I-Rhinoplasty

Incazelo, izinjongo kanye nemigomo

Igama elithi "rhinoplasty" libhekisela ekuguqulweni kwe-morphology yekhala ukuze kuthuthukiswe ubuhle futhi ngezinye izikhathi busebenze (ukulungiswa kwezinkinga ezingenzeka ngokuphefumula kwamakhala). Ukungenelela kuhloswe ekuguquleni ukuma kwekhala ukuze libe lihle kakhulu. Sikhuluma ngokulungisa ngokuqondile ububi obukhona, kungakhathaliseki ukuthi ukuzalwa, kwavela ebusheni, ngenxa yokulimala noma ngenxa yenqubo yokuguga. Isimiso siwukusebenzisa izimbobo ezifihlwe emakhaleni ukuze kulungiswe kabusha amathambo noqwanga olwakha ingqalasizinda eqinile yekhala futhi lunikeze isimo esikhethekile. Isikhumba esimboze ikhala kuzodingeka siguqule futhi sidlulelane ngenxa yokunwebeka kwaso kulesi scaffold se-bone cartilage esishintshiwe. Leli phuzu lokugcina liqokomisa ukubaluleka kwekhwalithi yesikhumba kumphumela wokugcina. Ngakho, kuyaqondakala ukuthi ngokuvamile asikho isibazi esibonakalayo esisele esikhumbeni. Lapho ukuvinjelwa kwamakhala kuphazamisa ukuphefumula, kungelashwa ngesikhathi sokuhlinzwa okufanayo, kungakhathaliseki ukuthi kungenxa ye-septum ephambukile noma i-hypertrophy yama-turbinates (ukwakheka kwamathambo okukhona emgodini wamakhala). Ukungenelela, okwenziwa kokubili kwabesifazane nabesilisa, kungenziwa ngokushesha lapho ukukhula kumile, okungukuthi, kusukela eminyakeni engaba ngu-16 ubudala. I-Rhinoplasty ingenziwa yodwa noma ihlanganiswe, uma kunesidingo, nezinye izenzo ezengeziwe ezingeni lobuso, ikakhulukazi ngokuguqulwa kwesilevu, ngezinye izikhathi okwenziwa kanyekanye nokusebenza ukuthuthukisa yonke iphrofayili). Ezimweni ezingavamile, ingase ikhokhelwe umshwalense wezempilo ngaphansi kwezimo ezithile. Ezimweni ezingavamile, ukuthuthukiswa kwe-morphology yekhala kungafinyelelwa ngezindlela ezingezona zokuhlinzwa eziphakanyiswe udokotela ohlinzayo, uma lesi sixazululo singenzeka esimweni sakho esithile.

NGAPHAMBI KOKUNGENELELA

Kuzohlaziywa izisusa nezicelo zesiguli. Ucwaningo olunzulu lwephiramidi yamakhala kanye nobuhlobo bayo nalo lonke ubuso luzokwenziwa, kanye nokuhlolwa kwe-endonasal. Umgomo ukuchaza umphumela "okahle", oguqulelwe kubo bonke ubuso, izifiso nobuntu besiguli. Udokotela ohlinzayo, esesiqonde ngokucacile isicelo sesiguli, uba umqondisi wakhe ekukhetheni umphumela wesikhathi esizayo nendlela esetshenziswayo. Ngezinye izikhathi angase acebise ukuthi angagxambukeli. Umphumela olindelekile ungalingiswa ngokuthinta kabusha isithombe noma ngokushintshashintsha kwekhompyutha. Isithombe esibonakalayo esitholwe ngale ndlela siyipulani kuphela elingasiza ukuqonda okulindelwe yiziguli. Kodwa-ke, ngeke siqinisekise nangayiphi indlela ukuthi umphumela ozuziwe uzobekwa phezu komunye nomunye nganoma iyiphi indlela. Ukuhlolwa okujwayelekile kwangaphambi kokuhlinzwa kwenziwa njengoba kumisiwe. Ungathathi imishanguzo equkethe i-aspirin izinsuku eziyi-10 ngaphambi kokuhlinzwa. Udokotela obulala izinzwa uzofika ezoboniswana kungakapheli amahora angama-48 ngaphambi kokuhlinzwa. Kunconywa kakhulu ukuthi uyeke ukubhema ngaphambi kwenqubo.

UHLOBO LWE-AESTHESIA KANYE NEZINDLELA ZOKULAlisa

Uhlobo lwe-anesthesia: Inqubo ngokuvamile yenziwa ngaphansi kwe-anesthesia ejwayelekile. Nokho, kwezinye izimo, ukulaliswa kwezinzwa okuphelele kwendawo okunezidambisi-zinzwa ezifakwa emithanjeni (i-anesthesia “yomsebenzi”) kungase kwanele. Ukukhetha phakathi kwalezi zindlela ezahlukene kuzoba umphumela wengxoxo phakathi kwakho, udokotela ohlinzayo kanye nodokotela obulala izinzwa. Izindlela zokulaliswa esibhedlela: Ukungenelela kungenziwa "isiguli esingalalisiwe", okungukuthi, ngokuhamba ngosuku olufanayo ngemva kwamahora ambalwa okubuka. Kodwa-ke, kuye ngecala, ukuhlala isikhashana esibhedlela kungase kube ngcono. Khona-ke ukungena kwenziwa ekuseni (futhi ngezinye izikhathi ngayizolo), futhi ukuphuma kuvunyelwe ngakusasa noma ngakusasa.

UKUNGENELELA

Udokotela ohlinzayo ngamunye usebenzisa izinqubo eziqondene ngqo naye futhi azivumelanisa nesimo ngasinye ukuze alungise amaphutha akhona ngokukhetha futhi athole imiphumela engcono kakhulu. Ngakho-ke, kunzima ukuhlela ukungenelela. Kodwa-ke, singagcina izimiso eziyisisekelo ezijwayelekile: Izimbobo: zifihliwe, ngokuvamile ngaphakathi kwamakhala noma ngaphansi kodebe olungaphezulu, ngakho asikho isibazi esibonakalayo ngaphandle. Ngezinye izikhathi, nokho, izimbobo zangaphandle zingadingeka: zenziwa ngaphesheya kwe-columella (insika ehlukanisa amakhala amabili) ukuze "i-open" rhinoplasty, noma ifihlwe phansi kwe-alae uma ubukhulu bamakhala buzoncishiswa. Ukulungiswa: Ingqalasizinda yethambo ne-cartilage ingashintshwa ngokuhambisana nohlelo olumisiwe. Lesi sinyathelo esibalulekile singasebenzisa inombolo engapheli yezinqubo, ukukhetha okuzokwenziwa ngokuhambisana neziphambeko okufanele zilungiswe kanye nezintandokazi zezobuchwepheshe zikadokotela ohlinzayo. Ngakho-ke, singakwazi ukunciphisa ikhala elibanzi kakhulu, sisuse i-hump, silungise ukuphambuka, sithuthukise ithiphu, sifinyeze ikhala elide kakhulu, siqondise i-septum. Ngezinye izikhathi ama-cartilage noma ama-graft amathambo asetshenziselwa ukugcwalisa ukucindezeleka, ukusekela ingxenye yekhala, noma ukuthuthukisa ukuma kwephuzu. Ama-Sutures: I-incisions ivaliwe nge-sutures encane, evame ukumuncwa. Ukugqoka kanye nama-splints: Umgodi wamakhala ungagcwaliswa ngezinto ezihlukahlukene zokumunca. Ubuso bekhala buvame ukumbozwa nge-bandage yokubunjwa kusetshenziswa imichilo emincane yokunamathela. Okokugcina, i-splint esekelayo futhi evikelayo eyenziwe nge-plaster, ipulasitiki noma insimbi ibunjwa futhi inamathele ekhaleni, ngezinye izikhathi ingakhuphukela ebunzini. Ngokuya ngodokotela ohlinzayo, izinga lokuthuthukiswa okudingekayo, kanye nesidingo esingenzeka sezinqubo ezengeziwe, inqubo ingathatha noma yikuphi ukusuka emaminithini angu-45 kuya emahoreni amabili.

NGEMVA KOKUNGENELELA: UKUBHALWA KWEZOKUSEBENZA

Imiphumela ayivamisile ukuba buhlungu futhi wukungakwazi ukuphefumula ngamakhala (ngenxa yokuba khona kwama-wicks) okuwukuphazamiseka okukhulu kwezinsuku zokuqala. Qaphela, ikakhulukazi ezingeni lamajwabu amehlo, ukubukeka kwe-edema (ukuvuvukala), futhi ngezinye izikhathi i-ecchymosis (imivimbo), ukubaluleka nobude bayo obuhluka kakhulu kumuntu oyedwa. Ezinsukwini ezimbalwa emva kokungenelela, kunconywa ukuba uphumule futhi ungenzi noma yimuphi umzamo. Izingidi zikhishwa phakathi kosuku olu-1 nolwesi-5 ngemva kokuhlinzwa. Isondo likhishwa phakathi kosuku lwesi-5 nolwesi-8, lapho ngezinye izikhathi lishintshwa lifakwe isondo elisha, elincane izinsuku ezimbalwa ezengeziwe. Kulokhu, ikhala lisazovela likhulu kakhulu ngenxa yokuvuvukala, futhi kusazoba nokungakhululeki kokuphefumula ngenxa yokuvuvukala kwe-mucosal kanye noqweqwe olungenzeka emigodini yamakhala. Ukucwaswa kokungenelela kuzokwehla kancane kancane, okuvumela ukubuyela empilweni evamile yezenhlalakahle emva kwezinsuku ezimbalwa (izinsuku eziyi-10 kuya kwezingu-20 kuye ngokuthi icala). Ezemidlalo nemisebenzi enodlame kufanele igwenywe ezinyangeni ezi-3 zokuqala.

IMIPHUMELA

Lo mphumela uvame ukuhambisana nezifiso zesiguli futhi useduze kakhulu nephrojekthi esungulwe ngaphambi kokuhlinzwa. Ukubambezeleka kwezinyanga ezimbili kuya kwezintathu kuyadingeka ukuze uthole umbono omuhle womphumela, wazi ukuthi ifomu lokugcina lizotholakala kuphela ngemva kwezinyanga eziyisithupha noma unyaka wokuziphendukela kwemvelo okuhamba kancane nokucashile. Izinguquko ezenziwe ngomunye ziwujuqu futhi kuzoba nezinguquko ezincane kuphela nezifike sekwephuzile maqondana nenqubo yokuguga yemvelo (njengekhala elingasebenzi). Umgomo walo msebenzi uwukuthuthukisa, hhayi ukuphelela. Uma izifiso zakho zingokoqobo, umphumela kufanele ukujabulise kakhulu.

UBUBI BOMPHUMELA

Zingase zibe umphumela wokungaqondi kahle izinjongo okufanele zifezwe, noma ngenxa yezibazi ezingavamile noma ukusabela kwezicubu ezingalindelekile (ukuqina kwesikhumba okuzenzakalelayo okungekuhle, i-retractile fibrosis). Lezi ziphambeko ezincane, uma zingabekezeleleki kahle, zingalungiswa ngokuthinta kabusha okuhlinzayo, ngokuvamile okulula kakhulu kunokungenelela kokuqala, kokubili ngombono wezobuchwepheshe kanye nombono wokubhekwa kokusebenza. Kodwa-ke, ukuthinta kabusha okunjalo akukwazi ukwenziwa izinyanga ezimbalwa ukuze kusebenze izicubu ezizinzile ezifinyelele ukuvuthwa okuhle kwezibazi.

IZINKINGA EZINGAKHO

I-Rhinoplasty, nakuba yenziwa ngokuyinhloko ngenxa yezizathu zobuhle, nokho iyinqubo yokuhlinzwa yeqiniso eza nezingozi ezihlobene nanoma iyiphi inqubo yezokwelapha, kungakhathaliseki ukuthi incane kangakanani. Kufanele kwenziwe umehluko phakathi kwezinkinga ezihlobene ne-anesthesia nalezo ezihambisana nokuhlinzwa. Ngokuphathelene ne-anesthesia, ngesikhathi sokubonisana, udokotela obulala izinzwa ngokwakhe wazisa isiguli ngezingozi ze-anesthesia. Kufanele uqaphele ukuthi ukulalisa izinzwa kubangela ukusabela emzimbeni ngezinye izikhathi okungabikezeleki futhi okulawuleka kalula kakhulu: iqiniso lokuya kudokotela obulala izinzwa ophrakthiza esimweni sokuhlinzwa ngempela kusho ukuthi ubungozi obuhilelekile ngokwezibalo buphansi kakhulu. Eqinisweni, kufanele kwaziwe ukuthi eminyakeni engamashumi amathathu edlule amasu, imikhiqizo yokubulala izinzwa, nezindlela zokuqapha zenze inqubekelaphambili enkulu enikeza ukuphepha okuphelele, ikakhulukazi lapho ukungenelela kwenziwa ngaphandle kwegumbi lezimo eziphuthumayo kanye nasekhaya lomuntu ophile kahle. Ngokuphathelene nenqubo yokuhlinzwa: Ngokukhetha udokotela ohlinzayo wepulasitiki oqeqeshiwe futhi onekhono oqeqeshwe kulolu hlobo lokungenelela, unciphisa lezi zingozi ngangokunokwenzeka, kodwa ungaziqedi ngokuphelele. Ngenhlanhla, ngemva kwe-rhinoplasty eyenziwa ngokuvumelana nemithetho, izinkinga zangempela azivamile ukwenzeka. Eqinisweni, imisebenzi eminingi yenziwa ngaphandle kwezinkinga, futhi iziguli zaneliseka ngokuphelele ngemiphumela yazo. Kodwa-ke, naphezu kokutholakala kwabo, kufanele wazi ngezinkinga ezingenzeka:

• Ukopha: lokhu kungenzeka emahoreni ambalwa okuqala, kodwa ngokuvamile kuhlala kuthambile kakhulu. Uma zibaluleke kakhulu, kungase kuthethelele ukubhola okusha, okuphelele noma ukululama egunjini lokuhlinzela.

• I-Hematomas: Lokhu kungase kudinge ukukhishwa uma kukhulu noma kubuhlungu kakhulu.

• Ukutheleleka: naphezu kokuba khona kwemvelo kwamagciwane emigodini yamakhala, akuvamile kakhulu. Uma kunesidingo, kuthethelela ngokushesha ukwelashwa okufanele.

• Izibazi Ezingabukeki: Lezi zingathinta kuphela izibazi zangaphandle (uma zikhona) futhi akuvamile ukuba zibukeke zifinyelele ezingeni lokudinga ukuthintwa kabusha.

• Ukuhlasela kwesikhumba: nakuba kungavamile, kuyenzeka njalo, ngokuvamile ngenxa yokuphonseka kwamakhala. Amanxeba alula noma ukuguguleka kuphola ngokuzenzakalelayo ngaphandle kokushiya amamaki, ngokungafani ne-cutaneous necrosis, ngenhlanhla ehlukile, evame ukushiya indawo encane yesikhumba esibomvu. Ngokuvamile, umuntu akufanele adlule izingozi, kodwa wazi nje ukuthi ukungenelela kokuhlinzwa, ngisho nokulula kwangaphandle, kuhlale kuhlotshaniswa nengxenye encane yezingozi. Ukusebenzisa udokotela ohlinzayo wepulasitiki oqeqeshiwe kuqinisekisa ukuthi banokuqeqeshwa kanye nekhono elidingekayo ukuze bazi ukuthi bangagwema kanjani lezi zinkinga noma baziphathe ngokuphumelelayo uma kunesidingo.