I-Uvulopalatopharyngoplasty (UPPP)

I-Uvulopalatopharyngoplasty (UPPP) ukuhlinzwa ukuvula imigwaqo yomoya engenhla ngokukhipha izicubu ezingeziwe emphinjeni. Kungenziwa ukwelapha ukuphefumula okuncane okuvimbela ukulala (OSA) noma ukugoqa okunzima.

I-UPPP isusa izicubu ezithambile ngemuva komphimbo. Lokhu kufaka:

• Konke noma ingxenye ye-uvula (ichopho elithambile lezicubu elenga emuva emlonyeni).
• Izingxenye zolwanga oluthambile nezicubu ezisezinhlangothini zomphimbo.
• Amathani kanye nama-adenoids, uma asekhona.

Udokotela wakho angancoma lokhu kuhlinzwa uma une-apnea yokulala ephazamisayo (OSA).

• Zama izinguquko zokuphila kuqala, njengokuncipha noma ukushintsha isimo sakho sokulala.
• Iningi lochwepheshe lincoma ukuzama ukusebenzisa i-CPAP, imichilo yokwandisa impumulo, noma ithuluzi lomlomo ukuphatha i-OSA kuqala.

Udokotela wakho angancoma lokhu kuhlinzwa ukuze welaphe ukugoba okunzima, noma ngabe ungenayo i-OSA. Ngaphambi kokuthi uthathe isinqumo ngalokhu kuhlinzwa:

• Bona ukuthi ukuncipha kwesisindo kuyakusiza yini ukuhona.
• Cabanga ukuthi kubaluleke kangakanani kuwe ukuphatha ukuhosha. Ukuhlinzwa akusebenzi kuwo wonke umuntu.
• Qiniseka ukuthi umshwalense wakho uzokukhokhela lokhu kuhlinzwa. Uma ungenayo i-OSA, umshwalense wakho kungenzeka ungakufihli ukuhlinzwa.

Kwesinye isikhathi, i-UPPP yenziwa kanye nokunye ukuhlinzwa okuthe xaxa ukuphatha i-OSA enzima kakhulu.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini noma ezinkingeni zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi zalokhu kuhlinzwa yilezi:

• Ukulimala kwezicubu zomphimbo nolwanga oluthambile. Ungaba nezinkinga ezithile zokugcina uketshezi ukuthi lungangeni ngamakhala akho lapho uphuza (okubizwa ngokuthi ukungasebenzi kahle kwe-velopharyngeal). Imvamisa, lokhu kungumphumela wecala wesikhashana.
• Isimungulu emphinjeni.
• Ukushintsha kwenkulumo.
• Ukuphela kwamanzi emzimbeni.

Qiniseka ukuthi utshela udokotela noma umhlengikazi wakho:

• Uma ukhulelwe noma ungakhulelwa
• Yiziphi izidakamizwa ozisebenzisayo, kufaka phakathi izidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela
• Uma uphuze utshwala obuningi, uphuza iziphuzo ezingaphezu kwezingu-1 noma ezi-2 ngosuku

Phakathi nezinsuku ngaphambi kokuhlinzwa:

• Ungacelwa ukuthi uyeke ukuthatha izinciphisi zegazi njenge-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Buza udokotela wakho ukuthi yimiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.
• Uma ubhema, zama ukuyeka. Ukubhema kunganciphisa ukwelashwa. Cela umhlinzeki wakho akusize uyeke.
• Vumela umhlinzeki wakho azi nganoma yikuphi ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ongaba nakho ngaphambi kokuhlinzwa kwakho. Uma ugula, ukuhlinzwa kwakho kungadinga ukuhlehliswa.

Ngosuku lokuhlinzwa:

• Cishe uzocelwa ukuthi ungaphuzi noma ungadli lutho amahora amaningi ngaphambi kokuhlinzwa.
• Thatha noma imiphi imishanguzo udokotela wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Landela imiyalo yokuthi uzofika nini esibhedlela. Qiniseka ukuthi ufika ngesikhathi.

Lokhu kuhlinzwa kaningi kudinga ukuhlala esibhedlela ubusuku bonke ukuqinisekisa ukuthi uyakwazi ukugwinya. Ukuhlinzwa kwe-UPPP kungaba buhlungu futhi ukutakula ngokugcwele kuthatha amasonto amabili noma amathathu.

• Umphimbo wakho uzoba buhlungu kakhulu kuze kube amasonto ambalwa. Uzothola imithi yezinhlungu eziwuketshezi ukunciphisa ubuhlungu.
• Ungase ube nemithungo ngemuva komphimbo wakho. Lokhu kuzoncibilika noma udokotela wakho azokususa ekuhambeleni kokuqala kokulandela.
• Yidla ukudla okuthambile noketshezi kuphela emavikini amabili okuqala ngemuva kokuhlinzwa. Gwema ukudla okunoshukela noma ukudla okunzima ukuhlafuna.
• Uzodinga ukugeza umlomo wakho ngemuva kokudla ngesisombululo samanzi anosawoti ezinsukwini zokuqala eziyi-7 kuya kwezingu-10.
• Gwema ukuphakamisa okunzima noma ukuhlunga amasonto amabili okuqala. Ungahamba futhi wenze umsebenzi olula ngemuva kwamahora angama-24.
• Uzoba nokuhambela okulandelayo nodokotela wakho amasonto ama-2 noma ama-3 ngemuva kokuhlinzwa.

I-apnea yokulala iba ngcono ekuqaleni kwengxenye yabantu abathola lokhu kuhlinzwa. Ngokuhamba kwesikhathi, inzuzo iyaphela kubantu abaningi.

Olunye ucwaningo lukhombisa ukuthi ukuhlinzwa kulungele kuphela abantu abanokukhubazeka kulwanga oluthambile.

Ukuhlinzwa kolwanga; Inqubo ye-UVulopalatal flap; UPPP; I-uvulopalaplasty esizwa nge-Laser; Radiofrequency palatoplasty; Ukwehluleka kweVelopharyngeal - UPPP; Ukuvimbela ukuphefumula kokulala - uvulopalaplasty; I-OSA - uvulopalaplasty

I-Katsantonis GP. I-uvulopalatopharyngoplasty yakudala. Ku: Friedman M, Jacobowitz O, ama-eds. Lala Umoya Wokulala Ne-Snoring. Okwesibili. IPhiladelphia, PA: Elsevier; 2020: isahluko 32.

I-Qaseem A, Ubungcwele JE, i-Owens DK, et al; Ikomidi Lezinkombandlela Zomtholampilo E-American College of Physicians. Ukuphathwa kwe-apnea yokulala evimbelayo kubantu abadala: umhlahlandlela wokusebenza ngokwelashwa ovela e-American College of Physicians. U-Ann Intern Med. 2013; 159 (7): 471-483. PMID: 24061345 www.ncbi.nlm.nih.gov/pubmed/24061345.

I-Wakefield TL, uLam DJ, u-Ishman SL. I-apnea yokulala nokuphazamiseka kokulala. 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 18.