Choanal atresia

Choanal atresia ndikuchepa kapena kutsekeka kwa njira yammphuno ndi minofu. Ndi chikhalidwe chobadwa nacho, kutanthauza kuti chimakhalapo pakubadwa.

Zomwe zimayambitsa choanal atresia sizikudziwika. Amaganiziridwa kuti zimachitika pomwe minofu yopyapyala yolekanitsa mphuno ndi pakamwa panthawi ya kukula kwa mwana imakhala itabadwa.

Vutoli ndilopunduka kwambiri m'mphuno mwa makanda akhanda. Akazi amakhala ndi vutoli kawiri kuposa amuna. Oposa theka la makanda okhudzidwa amakhalanso ndi mavuto ena obadwa nawo.

Choanal atresia nthawi zambiri amapezeka atangobadwa kumene mwanayo akadali mchipatala.

Ana ongobadwa kumene amakonda kupuma kudzera m'mphuno. Nthawi zambiri, makanda amangopuma mkamwa mwawo akalira. Ana omwe ali ndi choipa atresia amavutika kupuma pokhapokha atalira.

Choanal atresia imatha kukhudza mbali imodzi kapena mbali zonse ziwiri za njira yampweya. Choanal atresia yotsekereza mbali zonse ziwiri za mphuno imayambitsa kupuma kwamphamvu ndi kutulutsa kwaminyewa kwam'madzi ndikupumira. Makanda oterewa angafunike kuwatsitsimutsa akabereka. Oposa theka la ana ali ndi chotchinga mbali imodzi yokha, zomwe zimayambitsa mavuto ochepa.

Zizindikiro zake ndi izi:

• Chifuwa chimabwerera m'mbuyo pokhapokha mwana akapuma pakamwa kapena kulira.
• Kuvuta kupuma pambuyo pobadwa, komwe kumatha kubweretsa cyanosis (bluish discoloration), pokhapokha khanda likulira.
• Kulephera kuyamwitsa ndi kupuma nthawi yomweyo.
• Kulephera kupititsa catheter mbali zonse za mphuno mpaka pakhosi.
• Kulimbikira kutseka kwammphuno kwammbali imodzi kapena kutulutsa.

Kuyezetsa thupi kumatha kuwonetsa kutsekeka kwa mphuno.

Mayeso omwe angachitike ndi awa:

• Kujambula kwa CT
• Endoscopy mphuno
• X-ray ya sinus

Chodetsa nkhaŵa kwambiri ndikutsitsimutsa mwanayo ngati kuli kofunikira. Njira yapaulendo imafunika kuyikidwa kuti khanda lipume. Nthawi zina, intubation kapena tracheostomy imafunikira.

Khanda limatha kuphunzira kupuma pakamwa, zomwe zimachedwetsa kufunika kochitidwa opaleshoni yomweyo.

Opaleshoni yochotsa chotchinga imachiza vutoli. Kuchita opaleshoni kungachedwe ngati khanda likulekerera kupuma pakamwa. Kuchita opaleshoniyo kumatha kupangidwa kudzera m'mphuno (transnasal) kapena pakamwa (kusintha).

Kuchira kwathunthu kumayembekezeredwa.

Mavuto omwe angakhalepo ndi awa:

• Kutentha pamene mukudyetsa ndikuyesera kupuma kudzera pakamwa
• Kumangidwa kupuma
• Kukonzanso malowa atachitidwa opaleshoni

Choanal atresia, makamaka ikakhudza mbali zonse ziwiri, imapezeka pambuyo pobadwa mwana akadali mchipatala. Atresia yokhala mbali imodzi siyingayambitse zizindikiro, ndipo khanda limatha kutumizidwa kunyumba osazindikira.

Ngati khanda lanu lili ndi mavuto aliwonse omwe atchulidwa pano, funsani omwe akukuthandizani. Mwanayo angafunikire kufufuzidwa ndi khutu, mphuno, ndi mmero (ENT) katswiri.

Palibe njira yodziwika yopewera.

Elluru RG. Kobadwa nako malformations mphuno ndi nasopharynx. Mu: Flint PW, Haughey BH, Lund V, et al, olemba. Cummings Otolaryngology: Opaleshoni ya Mutu ndi Khosi. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2015: mutu 189.

Haddad J, Dodhia SN. Kobadwa nako matenda a mphuno. Mu: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 404.

Otteson TD, Wang T. Zilonda zapamtunda zapamtunda zomwe zili pafupi. Mu: Martin RJ, Fanaroff AA, Walsh MC, olemba., Eds. Fanaroff ndi Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 68.