Acoustic neuroma

Acoustic neuroma ndi chotupa chokula pang'onopang'ono cha mitsempha chomwe chimalumikiza khutu ndi ubongo. Mitsempha imeneyi imatchedwa mitsempha ya vestibular cochlear. Ndi kuseli kwa khutu, pansi pa ubongo.

Acoustic neuroma ndiyabwino. Izi zikutanthauza kuti sichifalikira mbali zina za thupi. Komabe, imatha kuwononga mitsempha ingapo yofunikira ikamakula.

Acoustic neuromas adalumikizidwa ndi matenda amtundu wa neurofibromatosis mtundu wa 2 (NF2).

Acoustic neuromas siachilendo.

Zizindikiro zimasiyanasiyana, kutengera kukula ndi malo a chotupacho. Chifukwa chotupacho chimakula pang'onopang'ono, zizindikiro zimayamba pambuyo pa zaka 30.

Zizindikiro zodziwika ndizo:

• Kumverera kwachilendo (vertigo)
• Kumva kutayika khutu lomwe lakhudzidwa lomwe limapangitsa kuti zikhale zovuta kumva zokambirana
• Kulira (tinnitus) mu khutu lomwe lakhudzidwa

Zizindikiro zochepa zimaphatikizapo:

• Kuvuta kumvetsetsa mawu
• Chizungulire
• Mutu
• Kutaya malire
• Dzanzi pankhope kapena khutu limodzi
• Kupweteka kumaso kapena khutu limodzi
• Kufooka kwa nkhope kapena nkhope asymmetry

Wothandizira zaumoyo atha kukayikira acoustic neuroma kutengera mbiri yanu yazachipatala, kuyesa kwamanjenje anu, kapena mayeso.

Kawirikawiri, kuyezetsa thupi kumakhala kachilendo pamene chotupacho chimapezeka. Nthawi zina, zizindikilo zotsatirazi zitha kupezeka:

• Kuchepetsa kumverera mbali imodzi ya nkhope
• Kutsamira mbali imodzi ya nkhope
• Kuyenda mosakhazikika

Chiyeso chothandiza kwambiri kuzindikira neuroustic neuroma ndi MRI yaubongo. Mayesero ena oti azindikire chotupacho ndikudziwitsa kupatula pazomwe zimayambitsa chizungulire kapena chizungulire ndi awa:

• Kuyesedwa kwakumva
• Kuyesedwa kwa kufanana ndi kulingalira (electronystagmography)
• Kuyesedwa kwakumva ndi magwiridwe antchito a ubongo (kuyankha kwamaubongo komwe kumatulutsidwa)

Chithandizo chimadalira kukula ndi malo okhala chotupacho, msinkhu wanu, ndi thanzi lanu lonse. Inu ndi omwe akukuthandizani muyenera kusankha ngati mungayang'anire chotupacho popanda chithandizo, gwiritsani ntchito radiation kuti ileke kukula, kapena kuyesa kuchichotsa.

Matenda ambiri acoustic neuromas ndi ochepa ndipo amakula pang'onopang'ono. Zotupa zazing'ono zomwe zimakhala ndi zochepa kapena zosawoneka zimatha kuwonedwa ngati zasintha, makamaka kwa okalamba. Kujambula pafupipafupi kwa MRI kudzachitika.

Ngati sanalandire chithandizo, ma neuromas ena omvera amatha:

• Kuwononga mitsempha yokhudzidwa ndi kumva
• Ikani kupanikizika kwa minofu yapafupi yaubongo
• Sokonezani mitsempha yomwe imayambitsa kuyenda ndikumverera pamaso
• Zitsogolereni ku kuchuluka kwa madzimadzi (hydrocephalus) muubongo (wokhala ndi zotupa zazikulu kwambiri)

Kuchotsa minyewa yama acoustic kumachitika nthawi zambiri ku:

• Zotupa zazikulu
• Zotupa zomwe zimayambitsa zizindikilo
• Zotupa zomwe zikukula msanga
• Zotupa zomwe zikukanikiza ubongo

Opaleshoni kapena mtundu wa mankhwala a radiation amachitika kuti achotse chotupacho komanso kupewa kuwonongeka kwamitsempha ina. Kutengera mtundu wa opareshoni yochitidwa, nthawi zina kumva kumatha kusungidwa.

• Njira yochitira opaleshoni yochotsa minyewa yotchedwa acoustic neuroma imatchedwa microsurgery. Ma microscope apadera ndi zing'onozing'ono, zida zenizeni zimagwiritsidwa ntchito. Njira imeneyi imapereka mpata waukulu wochira.
• Ma radiosurgery a stereotactic amayang'ana kwambiri ma x-ray pamalo ochepa. Ndi njira yothandizira poizoniyu, osati opaleshoni. Itha kugwiritsidwa ntchito pochepetsa kapena kuletsa kukula kwa zotupa zomwe ndizovuta kuzichotsa ndi opaleshoni. Zitha kuchitidwanso kuti zithandizire anthu omwe sangathe kuchitidwa opaleshoni, monga achikulire kapena anthu omwe akudwala kwambiri.

Kuchotsa minyewa yaphokoso kumatha kuwononga mitsempha. Izi zitha kupangitsa kuti asamve kapena kufooka m'minyewa yamaso. Kuwonongeka uku kumatha kuchitika chotupacho chikakhala chachikulu.

Acoustic neuroma si khansa. Chotupacho sichimafalikira mbali zina za thupi. Komabe, imatha kupitilirabe kukula ndikusindikiza pamakonzedwe amutu.

Anthu omwe ali ndi zotupa zazing'ono zomwe zikuchedwa kuchepa sangasowe chithandizo.

Kumva kutayika komwe kulipo asanalandire chithandizo sikungabwerere pambuyo pa opaleshoni kapena ma radiosurgery. Pakakhala zotupa zing'onozing'ono, kumva kwakumva komwe kumachitika pambuyo pa opaleshoni kumatha kubwerera.

Anthu ambiri omwe ali ndi zotupa zazing'ono sadzakhala ndi kufooka kosatha kwa nkhope atachitidwa opaleshoni. Komabe, anthu omwe ali ndi zotupa zazikulu amakhala ndi kufooka kosatha kwa nkhope atachitidwa opaleshoni.

Zizindikiro za kuwonongeka kwa mitsempha monga kutayika kwakumva kapena kufooka kwa nkhope kumatha kuchedwa pambuyo pa ma radiosurgery.

Nthawi zambiri, opaleshoni yaubongo imatha kuchotsa chotupacho.

Itanani omwe akukuthandizani ngati muli ndi:

• Kutaya kwakumva komwe kumadzidzimuka kapena kukuipiraipira
• Kulira khutu limodzi
• Chizungulire (vertigo)

Vestibular schwannoma; Chotupa - lamayimbidwe; Cerebellopontine ngodya chotupa; Chotupa cha ngodya; Kutaya kwakumva - kwamayimbidwe; Tinnitus - lamayimbidwe

• Opaleshoni ya ubongo - kutulutsa
• Ma stereosactic radiosurgery - kutulutsa

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Arriaga MA, Brackmann DE. Mitsempha ya posterior fossa. Mu: Flint PW, Francis HW, Haughey BH, et al, olemba. Cummings Otolaryngology: Opaleshoni ya Mutu ndi Khosi. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2021: chap 179.

DeAngelis LM. Zotupa zamkati wamanjenje. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 180.

Wang X, Mack SC, Taylor MD. Chibadwa cha zotupa zamaubongo a ana. Mu: Winn HR, mkonzi. Opaleshoni ya Youmans ndi Winn Neurological. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 205.