I-Choanal atresia

I-Choanal atresia ukuncipha noma ukuvinjelwa kwendlela yomoya ngamakhala ngezicubu. Kuyisimo sokuzalwa, okusho ukuthi sikhona ngesikhathi sokuzalwa.

Imbangela ye-choanal atresia ayaziwa. Kucatshangwa ukuthi kwenzeka lapho izicubu ezincane ezihlukanisa indawo yekhala nomlomo ngesikhathi sokukhula kombungu zihlala ngemuva kokuzalwa.

Isimo yisona sifo esivamile kakhulu samakhala ezinganeni ezisanda kuzalwa. Abesifazane bathola lesi simo cishe ngokuphindwe kabili kunabesilisa. Izinsana ezingaphezu kwesigamu ezithintekile nazo zinezinye izinkinga zokuzalwa.

I-choanal atresia ivame ukutholakala ngemuva nje kokuzalwa ngenkathi ingane isesibhedlela.

Izinsana ngokuvamile zikhetha ukuphefumula ngamakhala abo. Imvamisa, izinsana ziphefumula ngemilomo yazo lapho zikhala. Izingane ezine-atresia ekhethiwe zinobunzima bokuphefumula ngaphandle kokuthi zikhale.

I-choanal atresia ingathinta uhlangothi olulodwa noma zombili zomgudu womoya wamakhala. I-Choanal atresia evimba izinhlangothi zombili zempumulo idala izinkinga zokuphefumula ezinzima ngokushintshwa kombala okuluhlaza nokwehluleka ukuphefumula. Izinsana ezinjalo zingadinga ukuvuselelwa lapho zilethwa. Ingaphezu kwengxenye eyodwa yezinsana zivinjelwe ohlangothini olulodwa kuphela, okudala izinkinga ezingaphansi kakhulu.

Izimpawu zifaka:

• Isifuba sihlehla ngaphandle kokuthi ingane iphefumula ngomlomo noma ikhala.
• Kunzima ukuphefumula ngemuva kokuzalwa, okungaholela ku-cyanosis (ukushintsha kombala okuluhlaza okwesibhakabhaka), ngaphandle kwalapho usana likhala.
• Ukungakwazi ukuncelisa nokuphefumula ngasikhathi sinye.
• Ukungakwazi ukudlulisa ipayipi ngaphesheya kohlangothi ngalunye lwekhala uye emphinjeni.
• Ukuvinjelwa kwamakhala okucindezelayo noma okukodwa okuqhubekayo.

Ukuhlolwa komzimba kungakhombisa ukuvinjelwa kwekhala.

Ukuhlolwa okungenziwa kufaka phakathi:

• Iskena se-CT
• I-endoscopy yekhala
• I-x-ray yesinus

Okukhathaza ngokushesha ukuvusa ingane uma kunesidingo. Kungadinga ukuthi kubekwe indlela yezindiza ukuze ingane iphefumule. Kwezinye izimo, i-intubation noma i-tracheostomy ingadingeka.

Usana lungafunda ukuphefumula ngomlomo, okungabambezela isidingo sokuhlinzwa ngokushesha.

Ukuhlinzwa ukususa ukuvimba kuyelapha inkinga. Ukuhlinzwa kungabambezeleka uma usana lukwazi ukubekezelela ukuphefumula ngomlomo. Ukuhlinzwa kungenziwa ngamakhala (transnasal) noma ngomlomo (okusobala).

Kulindeleke ukululama ngokugcwele.

Izinkinga ezingaba khona zifaka:

• Ukuphefumula ngenkathi usondla futhi uzama ukuphefumula ngomlomo
• Ukuboshwa ngokuphefumula
• Ukuqanjwa kabusha kwendawo ngemuva kokuhlinzwa

I-Choanal atresia, ikakhulukazi uma ithinta izinhlangothi zombili, ivame ukutholakala ngemuva nje kokuzalwa ngenkathi ingane isesibhedlela. I-atresia eseceleni elilodwa kungenzeka ingazibangeli izimpawu, kanti usana lungathunyelwa ekhaya ngaphandle kokuxilongwa.

Uma usana lwakho lunenkinga ethile ebhalwe lapha, thintana nomhlinzeki wakho wezokunakekelwa kwempilo. Ingane ingadinga ukuhlolwa ngudokotela, ikhala, nomphimbo (ENT).

Akukho ukuvimbela okwaziwayo.

U-Elluru RG. Ukukhubazeka okuzelwe ekhaleni nasopharynx. Ku: Flint PW, Haughey BH, Lund V, et al, ama-eds. I-Cummings Otolaryngology: Ukuhlinzwa Kwekhanda Nentamo. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 189.

UHaddad J, uDodhia SN. Izinkinga zokuzalwa zekhala. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 404.

I-Otteson TD, i-Wang T. Izilonda zomgwaqo ezingenhla ku-neonate. Ku: Martin RJ, Fanaroff AA, Walsh MC, ama-eds. UFanaroff kanye neMithi kaMartin's Neonatal-Perinatal Medicine. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 68.