Laryngomalacia

-Delile

• Ukubuka konke
• Ziyini izimpawu ze-laryngomalacia?
• Yini ebangela i-laryngomalacia?
• Itholakala kanjani i-laryngomalacia?
• Yelashwa kanjani i-laryngomalacia?
• Izinguquko ongazenza ekhaya
• Kungavinjelwa?
• Uyini umbono?

Ukubuka konke

ILaryngomalacia yisimo esivame kakhulu ezinganeni ezisencane. Kuyinto engavamile lapho izicubu ezingenhla nje kwezintambo zezwi zithambe ngokukhethekile. Lokhu kuthambeka kubangela ukuthi iphaphalaze iye ku-airway lapho idonsa umoya. Lokhu kungadala ukuvinjelwa okuyingxenye kwendlela yomoya, okuholele ekuphefumuleni okunomsindo, ikakhulukazi lapho ingane isemhlane.

Izintambo zomlomo ziyisigaxa semphimbo, esaziwa nangokuthi ibhokisi lezwi. Umphimbo uvumela umoya ukuba ungene emaphashini, futhi usiza nokwenza imisindo yezwi.I-larynx iqukethe i-epiglottis, esebenza nayo yonke i-larynx ukugcina ukudla noma iziphuzo zingangeni emaphashini.

ILaryngomalacia yisimo sokuzalwa, okusho ukuthi yinto izingane ezizalwa nazo, kunesimo noma isifo esiqala kamuva. Cishe amaphesenti angama-90 wamacala e-laryngomalacia axazululwa ngaphandle kokwelapha. Kepha kwezinye izingane, imithi noma ukuhlinzwa kungadingeka.

Ziyini izimpawu ze-laryngomalacia?

Uphawu oluyinhloko lwe-laryngomalacia ukuphefumula okunomsindo, okwaziwa nangokuthi i-stridor. Ngumsindo ophakeme ozwakalayo lapho ingane yakho idonsa umoya. Enganeni ezalwe ine-laryngomalacia, i-stridor ingabonakala lapho izalwa. Ngokwesilinganiso, isimo siqala ukuvela lapho izingane zinamasonto amabili ubudala. Inkinga ingase ibe yimbi lapho ingane isemhlane noma lapho icasukile futhi ikhala. Ukuphefumula okunomsindo kuvame ukuba phezulu ezinyangeni ezimbalwa zokuqala ngemuva kokuzalwa. Izingane ezine-laryngomalacia nazo zingadonsela entanyeni noma esifubeni lapho zihogela (okubizwa ngokuthi ukuhlehla).

Isimo esivamile esihambisanayo yi-gastroesophageal reflux disorder (GERD), engadala ukucindezeleka okukhulu kwengane encane. I-GERD, engathinta noma ngubani kunoma yisiphi isikhathi, yenzeka lapho i-digestive acid inyuka isuka esiswini iye esiswini ebanga ubuhlungu. Umuzwa ovuthayo, ocasulayo waziwa kakhulu njengesilungulela. I-GERD ingadala ukuthi ingane iphinde ibuye futhi ihlanze futhi iba nenkinga yokuthola isisindo.

Ezinye izimpawu ze-laryngomalacia ezinzima kakhulu zifaka:

• ubunzima bokudla noma ubuhlengikazi
• ukuzuza kancane, noma ukwehla kwesisindo
• ukuklinya lapho ugwinya
• ukufisa (lapho ukudla noma uketshezi kungena emaphashini)
• ukuhlaba ikhefu ngenkathi uphefumula, okwaziwa nangokuthi i-apnea
• ukushintsha okwesibhakabhaka, noma i-cyanosis (okubangelwa amazinga e-oxygen aphansi egazini)

Uma ubona izimpawu ze-cyanosis noma uma ingane yakho iyeka ukuphefumula isikhathi esingaphezu kwamasekhondi ayi-10 ngesikhathi, iya esibhedlela ngokushesha. Futhi, uma ubona ingane yakho ihlupha ukuphefumula - ngokwesibonelo, idonsa esifubeni nasentanyeni - phatha lesi simo njengesiphuthumayo futhi uthole usizo. Uma ezinye izimpawu zikhona, yenza i-aphoyintimenti nodokotela wezingane wengane yakho.

Yini ebangela i-laryngomalacia?

Akucaci kahle ukuthi kungani ezinye izingane ziba ne-laryngomalacia. Isimo sicatshangwa njengokuthuthuka okungajwayelekile kwe-cartilage ye-larynx noma enye ingxenye yebhokisi lezwi. Lokho kungaba umphumela wesimo sezinzwa esithinta izinzwa zezintambo zezwi. Uma i-GERD ikhona, ingenza ukuphefumula okunomsindo kwe-laryngomalacia kube kubi kakhulu.

ILaryngomalacia ingaba yisici esizuzwe njengefa, noma kunjalo ubufakazi abunamandla ngale mbono. I-Laryngomalacia kwesinye isikhathi ihlotshaniswa nezimo ezithile ezizuzwe njengefa, njenge-gonadal dysgenesis ne-Costello syndrome, phakathi kwabanye. Kodwa-ke, amalungu omndeni ane-syndrome ethile akudingeki abe nezimpawu ezifanayo, futhi futhi awanawo wonke ama-laryngomalacia.

Itholakala kanjani i-laryngomalacia?

Ukukhomba izimpawu, njenge-stridor, nokubona ukuthi zenzeka nini kungasiza udokotela wengane yakho ukuthi enze ukuxilongwa. Ezimweni ezimnene, ukuhlolwa nokulandelwa okusondele kungaba yikho konke okudingekayo. Ezinganeni ezinezimpawu eziningi, ukuhlolwa okuthile kungadingeka ukukhomba ngokusemthethweni isimo.

Isivivinyo esiyinhloko se-laryngomalacia yi-nasopharyngolaryngoscopy (NPL). I-NPL isebenzisa ububanzi obuncane kakhulu obufakwe ikhamera encane. Ububanzi buqondiswa ngobumnene phansi kwelinye lamakhala engane yakho emphinjeni. Udokotela angabheka kahle impilo nokwakheka komphimbo.

Uma ingane yakho ibonakala ine-laryngomalacia, udokotela anga-oda ezinye izivivinyo, ezinjenge-X-ray entanyeni nasesifubeni nolunye uvivinyo olusebenzisa isilinganiso esincanyana, esikhanyisiwe, esibizwa nge-airway fluoroscopy. Olunye uvivinyo, olubizwa ngokuthi yi-functional endoscopic assessment of swallow (FEES), kwesinye isikhathi lwenziwa uma kunezinkinga ezinkulu zokugwinya kanye nesifiso.

I-Laryngomalacia ingatholakala ukuthi imnene, ilingene noma inzima. Cishe amaphesenti angama-99 ezinsana ezizalwa zine-laryngomalacia zinezinhlobo eziphansi noma ezilinganiselayo. I-laryngomalacia emnene ibandakanya ukuphefumula okunomsindo, kepha azikho ezinye izinkinga zempilo. Imvamisa idlulwa ngaphakathi kwezinyanga eziyi-18. I-laryngomalacia emaphakathi ngokuvamile isho ukuthi kunezinkinga ezithile zokondla, ukuphinda uhlaziye, i-GERD, nokubuyiselwa emuva kwesifuba okuncane noma okulingene. I-laryngomalacia enamandla ingafaka ukondla okunenkinga, kanye ne-apnea ne-cyanosis.

Yelashwa kanjani i-laryngomalacia?

Iningi lezingane lizokhipha i-laryngomalacia ngaphandle kokwelapha ngaphambi kosuku lwayo lokuzalwa lwesibili, ngokusho kwe-Children's Hospital yaseFiladelphia.

Kodwa-ke, uma i-laryngomalacia yengane yakho idala izinkinga zokondla ezivimbela ukuzuza kwesisindo noma uma kwenzeka i-cyanosis, kungadingeka ukuhlinzwa. Ukwelashwa okujwayelekile okuhlinzekwayo kuvame ukuqala ngenqubo ebizwa nge-laryngoscopy eqondile kanye ne-bronchoscopy. Kwenziwe egumbini lokuhlinza futhi kubandakanya udokotela besebenzisa izikali ezikhethekile ezinikeza ukubhekisisa i-larynx ne-trachea. Isinyathelo esilandelayo ukuhlinzwa okubizwa ngokuthi i-supraglottoplasty. Kungenziwa ngesikele noma nge-laser noma enye yezindlela ezimbalwa. Ukuhlinzwa kuhilela ukuhlukanisa uqwanga lomphimbo kanye ne-epiglottis, isicubu somphimbo esimboza uqhoqhoqho lapho udla. Ukuhlinzwa kuhilela nokunciphisa kancane izicubu ngenhla nje kwezintambo zezwi.

Uma i-GERD iyinkinga, udokotela wakho angakunikeza umuthi we-reflux ukusiza ukulawula ukukhiqizwa kwe-asidi esiswini.

Izinguquko ongazenza ekhaya

Ezimweni ezimnene noma ezilinganiselayo ze-laryngomalacia, wena nengane yakho kungenzeka kungadingeki nenze ushintsho olukhulu ekondleni, ekulaleni, noma kunoma yimuphi omunye umsebenzi. Uzodinga ukuthi ubuke ingane yakho ngokucophelela ukuze uqiniseke ukuthi idla kahle futhi ayiziboni izimpawu eziyingozi ze-laryngomalacia. Uma ukondla kuyinselele, kungadingeka ukuthi ukwenze kaningi, ngoba ingane yakho ingahle ingatholi ama-calories nezakhi eziningi ngokudla ngakunye.

Kungase kudingeke nokuthi uphakamise ikhanda likamatilasi wengane yakho kancane ukuze ubasize baphefumule kalula ebusuku. Ngisho ne-laryngomalacia, izingane zisalele ngokuphepha emhlane wazo ngaphandle uma kunconywa ngenye indlela udokotela wezingane.

Kungavinjelwa?

Ngenkathi ungakwazi ukuvimbela i-laryngomalacia, ungakwazi ukusiza ukuvimbela izimo eziphuthumayo zezokwelapha ezihlobene nalesi simo. Cabanga ngamasu alandelayo:

• Yazi ukuthi yiziphi izimpawu okufanele uzibheke uma kukhulunywa ngokudla, ukukhuluphala, nokuphefumula.
• Esimweni esingavamile ukuthi ingane yakho ine-apnea ehlotshaniswa ne-laryngomalacia yabo, khuluma nodokotela wezingane mayelana nokusebenzisa ukwelashwa okuqhubekayo kwe-airway pressure (CPAP) noma enye indlela yokwelashwa kwe-apnea.
• Uma i-laryngomalacia yengane yakho idala izimpawu ezingaqinisekisa ukwelashwa, thola onguchwepheshe onolwazi lokwelapha i-laryngomalacia. Ungadinga ukuya ku-inthanethi ukuthola amaqembu okusekela angasiza noma azame isikole sezokwelapha saseyunivesithi esiseduze. Uchwepheshe ohlala kude nawe angakwazi ukuxhumana nodokotela wezingane kude.

Uyini umbono?

Kuze kube yilapho i-larynx yengane yakho ivuthwa futhi inkinga inyamalala, kuzodingeka ubheke noma yiziphi izinguquko empilweni yengane yakho. Ngenkathi izingane eziningi zidlula i-laryngomalacia, ezinye zidinga ukuhlinzwa, futhi lokho kuvame ukwenziwa ngaphambi kosuku lokuzalwa kwengane lokuqala. I-apnea ne-cyanosis kungabeka impilo engozini, ngakho-ke unganqikazi ukubiza u-911 uma ingane yakho ihlale inenkinga.

Ngenhlanhla, amacala amaningi e-laryngomalacia awadingi ukuhlinzwa noma yini enye ngaphandle kwesineke nokunakekelwa okwengeziwe kwengane yakho. Ukuphefumula okunomsindo kungakucasula kancane futhi kukucindezele uze wazi ukuthi kwenzekani, kepha ukwazi ukuthi inkinga kufanele izixazulule kungakwenza kube lula.