Neurilemmoma

Schwannoma

Ka taea te puta mai o ngā mate pukupuku ngākau pai ki roto i ngā ngongo, i ngā uaua, i ngā wheua. Ka whakaatu mai tēnei whakaahua i tētahi schwannoma o te ngongo tibial i te waewae.

Ka tangohia e ngā tākuta ngā schwannomas mā te ata whakaaro kia tiakina ngā fascicles ngongo kāore i pāngia e ngā mate pukupuku. Ko ngā fascicles ngongo he kohinga o ngā muka ngongo.

He momo mate pukupuku ngongo o te kōpū ngongo te schwannoma. Ko te momo tino noa o te mate pukupuku ngongo taha o waho ngākau pai i roto i ngā pakeke. Ka taea te puta mai i hea i roto i tō tinana, i tetahi tau rānei.

Ka puta mai te schwannoma i te nuinga mai i tētahi kohinga kotahi (fascicle) i roto i te ngongo matua, ā, ka nekehia te toenga o te ngongo. Ka nui ake te tipu o te schwannoma, ka nui ake ngā fascicles e pāngia ana, ka uaua ake te tango. I te nuinga, ka tipu haere te schwannoma.

Ki te whānau mai tētahi schwannoma ki roto i tētahi ringa, i tētahi waewae rānei, ka kite pea koe i tētahi pupuhi kore mamae. Kaore ngā schwannomas e mate pukupuku, engari ka taea e rātou te arahi ki te pakaru o te ngongo me te ngaro o te mana uaua. Tirohia tō tākuta ki te whai koe i ētahi pupuhi rerekē, i te ngenge rānei.

Hei whakamātautau i tētahi schwannoma, ka ui pea tō tākuta ki a koe mō ngā tohu me ngā tohu, ka kōrero mō tō hītori hauora, ka mahi i tetahi whakamātautau tinana whānui me te neurological. Ki te whakaatu mai ngā tohu kei a koe pea tētahi schwannoma, i tētahi mate pukupuku ngongo rānei, ka tūtohutia pea e tō tākuta tētahi, i ētahi atu rānei o ēnei whakamātautau whakamātautau:

• Whakaahua pūkaha pāmahana (MRI). Ka whakamahi tēnei karapa i tētahi maheni me ngā ngaru reo hei whakaputa i tētahi tirohanga taipitopito, 3-D o ō ngongo me ngā kōpū e karapoti ana.
• Whakaahua rorohiko (CT). Ka huri tētahi kaiwhakaahua CT a tawhio noa i tō tinana hei tuhi i te raupapa o ngā whakaahua. Ka whakamahi tētahi rorohiko i ngā whakaahua hei hanga i tētahi tirohanga taipitopito o tō tipu kia taea ai e tō tākuta te aromatawai me pēhea te pānga atu ki a koe.
• Electromyogram (EMG). Mō tēnei whakamātautau, ka whakatū te tākuta i ngā ngira iti ki roto i ō uaua kia taea ai e te taputapu electromyography te tuhi i te mahi hiko i roto i tō uaua i a koe e ngana ana ki te neke.
• Ako arahi ngongo. Ka tino whai koe i tēnei whakamātautau me tō EMG. Ka ine i te tere o te kawe mai e ō ngongo i ngā tohu hiko ki ō uaua.
• Biopsy mate pukupuku. Ki te tautuhi ngā whakamātautau whakaahua i tētahi mate pukupuku ngongo, ka tango pea tō tākuta ka wetewete i tētahi tauira iti o ngā pūtau (biopsy) mai i tō mate pukupuku. I runga i te rahi me te wāhi o te mate pukupuku, ka hiahia pea koe ki te anesthetic rohe, i te anesthetic whānui rānei i te wā o te biopsy.
• Biopsy ngongo. Ki te whai koe i tētahi āhuatanga penei i te neuropathy taha o waho e ahu whakamua ana, i ngā ngongo nui e rite ana ki ngā mate pukupuku ngongo rānei, ka tango pea tō tākuta i tētahi biopsy ngongo.

Ko te maimoatanga schwannoma e whakahaeretia ana e te wāhi kei reira te tipu rerekē, me te mea kei te pāngia e te mamae, kei te tipu tere rānei. Ko ngā whiringa maimoatanga ko:

• Aroturuki. Ka tūtohu pea tō tākuta ki te tirotiro i tō āhuatanga i te wā. Ka uru pea te tirotiro ki ngā tirotiro auau me te karapa CT, i te karapa MRI rānei i ia torutoru marama kia kite ai mēnā kei te tipu tō mate pukupuku.
• Taha. Ka taea e tētahi tākuta ngongo taha o waho whai wheako te tango i te mate pukupuku ki te pāngia e te mamae, kei te tipu tere rānei. Ka mahia te pokanga schwannoma i raro i te anesthetic whānui. I runga i te wāhi o te mate pukupuku, ka taea e ētahi manuhiri te haere ki te kāinga i te rā o te pokanga. Ka hiahia pea ētahi atu ki te noho i te hōhipera mō tētahi, i rua rānei. Ahakoa muri i te tango angitu o te mate pukupuku i te wā o te pokanga, ka taea e te mate pukupuku te hoki mai.
• Maimoatanga radiation. Ka whakamahia te maimoatanga radiation hei awhina i te whakahaere i te tipu o te mate pukupuku me te whakapai ake i ō tohu. Ka taea te whakamahi tahi me te pokanga.
• Radiosurgery stereotactic. Ki te tata te mate pukupuku ki ngā ngongo nui, ki ngā oko toto rānei, ka taea te whakamahi i tētahi hangarau e kiia nei ko te radiation therapy tinana stereotactic hei whakaiti i te pakaru ki ngā kōpū hauora. Mā tēnei hangarau, ka tukuna e ngā tākuta te radiation ki tētahi mate pukupuku kaore e hanga he tapahi.

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Hei whakatau i te mate pukupuku o te pūnaha io, ka ui atu tō kaiwhakarato hauora ki ō tohu me tō hītori hauora. Ka taea e koe te whakahaere i te whakamātautau tinana whānui me te whakamātautau neurological. He maha ngā whakamātautau ka āhei te awhina i te tohu i te take o ō tohu.

• Whakaahua ā-mahi (MRI). Ka whakamahi tēnei karapa i te maheni me ngā ngaru reo hei whakaputa i te tirohanga 3D taipitopito o ngā io me ngā kiko.
• Tomokaraha rorohiko (CT). Ka hurihuri te kaiwhakaatu CT i te tinana hei tango i te raupapa o ngā whakaahua. Ka whakamahi te rorohiko i te whakaahua hei hanga i te tirohanga taipitopito o te mate pukupuku io taha. Ka taea e te karapa CT te awhina i tō kaiwhakarato ki te whakatau me pēhea te pānga o te mate pukupuku ki a koe.
• Electromyogram (EMG). Mō tēnei whakamātautau, ka whakanohoia ngā ngira iti ki roto i ngā uaua. Ka tuhi te taputapu i te mahi hiko i roto i te uaua i a rātou e neke haere ana.
• **Ako ara ia. ** Ka mahia pinepine tēnei whakamātautau me te EMG. Ka ine i te tere o te kawe a ngā io i ngā tohu hiko ki ngā uaua.
• Biopsy mate pukupuku. Ki te pēhea koe he mate pukupuku io, ka hiahia pea koe ki te biopsy. Ka tangohia me te wetewete he tauira iti o ngā pūtau mai i te mate pukupuku. I runga i te rahi me te wāhi o te mate pukupuku, ka hiahia pea koe ki te rongoā e whakahaurangi ana i tētahi wāhi o te tinana, e kiia nei ko te whakahaurangi rohe, te rongoā rānei e moe ai koe, e kiia nei ko te whakahaurangi whānui, i te wā o te biopsy. I etahi wā, ko te biopsy anake te huarahi hei whakatau mena he mate pukupuku te mate pukupuku.
• Biopsy io. Ka hiahiatia pea he biopsy o te io i ngā tāngata he mate motuhake, pēnei i te neuropathy taha e ahu whakamua ana me ngā io nui e rite ana ki ngā mate pukupuku io.

Kāore i te noa ngā mate pukupuku io taha. He mea nui te kimi i tētahi kaiwhakarato he wheako ki te whakatau me te whakaora i a rātou. Ki te hiahiatia, rapua he whakaaro tuarua.

Ko te rongoā i te mate pukupuku o te pūnaha io kei runga i te momo mate pukupuku, ngā io me ētahi atu kiko e pā ana, me ngā tohu. Āhei ngā whiringa rongoā:

Ko te tirotiro me te tatari kia kite mena ka tupu te mate pukupuku he whiringa pea mena kei te wāhi e uaua ai te tango. Āhei rānei he whiringa mena he iti te mate pukupuku, he puhoi te tipu, ā, he torutoru noa rānei ngā tohu, kāore rānei. Ka whai koe i ngā tirotiro whānui, ā, ka taea pea te whakamahi i ngā tātaritanga MRI, CT rānei, ngā whakaahua ultrasound rānei i ia 6 ki te 12 marama kia kite mena kei te tupu te mate pukupuku. Mena ka whakaatu ngā tātaritanga whakahoki anō kei te pumau te mate pukupuku, ka taea pea te tirotiro i ia tau torutoru.

Ka tangohia e ngā tākuta ngā schwannomas mā te ata tiaki kia mau tonu ngā fascicles io kāore i pā te mate pukupuku. Ko ngā fascicles io he kohinga o ngā muka io.

Ka tangohia etahi mate pukupuku o te pūnaha io mā te pokanga. Ko te whāinga o te pokanga ko te tango i te mate pukupuku katoa kaore e whakaraweke i ngā kiko hauora me ngā io e tata ana. Ki te kore e taea tena, ka tangohia e ngā tākuta te nui o te mate pukupuku e taea ana e rātou.

Ka taea e ngā tikanga me ngā taputapu hou te tae atu ki ngā mate pukupuku e uaua ana te uru atu. Ka ngāwari ake te wehewehe i waenganui i te mate pukupuku me te kiko hauora mā ngā karāpīpene kaha e whakamahia ana i te pokanga iti. Ā, ka taea te tirotiro i te mahi a ngā io i te wā o te pokanga, ā, tēnā ka āwhina i te tiaki i te kiko hauora.

Ko ngā tūponotanga o te pokanga ko te pakaru o te io me te kore e taea te mahi. Ko ēnei tūponotanga e whakaū ana i te rahi o te mate pukupuku, te wāhi kei reira, me te huarahi e whakamahia ana mō te pokanga. Ka tupu anō ētahi mate pukupuku.

Ka whakamahi te hangarau radiosurgery stereotactic i te maha o ngā hihi gamma iti hei tuku i te horopeta tika o te radiation ki te whāinga.

Ka whakamahia te radiosurgery stereotactic hei rongoā i ētahi mate pukupuku o te pūnaha io kei roto, kei te taha rānei o te roro. Ka tukuna tika te radiation ki te mate pukupuku kaore e hiahiatia he tapahi. Ko tētahi momo o tēnei momo pokanga ko te Gamma Knife radiosurgery.

Ko ngā tūponotanga o te radiosurgery ko te ngoikore, te ngenge rānei i te wāhi i rongoāhia. Ā, pea ka tupu tonu te mate pukupuku. He tino onge, ka taea e te radiation te whakaeke i te mate pukupuku i te wāhi i rongoāhia i muri mai.

Ka rongoāhia ngā mate pukupuku pukupuku mā ngā rongoā mate pukupuku noa. Hei tāpiri atu ki te pokanga, ko te chemotherapy me te radiation therapy. Ko te taumata whakamutunga me te rongoā te mea nui rawa atu mō te hua pai. Pea ka hoki mai ngā mate pukupuku i muri i te rongoā.

I muri i te pokanga, pea ka hiahia koe ki te whakaora tinana. Pea ka whakamahi tō kaiwhakarongo hauora i te kākahu, i te papa rānei kia mau tonu tō ringa, tō waewae rānei i te tūnga e āwhina ana i a koe kia ora. Ka taea e ngā kaiwhakaora tinana me ngā kaiwhakaora mahi te āwhina i a koe kia ora anō te mahi me te nekehanga i ngaro i te pakaru o te io, i te tapahi rānei o te waewae.

Ka taea te ahotea te whakahaere i te tūponotanga o ngā raruraru o te mate pukupuku o te pūnaha io. Ka taea hoki te whakatau i te rongoā pai mōu he whakatau uaua. Pea ka āwhina ēnei whakaaro:

• Akohia te nui e taea ana e koe mō ngā mate pukupuku o te pūnaha io. Ko te nui o tō mōhiotanga, ko te pai ake o tō whakarite ki te mahi i ngā whiringa pai mō te rongoā. I tua atu i te kōrero ki tō kaiwhakarongo hauora, pea ka hiahia koe ki te kōrero ki te kaitohutohu, ki te kaimahi whānau rānei. Ā, pea ka kite koe he āwhina te kōrero ki ētahi atu tangata kua pā ki a rātou te āhuatanga rite ki tōu. Pātaihia ngā wheako i te wā o te rongoā me muri iho.
• Whakaritea he pūnaha tautoko kaha. Ka taea e te whānau me ngā hoa te waiho hei puna tautoko. Pea ka kite koe he whakamārama te awangawanga me te mārama o ētahi atu tangata kei a rātou te āhuatanga rite ki tōu. Pea ka taea e tō kaiwhakarongo hauora, e te kaimahi whānau rānei te whakapiri atu i a koe ki tētahi rōpū tautoko.

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