Ukuqina Kwekhanda: Izimpawu, Izimbangela, Nokwelashwa

Ukuqina kwekhanda kwenzeka lapho enye noma ngaphezulu kwamalunga ekhanda lomntwana evala ngokushesha kakhulu, ngaphambi kokuba ubuchopho buqede ukukhula. Cabanga ngekhanda lomntwana wakho njengoba linezinhlanganisela zemvelo ebizwa ngokuthi yi-sutures ezivame ukuba nokuguquguquka phakathi neminyaka embalwa yokuqala yokuphila, ivumela ubuchopho ukuba bukhule futhi buthuthuke kahle.

Uma le sutures ihlanganiswa ngokushesha, ingathinta indlela ikhanda lomntwana wakho elikhula ngayo futhi ngezinye izikhathi ingathinta ukuthuthuka kobuchopho. Nakuba lokhu kungase kuzwakale kuyesabekayo, abantwana abaningi abane-craniosynostosis bayaqhubeka bephila impilo evamile, enempilo ngokwelashwa okufanele.

Ziyini izimpawu zokuqina kwekhanda?

Isisindo esibonakalayo ngokuvamile yisimo sekhanda esingavamile esiba sicacile njengoba umntwana wakho ekhula. Ungase uqaphele lokhu ngesikhathi sokukhathalela okuvamile noma udokotela wakho angase akuqaphele ngesikhathi sokuhlola okuvamile.

Nawa ama-symptom abalulekile okumelwe uwabukele:

• Isakhiwo sekhanda esingavamile esingabonakali siqhubeka sikhuphuka ngokuhamba kwesikhathi
• Umgogodla oluqine kanye noma ngaphezulu kwezinhlanganisela ze-suture ekhanda lomntwana wakho
• Ukukhula okuhamba kancane noma okungekho khona komjikelezo wekhanda ngenkathi umzimba womntwana wakho uqhubeka ukukhula ngokujwayelekile
• Ukweba noma amanqaku amancane kakhulu (fontanelles) ekhanda lomntwana wakho
• Izimpawu zokwanda kokucindezeleka kwangaphakathi njengokugabha okuqhubekayo, ukucasuka, noma ukulibaziseka kokuthuthuka

Ukushintsha okukhethekile kwesakhiwo sekhanda kuncike ekuvaleni kwe-sutures ngokushesha. Isibonelo, uma i-suture ehamba ukusuka phambili kuya emuva ivala ngokushesha kakhulu, ikhanda lomntwana wakho lingase libe lide futhi libe luqine.

Kwezinye izimo, ungase futhi uqaphele ukungalingani kobuso, lapho ohlangothini olulodwa lobuso lomntwana wakho lubukeka luhlukile kwelolunye. Lokhu kuvame kakhulu lapho i-sutures eceleni kwekhanda ithinteka.

Ziyini izinhlobo zokuqina kwekhanda?

Ukuqina kwekhanda kuhlukaniswe ngokusekelwe ekuvaleni kwe-sutures ngokushesha. Uhlobo ngalunye lwenza iphethini yesakhiwo sekhanda ehlukile, okusiza odokotela ukuthi baqonde ukuthi kwenzekani futhi bahlele indlela yokwelapha engcono kakhulu.

Izinhlobo ezivamile kakhulu zihlanganisa:

• Ukuqina kwe-sagittal - kuthinta i-suture ehamba ukusuka phambili kuya emuva, kudala isakhiwo sekhanda elide, eliqine
• Ukuqina kwe-coronal - kuhilela i-sutures ehamba ukusuka endlebeni kuya endlebeni, ngokuvamile kubangela i-forehead eqinile
• Ukuqina kwe-metopic - kuthinta i-suture ephakathi kwe-forehead, kudala isakhiwo se-forehead esingu-triangular
• Ukuqina kwe-lambdoid - kuhilela i-sutures ngemuva kwekhanda, kubangela ukulingana ohlangothini olulodwa

Izigameko eziningi zihilela i-suture eyodwa kuphela, okuyibizwa ngokuthi yi-single-suture craniosynostosis. Uma i-sutures eminingi ithinteka, iyinkimbinkimbi kakhulu futhi ngokuvamile ihlotshaniswa nezifo ze-genetic.

Ukuqonda uhlobo kusiza iqembu lakho lezokwelapha ukuthi linqume ukuphazamiseka kokwelapha kanye nendlela yokwelapha engcono kakhulu uma kudingeka.

Yini ebangela ukuqina kwekhanda?

Ezigameko eziningi, ukuqina kwekhanda kwenzeka ngaphandle kwesizathu esicacile, futhi akuyona into owenzile noma awenzanga ngesikhathi sokukhulelwa. Isimo ngokuvamile sithuthuka ngokungahleliwe ngesikhathi sokuthuthukiswa kwesifo esiqalayo lapho ikhanda likhahlela.

Kodwa-ke, kunezici ezithile ezibangelayo ezaziwayo:

• Ukuguqulwa kwe-genetic okuthinta ukuthuthukiswa kwekhanda, nakuba lokhu kungavamile
• Izifo ezithile ze-genetic njenge-Apert syndrome, i-Crouzon syndrome, noma i-Pfeiffer syndrome
• Umbukiso womndeni wokuqina kwekhanda, nakuba izigameko eziningi zenzeka emindenini engenayo imbukiso yangaphambili
• Imithi ethile ethathwe ngesikhathi sokukhulelwa, nakuba lokhu kungavamile
• Izimo ezithile ze-metabolic ezithinta ukuthuthukiswa kwamathambo

Iningi lezigameko zokuqina kwekhanda yilokho odokotela abakubiza ngokuthi “i-nonsyndromic,” okusho ukuthi zenzeka zodwa ngaphandle kokuba yingxenye yesimo se-genetic esikhulu. Lokhu empeleni kuyakuqinisekisa ngoba kusho ukuthi umntwana wakho cishe uzothuthuka ngokujwayelekile ngezindlela ezinye zonke.

Uma umntwana wakho ekhombiswe ukuqina kwekhanda, udokotela wakho angase acebise ukuhlolwa kwe-genetic ukuze akhiphe izifo ezihlotshaniswayo, ikakhulukazi uma i-sutures eminingi ihilelekile noma uma kunezici ezinobuhlungu.

Nini okumelwe ubona udokotela ngokuqina kwekhanda?

Kufanele uxhumane nodokotela wakho uma uqaphela noma yikuphi ukushintsha kwesakhiwo sekhanda lomntwana wakho noma uma ikhanda labo libonakala likhula ngokungavamile. Ukutholakala kwangaphambi kwesikhathi kwenza umehluko omkhulu eziphumeleni zokwelapha.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uqaphela:

• Isakhiwo sekhanda lomntwana wakho sibe sicacile kakhulu ngokuhamba kwesikhathi
• Imigoqo eqinile eyenziwe eceleni kwekhanda lapho i-sutures kufanele ibe khona
• Umjikelezo wekhanda lomntwana wakho awukhulumi ngesilinganiso esilindelekile
• Izimpawu zokwanda kokucindezeleka njengokugabha okuqhubekayo, ukucasuka okukhulu, noma ukulibaziseka kokuthuthuka
• Ukushintsha emehlweni omntwana wakho, njengokubukisa noma ubunzima bokuwagijima ngokujwayelekile

Unganqikazi ukukhuluma ngezinkathazo zakho ngisho noma abanye bethi isakhiwo sekhanda “sijwayelekile” noma sizophumelela “sijwayelekile” ngokwalo. Uyazi umntwana wakho kangcono, futhi kuhlale kungcono ukuba nokuhlolwa kwesiphequluli ukuze uthole ukuthula kwengqondo.

Uma kukhona ukungabaza ngokuqina kwekhanda, udokotela wakho cishe uzakukubhekisela ku-neurosurgeon yabantwana noma ochwepheshe we-craniofacial onolwazi olukhulu ekwelapheni lesi simo.

Ziyini izici ezingaholela ekuqineni kwekhanda?

Nakuba ukuqina kwekhanda kungenzeka kunoma yimuphi umntwana, izici ezithile zingase zikhulise kancane amathuba okuthuthukisa lesi simo. Ukuqonda lezi zici ezingaholela kulokhu kungakusiza uqonde isimo sakho.

Izici eziyinhloko ezingaholela kulokhu zihlanganisa:

• Ukuba owesilisa - abafana banamathuba amaningi okuthuthukisa izinhlobo ezithile zokuqina kwekhanda
• Ukuba nomlando womndeni wokuqina kwekhanda noma ukungalingani kwezitho zekhanda
• Izifo ezithile ze-genetic ezidlula emindenini
• Ukuba umntwana wokuqala, nakuba isizathu salokhu singaqondakali ngokuphelele
• Ukukhulelwa okuningi (amawele, ama-triplets) ngenxa yokucindezeleka okungenzeka esibindini

Ezinye izici ezibangelayo ezingavamile zingase zihlanganise ukukhombisa imithi ethile ngesikhathi sokukhulelwa noma isifo se-thyroid sikamama, kodwa lezi zixhumanisi zisacwaningwa ochwepheshe.

Kubalulekile ukukhumbula ukuthi ukuba nezici ezingaholela kulokhu akusho ukuthi ukuqina kwekhanda kuzokwenzeka ngokuqinisekile. Abantwana abaningi abanezici eziningi ezingaholela kulokhu abakuthuthukisi lesi simo, kanti abanye abangenazo izici ezibonakalayo bayakuthuthukisa.

Ziyini izinhlanganisela ezingaba khona zokuqina kwekhanda?

Uma kutholakala ngokushesha futhi kuphathwe ngokufanele, abantwana abaningi abane-craniosynostosis bathuthuka ngokujwayelekile ngaphandle kwezinhlanganisela zesikhathi eside. Kodwa-ke, ukushiya isimo singaphathwa ngezinye izikhathi kungabangela izinkinga ezinzima kakhulu.

Izinhlanganisela ezingaba khona zihlanganisa:

• Ukwanda kokucindezeleka kwangaphakathi njengoba ubuchopho obukhula buphuma endaweni
• Ukulibaziseka kokuthuthuka uma ukukhula kobuchopho kuvinjelwe
• Izinkinga zobona ngenxa yokucindezeleka emithanjeni ye-optic
• Ubunzima bokuzwa kwezinye izimo
• I-sleep apnea noma izinkinga zokuphefumula, ikakhulukazi ngezinhlobo ezithile ezihlotshaniswa nesifo
• Izinkinga zokuzethemba ezihlotshaniswa nokubukeka njengoba umntwana ekhula

Izindaba ezinhle ukuthi ngokwelashwa okufanele, lezi zinhlanganisela zivimbeka kakhulu. Amathuluzi okuhlinzwa anamuhla aphelele kakhulu ekunciphiseni ukucindezeleka futhi avumela ukuthuthuka kobuchopho okujwayelekile ukuqhubeka.

Kwezinye izimo lapho ukuqina kwekhanda kuyingxenye yesifo se-genetic, kungase kube khona izinhlanganisela ezengeziwe ezithinta amanye amasiko omzimba. Iqembu lakho lezokwelapha lizokulandelela lokhu futhi lilibhekane njengoba kudingeka.

Ukuqina kwekhanda kungavikeleka kanjani?

Ngeshwa, ayikho indlela eyaziwayo yokuvimbela ukuqina kwekhanda njengoba ngokuvamile kwenzeka ngokungahleliwe ngesikhathi sokuthuthukiswa kwesifo. Lokhu akuyona into abazali abayibangelayo noma abangayigwema ngokwenza izinqumo ezihlukile ngesikhathi sokukhulelwa.

Kodwa-ke, ukugcina ukunakekelwa okuhle kokukhulelwa kungasiza ukuqinisekisa ukutholakala kwangaphambi kwesikhathi kanye nemiphumela engcono kakhulu. Ukuvakasha okuvamile kokukhulelwa kuvumela umhlinzeki wakho wezokunakekelwa kwezempilo ukuthi alandelele ukuthuthukiswa kwesifo futhi athole noma yikuphi ukukhathazeka kwangaphambi kwesikhathi.

Uma unomlando womndeni wokuqina kwekhanda noma izimo ze-genetic ezihlotshaniswayo, ukwelulekwa kwe-genetic ngaphambi kokukhulelwa kungakusiza uqonde izingozi ezingaba khona nezinketho. Ezinye izinhlobo ze-genetic zingatholakala ngokuhlolwa kokukhulelwa.

Into ebaluleke kakhulu ongayenza iwukuqinisekisa ukuthi umntwana wakho uthola ukuhlolwa okuvamile kwabantwana ngemuva kokuzalwa, lapho umjikelezo wekhanda nesakhiwo kuqashwa khona njalo. Ukutholakala kwangaphambi kwesikhathi kuholela eziphumeleni ezinhle.

Ukuqina kwekhanda kuhlonzwa kanjani?

Ukuhlonzwa ngokuvamile kuqala ngokuhlolwa komzimba lapho udokotela wakho ehlola ngokucophelela isakhiwo sekhanda lomntwana wakho futhi azizwe i-sutures. Bazophinde balinganise umjikelezo wekhanda futhi bawuhlanganise nemiyalo yokukhula evamile.

Udokotela wakho cishe uzokubuza ngokukhulelwa kwakho, umlando womndeni, nanoma yikuphi ukukhathazeka okuqaphile ngokuthuthuka komntwana wakho. Bazophinde benze ukuhlolwa okujwayelekile ukuze bahlole ezinye izici ezingase zikhombe isifo se-genetic.

Uma kukhona ukungabaza ngokuqina kwekhanda, ukuhlolwa kwezithombe kuzodingeka:

• I-CT scan - inikeza izithombe ezinemininingwane yekhanda nobuchopho ukuze kuqinisekiswe ukuthi yiziphi i-sutures ezihlanganisiwe
• I-X-rays - ingase isetshenziswe ukuze ithole umbono ocacile wamathambo ekhanda
• I-MRI - ngezinye izikhathi isetshenziswa ukuhlola ukuthuthuka kobuchopho futhi ikhiphe ezinye izimo
• Izithombe ze-3D - zisiza ochwepheshe bokuhlinzwa ukuhlela indlela yokwelapha engcono kakhulu

Inqubo yokuhlola ngokuvamile ilula futhi ngokuvamile ingaphelelwa emasontweni ambalwa. Iqembu lakho lezokwelapha lizokuchaza isinyathelo ngasinye nokuthi imiphumela isho ukuthini nge-care plan yomntwana wakho.

Kwezinye izimo, ukuhlolwa kwe-genetic kungase kunconywe ukuze kunqunywe ukuthi ukuqina kwekhanda kuyi-syndrome ebanzi, ikakhulukazi uma i-sutures eminingi ihilelekile noma ezinye izici zikhona.

Yikuphi ukwelashwa kokuqina kwekhanda?

Ukwelashwa kokuqina kwekhanda cishe kuhlale kuhilela ukuhlinzwa ukuvula i-sutures ehlanganisiwe futhi kuvumele ukuthuthuka kobuchopho okujwayelekile ukuqhubeka. Indlela ekhethekile incike ebudaleni bomntwana wakho, ukuthi yiziphi i-sutures ezithintekile, kanye nobunzima besimo.

Izinketho eziyinhloko zokuhlinzwa zihlanganisa:

• Ukuhlinzwa kwe-endoscopic - indlela encane yokungena engcono kakhulu kubantwana abaneminyaka engaphansi kwengu-3-4
• Ukwakhiwa kabusha kwe-cranial vault evulekile - ukuhlinzwa okubanzi okubumba kabusha ikhanda, ngokuvamile kubantwana abadala
• I-distraction osteogenesis - ubuchwepheshe obusha obukhulisa ikhanda kancane kancane ngokuhamba kwesikhathi
• Ukuhlinzwa okusiziwe yi-spring - kusebenzisa ama-spring akhethekile ukuqondisa ukukhula kwekhanda ngemuva kokuhlinzwa

Isikhathi sokuhlinzwa sibalulekile. Ukungenelela kwangaphambi kwesikhathi, ngokukhethekile ngaphakathi nonyaka wokuqala wokuphila, ngokuvamile kuholela eziphumeleni ezinhle ngoba amathambo ekhanda aguquguquka kakhulu futhi ubuchopho bukhula ngokushesha.

Iqembu lakho lokuhlinzwa lizobandakanya i-neurosurgeons yabantwana kanye nochwepheshe bokuhlinzwa abakhethekile ezimweni ze-craniofacial. Bazosebenzisana ndawonye ukuze bafinyelele imiphumela engcono kakhulu yokusebenza nobuhle bomntwana wakho.

Ukuphulukiswa kuyahlukahluka kuye ngohlobo lokuhlinzwa, kodwa abantwana abaningi bayaphulile kahle futhi bangabuyela emisebenzini evamile ngaphakathi kwamasonto ambalwa kuya ezinyangeni. Ukulandelela ukunakekelwa kubalulekile ekuqondiseni ukuphulukiswa nokuqinisekisa ukuthi ukukhula kwekhanda okujwayelekile kuyaqhubeka.

Unganakekela kanjani ekhaya ngesikhathi sokwelashwa kokuqina kwekhanda?

Ukukhathalela umntwana onokuqina kwekhanda ekhaya kugxile ekusekeleni ukuthuthuka kwabo okujwayelekile ngenkathi ulungiselela noma uphulukiswa ngokwelashwa. Imihla yakho yansuku zonke ingase ihlale ijwayelekile ngezinye izinto ezibalulekile.

Ngaphambi kokuhlinzwa, ungasiza ngokuthi:

• Ugcine amashejuli okugawula okujwayelekile futhi uqinisekise ukudla okuhle ukuze uphulukiswe kahle
• Ulandela izindlela zokulala eziphephile - beka umntwana wakho ngemuva ukuze alale
• Ugweme ukucindezela okukhulu ezindaweni ezithintekile zekhanda
• Ugcine ukuvakasha okuvamile kwabantwana ukuze uqaphele ukukhula nokuthuthuka
• Uthathe izithombe ukuze ubhale ukushintsha kwesakhiwo sekhanda leqembu lakho lezokwelapha

Ngemuva kokuhlinzwa, iqembu lakho lezokwelapha lizonikeza imiyalo ekhethekile yokunakekelwa kwezinyosi, ukulinganiselwa kwemisebenzi, kanye nezibonakaliso zokuqapha okumelwe uzibone. Abantwana abaningi bayaphulile kahle futhi bangabuyela emisebenzini evamile ngokushesha.

Khumbula ukuthi isikhathi sesisu sisabalulekile ekuthuthukeni, kodwa ungase udinga ukuguqula izikhundla ngokusekelwe ezincomeneni zochwepheshe bakho bokuhlinzwa. Ukuthuthuka komntwana wakho kwezinye izindawo kufanele kuqhubeke ngokujwayelekile kulo lonke inqubo yokwelapha.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela i-appointment yakho kungasiza uqinisekise ukuthi uthola ulwazi oluwusizo kakhulu futhi uzizwe uqinisekile ngezinyathelo ezilandelayo. Letha noma yimiphi imibuzo noma ukukhathazeka okuye kwakucatshangelwa.

Nawa okumelwe ulungiselele ngaphambi kokuya kwakho:

• Uhlu lwezinkathazo zakho ngesakhiwo sekhanda somntwana wakho noma ukuthuthuka
• Amarekhodi okukhula omntwana wakho nanoma yimaphi amarekhodi ezokwelapha angaphambili
• Izithombe ezibonisa ikhanda lomntwana wakho ezibukhoneni ezihlukene naseminyakeni ehlukene
• Umbukiso womndeni wezokwelapha, ikakhulukazi noma yikuphi ukungalingani kwekhanda noma ubuso
• Uhlu lwemithi noma izithasiselo umntwana wakho azithathayo
• Imibuzo mayelana nezinketho zokwelapha, ukuphulukiswa, kanye nombono wesikhathi eside

Unganqikazi ukubuza nganoma yini ongayiqondi. Iqembu lakho lezokwelapha lifuna ukuqinisekisa ukuthi uzizwa ulwazi futhi ukhululekile nge-treatment plan.

Kungaba usizo ukuletha umuntu osekela nawe ukuze akusize ukukhumbula ulwazi futhi unikeze ukwesekwa ngokomzwelo. Abazali abaningi bathola lezi zi-appointments zikhathaza, futhi ukuba nezinye izindlebe kungaba yigugu.

Yini eyinhloko yokuthatha ngokuqina kwekhanda?

Ukuqina kwekhanda kuyisimo esingelashwa esinemiphumela emihle uma siphathwa ngokushesha amaqembu ezokwelapha anamava. Nakuba ukwamukela leli bizo kungase kuzwakale kuyikhathaza, abantwana abaningi abane-craniosynostosis bayaqhubeka bekhula ngokujwayelekile ngemuva kokwelashwa.

Into ebaluleke kakhulu okumelwe uyikhumbule ukuthi ukutholakala kwangaphambi kwesikhathi nokwelashwa kwenza umehluko omkhulu eziphumeleni. Amathuluzi okuhlinzwa anamuhla aphelele kakhulu futhi ancane kakhulu kunangaphambili.

Iqembu lezokwelapha lomntwana wakho lizokukhokhela kuzo zonke izinyathelo zenqubo, kusukela ekuhlonzweni kuya ekwelapheni nasekuphulukiseni. Unganqikazi ukubuza imibuzo, ukukhuluma ngezinkathazo, noma ufune imibono yesibili uma lokho kungakusiza uzizwe uqinisekile.

Ngokunakekelwa okufanele, umntwana wakho angalindela ukuphila impilo egcwele, evamile. Abazali abaningi bathola ukuthi ukuxhumana namaqembu wokusekela noma ezinye imindeni ebe idlule eziphumeleni ezifanayo kungaba usizo kakhulu kulolu hambo.

Imibuzo evamile ebuzwayo ngokuqina kwekhanda

Ingabe ukuqonda komntwana wakho kuzothinteka yini ngokuqina kwekhanda?

Abantwana abaningi abane-single-suture craniosynostosis banokuqonda okujwayelekile ngokuphelele, ikakhulukazi uma belashwa ngokushesha. Okubalulekile ukuqinisekisa ukuthi ukwelashwa kwenzeka ngaphambi kokuba ukukhula kobuchopho kuvinjelwe. Ukuthuthuka kobuchopho bomntwana wakho kufanele kuqhubeke ngokujwayelekile ngokwelashwa okufanele.

Ubude kangakanani ukuphulukiswa ngemuva kokuhlinzwa kokuqina kwekhanda?

Isikhathi sokuphulukiswa sihlukahluka kuye ngohlobo lokuhlinzwa nobudala bomntwana wakho. Ukuhlinzwa kwe-endoscopic okuncane ngokuvamile kunesikhathi esifushane sokuphulukiswa se-1-2 weeks, kuyilapho ukwakhiwa kabusha okubanzi kungase kudingeke amaviki angu-4-6 ukuze kuphulukiswe ngokuphelele. Abantwana abaningi banamandla kakhulu futhi babuyela ngokushesha.

Ingabe umntwana wakho uzodinga ukuhlinzwa okuningi?

Abantwana abaningi badinga ukuhlinzwa okukodwa kuphela ukulungisa ukuqina kwekhanda. Kodwa-ke, abanye bangase badinge izinqubo ezengeziwe, ikakhulukazi uma i-sutures eminingi ihilelekile noma uma isimo kuyi-syndrome ye-genetic. Iqembu lakho lokuhlinzwa lizokuxoxela ngamathuba wezinqubo zesikhathi esizayo ngokusekelwe esimweni sakho esikhethekile somntwana.

Ingabe ukuqina kwekhanda kungabuya ngemuva kokuhlinzwa?

Ukuphinda kwenzeke kokuqina kwekhanda akuvamile uma ukuhlinzwa kwenziwa ochwepheshe bokuhlinzwa abanamakhono. Kodwa-ke, abanye abantwana bangase badinge ukulungiswa okuncane njengoba bekhula, ikakhulukazi ngokulungiswa kwezinto zokubukeka. Ukuvakasha okuvamile kokulandelela kusiza ekuqondiseni ukuphulukiswa nasekutholeni noma yiziphi izinkinga kwangaphambi kwesikhathi.

Nizobona nini imiphumela yokugcina yokuhlinzwa?

Nizobona ukuthuthuka okusheshayo kwesakhiwo sekhanda ngemuva kokuhlinzwa, kodwa imiphumela yokugcina yobumuhle iyaqhubeka ithuthuka njengoba umntwana wakho ekhula. Iningi lokuphulukiswa kwenzeka phakathi kwamasonto ambalwa okuqala, kodwa ukuthuthuka okuthambile kungase kuqhubeke unyaka noma ngaphezulu njengoba ikhanda liqhubeka likhula futhi libuyekeze.