle okanye i-formaldehyde
- izidlo eziphezulu ekudleni kunye / okanye inyama
- imfuza kunye nembali yentsapho
- ukukhutshwa komzimba, kuquka nabamkeli begciwane kunye nabantu abane-HIV
- umncintiswano (kunye nabanye base-Afrika baseMelika abafumana umdlavuza womdlavuza kunabamhlophe)
I-GERD, i-HPV neLayngeal Cancer Risk
Ezinye iziphumo ziye zaqhakamshelana nomdlavuza we-laryngeal kwisifo se-reflux esiswini (GERD) . Ngoxa i-association isabonwa njengengxabano, i-American Cancer Society iye yahluleka ukuba ifuthe ye-asidi eqhubekayo i-reflux kwi-laryngeal umdlavuza.
Ngokufanayo, i- papillomavirus yabantu (HPV) , intsholongwane ehlanganiswe nama-95 ekhulwini lomhlaza wesibeleko somlomo wesibeleko, inokunyusa umngcipheko wesifo somhlaza. Nangona amanye amaqela ebona ingozi ephantsi, ezinye iingxelo zibonise ukuba ama-25 ekhulwini lwe-laryngeal carcinomas i-HPV isifo sokutheleleka (kuquka i-HPV enobungozi obuphezulu 16 no-18).
Iimpawu
Enye yeempawu eziqhelekileyo zesifo somhlaza we-laryngeal ngumsindo oqhubekayo wezwi . Ukunyamezela okungahambi emva kweveki ezimbini kufuneka kuxelelwe ugqirha wakho. Nangona imeko ingabangelwa yiyiphi into ephuma kwixesha elidlulileyo ukuya kwi-laryngitis, ukuphikelela kokunyuka kufuneka kuhlale kuyinkxalabo nayiphi na isizathu.
Ezinye iimpawu zingabandakanya:
- ubunzima bokugwinya (dysphagia)
- intlungu okanye uvutha xa ugwinya
- ukuvakalelwa kokutya kubanjwe emqaleni wakho
- ukukhwehlela okuqhubekayo okungahambelani nokubandayo okanye ukungabikho komzimba kunye nokuhlala ixesha elingaphezulu kweeveki ezisibhozo
- ihlunu entanyeni ejikeleze ibhokisi lezwi
- umqala obuhkungu
- indlebe
- ukukhahlela ukutya
- ukuphefumula okuqhubekayo (halitosis)
- ukulahlekelwa kwexabiso lokungazinzi ngokungaphantsi kwamaphesenti angamahlanu kwiinyanga ezili-12
Ubunzima bokutya kunye nendawo yimiba emikhulu ekuqaliseni ukuba yimaphi iimpawu umntu anokufumana. Ukuba i-tumor ivela kwiintambo zamagama, utshintsho kwizwi kunye nokutya luqhelekile.
Xa iimvumi zikhula ngaphezulu okanye ngaphantsi kweentambo zezwi, iimpawu ezahlukileyo ezifana ne-earache okanye ubunzima bokuphefumla.
Ukuxilongwa
Umhlaza weLaryngeal ufunyaniswa ngowokuqala uvavanyo lomzimba ukuze uzivelele naziphi na izilwanyana okanye ukungavumeleki emqaleni. Ukuze ufumane iliso elingcono ngaphakathi, ugqirha unokucebisa ukuba ungabonanga ngqo okanye i-laryngoscopy ngqo:
- An i-laryngoscopy engacacanga iquka isixhobo esilula kunye nesibuko esifakelwe emlonyeni wakho ukuze ukhangele ngokungathanga ngqo kwi-larynx yakho.
- Kwi-laryngoscopy ngokuthe ngqo, i-spray isetyenziswe kuqala ukuphazamisa umqala, emva koko umgangatho wefiberoptic ukondliwa ngaphakathi ukuze ukhangele bhetele kwimva yakho, i-larynx kunye neentambo zezwi. Isampuli yesishu (i-biopsy) inokuthathwa ukuba kukho nayiphi na isityholo.
Ezinye iindlela zokuphanda zibandakanya ukucatshulwa kwamagontic magnetic (MRI), ikhompyutha ye-tomography (CT scan), i-X-ray ibhonum swallow, okanye i-postitron emission tomography (i-PET scan).
Ukucwangcisa
Ukuba umhlaza ufunyenwe, ugqirha wakho uya kujolisa ukuchonga ubungakanani kunye nobukhulu bomhlaza. Le yinkqubo ebizwa ngokuba yi-stage. Isigaba somdlavuza we-laryngeal siya kuncedisa indlela yokwenza unyango olufanelekileyo kakhulu kuwe njengomntu.
Oogqirha benza oku kuqala ngokusebenzisa uhlelo lwe-TNM. Kule nkqubo:
- T imela i-tumor kwaye ibonisa ubukhulu be-tumor yakho ukusuka kwi-T1 (echaphazela inxalenye encinci ye-larynx) ukuya kwi-T4 (isasazeka ngaphaya kwe-larynx).
- I-N imele i- lymph node kwaye imele ukuba umhlaza unjani kwi-lymph nodes zakho ezivela kwi-N0 (akukho mhlaza) ukuya ku-N3 (ukusasazeka ngaphaya kwee-lymph nodes).
- M imelela i-metastasis kwaye ibonisa ukuba umhlaza usasazeke kangakanani (ukulungiswa kwemitha) kwizitho ezikude ezivela kuM0 (akukho metastasis) ukuya kwi-M1 (i-metastasis).
Ngokusekelwe kulo vavanyo, umhlaza wakho uza kunikwa isigaba:
- Isigaba se-0 (okanye i- carcinoma in situ ) iisifo somdlavuza zibhekiselwe kungekhona.
- Isigaba mna ngamanomdla angama-cancer atholakala kwicandelo elinye lomzimba.
- Isigaba sesi-2 sinomdlavuza ongasemaphandleni kodwa ephakamileyo.
- Isigaba sesi-3 sinomdlavuza oye wakhiwe kwaye uphambili kodwa ucinga ngakumbi.
- Isigaba sesi-4 sisifo somdlavuza oye waqulunqa.
Unyango
Ugqirha kunye nonyango lwe-radiation yiendlela eziqhelekileyo zonyango lomhlaza wesilaryal. Ezi ziquka ukulandelelaniswa kwezi zilandelayo:
- i-laryngectomy epheleleyo, ukususwa kokukhishwa kwe-larynx yonke (engayishiya loo mntu akakwazi ukuthetha ngaphandle kweso sixhobo)
- i-laryngectomy ekhethekileyo equka ukususwa kokutyalwa kwendawo echaphazelekayo ye-larynx
- i-laryngectomy ephakamileyo ebonisa ukukhishwa kwe-larynx phantsi kweentambo zezwi
- i-cordectomy equka ukususwa kocwangco komnye okanye zombini lweentambo zezwi
Ezinye iinkqubo ziquka:
- unyango lwe-radiation lunikezelwa njengonyango lokuqala okanye lisetyenziswe emva kokuhlinzwa ukuze kususwe nayiphi na iseli yomhlaza
- i-lymph node dissection echaphazelekayo yokukhupha i-lymph nodes kufuphi nesiza sobuhlungu
- i-chemotherapy esetyenziswa ngokuqhelekileyo njengonyango lwe-neoadjuvant (ukuhlahlela isisu phambi kokuhlinzwa) okanye unyango olusisigxina (ukucima nayiphi na iseli yomhlaza emva kokuhlinzwa)
Iziphumo zingahluka kumntu kumntu. Umgaqo jikelele wesohlwayo kukuba ngaphambili ufunyaniswe kwaye uphathwe, ithuba elikhulu oya kuba nalo lokuphiliswa. Izifo zokuqala ziquka izigaba zesigaba 1, 2, kunye ne-3.
ILizwi
Ukufumanisa ukuba unomdlavuza kunokuguqula ubomi bakho kwiindawo zokuqala zesifo. Cela uncedo, kwaye uvumele abantu ukuba bancede. Finyelela kwabanye. Cinga ukujoyina iqela lokuxhaswa ngumdla nokuba ngaba liziko loluntu okanye kwi-intanethi.
Utshintsho olutshintsha ngokukhawuleza kwaye ube ngummeli wakho akusikuncedi nje ukuba uzive ngakumbi ekulawuleni, kunokukunceda wenze izigqibo ezingcono malunga nempilo yakho. Oku kubandakanya iintlobo zokonyango ozikhethayo.
Ukugqiba ukuba ngaba utyando - okanye nokuba ubukhulu bonyango lwakho - lukhetho olukhethekileyo. Umgangatho wobomi unokuchaphazeleka, ngoko kubalulekile ukuchitha ixesha elininzi lokufunda ngesifo sakho kwaye kuthatha ntoni ukunyanga. Into ebalulekileyo kukuba wenze ukhetho oluchanekileyo ngokusekelwe ekuqondeni kwakho konke okukhethwa kukho.
Imithombo
- Blanchard, P., Volk, R., Ringash, J., Peterson, S., Hutcheson, K., noS. Frank. "UkuHlola iNtloko kunye neNtsholongwane yeNeck Iimfuno zokuLandelwa kweMonde kunye nokuLindela: UkuHlola okuHlolo." Onalology Oral . 2016. 62: 44-53.
- National Cancer Institute. "I-PDQ yengxelo yeCanscer Summarie s." I-Laryngeal Cancer Treatment (PDQ): i-Health Professional Version. IBethesda, eMarikana: 2002 (ihlaziywe ngoDisemba 2016).
- USalvador-Coloma, C., kunye neChohen, E. "Ukunyamekela kweMithinja yeLaryngeal." I-Journal ye-Oncology Practice . 2016; 12 (8): 717-24.