Maxillary Antrostomy

Endoscopic Sinus Surgery

Maxillary Antrostomy

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

I-antillastomy yama-Maxillary yinkqubo yokucanda ukwandisa ukuvula (ostium) ye sinus maxillary. Oku kuvumela ukuba kungenelelo olungakumbi lokungenelela ngaphakathi kwinqanaba le-sinilla maxillary kunye nesiphakamiso se-sinus esiphuculweyo. I-antillastomy yama-Maxillary iye yaqhutyelwa ukususela kwiminyaka yee-1980 kwaye iyona ndlela inokwenzeka ukuba inokwenziwa ukuhlinzwa xa unesifo esingapheliyo esingasithobeli kwezinye iindlela zokwelapha.

Kule meko inqubo inxalenye ye- endoscopic sinus ukuhlinzwa othe ukukhetha kwakho okulandelayo. Iingcali zokwelapha eziqhelekileyo ziquka isilingo se-antibiotics (iiveki ezi-3-6), i-nasal steroids, kunye nokunkcenkceshela okunesirini.

Ukuchonga i-Chronic Sinusitis

Ngaphambi kokuba utyunjwa, ugqirha wakho uya kufuna ukuqinisekisa ubungqina obungapheliyo nge-CT scan. I-ray-ray ayifuni rhoqo, njengokuba iyakubonisa kuphela isifo sesono kunye nenkcazelo engaphantsi kweminye imiba ye-sinus. I-CT scan ayiyi kubonisa kuphela ubunzima be-maxillary sinus inflammation, kodwa iya kunika ugqirha wakho ngolunye ulwazi olubalulekileyo:

• Isikhundla sobhenxa obunamala
• uncinate inkqubo - ebalulekileyo inxalenye yenkqubo yokucoca
• ukuqina kweembumba ze-mucus
• emoyeni ngokubhekisele kumanqanaba amanzi kumagumbi e-sinus
• iipolisi
• i-osteomeatal isithintelo esiyinkimbinkimbi - inqanda umkhamo we sinus maxillary

Nangona eli liqela lolwazi lwezonyango lwezobugcisa, yonke le ngcaciso iya kunika ugqirha wakho ngolwazi olufunekayo ukuba lulungiswe kakuhle lwenkqubo yakho yokupasa.

Inkqubo ye-osteomeatal yenziwe ngamanyathelo amane alandelayo:

• uncinate inkqubo - ithambo elingu-L eliya kususwa
• i-maxillary ostium (ukuvulwa kwesono esikhulu se-maxillary)
• kwisiteshi se -fundibulum-curved kwimpumlo
• i-bulmo ye-ethmoid-enye yesono se-ethmoid

Ukulungiselela i-Endoscopic Sinus Surgery kunye ne-Maxillary Antrostomy

Ngaphambi kokuhlinzwa, uya kufundiswa ukuba ungadli nto okanye uyiphuze ukusuka phakathi kobusuku ngosuku lokuhlinzwa kuze kube emva kokuhlinzwa.

Oku kuya kunceda ukukhusela umngcipheko wokubangela isisu sesisu (aspiration). Endaweni yangaphambili, uya kuthi unikwe i- Afrin nasal spray ukuze unqande amaqonga akho omnxeba ukunceda ukwandisa indawo yokubonakala ngexesha lotyando lwakho. Emva kokuba unesicatshulwa, unokuba ne-gauze ene-Afrin okanye i-cocaine yama-topical asetyenziswa ekhaleni lakho ukuze ukhulise ukubonakala xa kuyimfuneko.

Ngexesha le-Maxillary Antrostomy

Kukho iinjongo ezi-3 ogqirha uzakuzama ukuzenza ngexesha le-Antrostomy yama-maxillary

1. Susa inkqubo ye-uncinate
2. Ukufumana ukuvulwa kwemvelo kwi sinus maxillary
3. Ukwandisa ukuvula kwi sinus maxillary
4. Susa ama-polyps ukusuka ngaphakathi kwendawo ye-sinilla maxillary

Kubalulekile ukuba ugqirha wakho asuse inkqubo ye-uncinate ekuqaleni kwenkqubo ukwenzela ukuba ukhangele ngcono indlela yokuvula i-sinus maxillary. Ukuba ukuvula kwesono akukho kunye nokuvula olutsha kudala, unokwenziwa kwakhona kwemithombo ye-sinus, apho umjelo uphuma khona uvula olunye uphinde uphinde ungene ngaphakathi kwithuba lokuvula.

Emva kokuba ne-Antrostomy yama-Maxillary

Emva kokuba utyando lwakho luphelile, uya kuvuka e-unit eh post-anesthesia yonyango (PACU). Kulapho uza kuhlolwa malunga nokuphuma kwegazi, isicupunu (esingenzeka xa igazi ligxinyiwe), okanye ezinye iingxaki ezinokuthi zenziwe kutyando.

Uya kuthi ulandele ugqirha wakho phakathi kweentsuku ezi-3 ukuya kwezi-5 ukuze uphakamise ukupakisha kwakho. Ngokuxhomekeke kwimpumelelo kwaye ukuba unayo impawu ekhoyo, uya kugqiba ukuba unyathelo elongezelelweyo lonyango olwenziwe emva kokuhlinzwa.

Izingozi ezinxulumene noMaxillary Antrostomy

Ngaphandle kweengozi eziqhelekileyo ezinxulumene naluphi na uphando olufuna i-anesthesia jikelele, i-maxillary antrostomy nayo inezinto ezilandelayo zengozi:

• ukulimala kummandla ojikeleze iliso (ukulimala komzimba)
• yimfama
• ukulimala kweengcingo ezingekho phantsi
• i-nosebleed (epistaxis)
• i-cerebrospinal fluid (CSF) i-rhinorrhea
• i-meningitis

Ngaphandle kwimiba ephazamisayo , ubuninzi bezinto ezisemngciphekweni ezidlulileyo ngaphambili aziqabile.

I-antillastomy yama-Maxillary yinto eqhelekileyo, nangona kunjalo, ezi zizinto ezibangelwa umngcipheko. Uninzi lwezi zinto zibhekiselele kwizixhobo zokugqithisa ezisetyenziswe njenge- microdebrider , ekhuselekileyo ngokubanzi kwaye ineenkcenkceshe ezimbalwa. Nangona kunjalo iingozi ezichazwe apha ngasentla zinzima kakhulu, ngoko nceda khawuleza ukhethe i-ENT enekhono ukwenza inkqubo.

_Imithombo:

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

_{Patel, A., Vaughan, WC & Meyers, AD (2015). Ukunyangwa koPhando lwe-Maxillary Sinusitis.}