I-Advanced Trigeminal Neuralgia Surgery eBhubaneswar
Isayensi yezokwelapha iyaqaphela i-trigeminal neuralgia (TN) njengesinye sezimo ezibuhlungu kakhulu ebusweni. Lesi sifo esibuhlungu esingapheli sithinta inzwa ye-trigeminal eqala eduze nendawo ephezulu yendlebe bese ihlukana ibe amagatsha amathathu ukuze inikeze izindawo zamehlo, ezihlathini, nemihlathi. Imithi iyindlela yokwelapha yokuqala yokwelashwa kwe-neuralgia ye-trigeminal. Odokotela ngokuvamile batusa ukuhlinzwa kwe-trigeminal neuralgia lapho imithi yehluleka ukulawula ubuhlungu obukhulu, obuphindelelayo ebusweni.
Izinhlobo ze-Trigeminal Neuralgia
Ochwepheshe bezokwelapha bahlanganisa i-trigeminal neuralgia (TN) ibe izigaba ezintathu eziyinhloko ngokusekelwe kuzinqubo nezici zabo:
- I-Classical Trigeminal Neuralgia: Le neuralgia isuka ekucindezelekeni komkhumbi wegazi eduze kwesiqu sobuchopho. Umthambo noma umthambo ucindezela umthambo we-trigeminal endaweni ebucayi. Ungqimba lwangaphandle oluvikelayo lwenzwa, olubizwa ngokuthi i-myelin sheath, luyaguga ngenxa yalokhu kucindezela futhi lubangele amasignali ezinhlungu ukuba ahambe emthanjeni.
- I-Secondary Trigeminal Neuralgia: Ivela kwezinye izimo zezokwelapha. Izimila, ama-cysts, ukungasebenzi kahle kwe-arteriovenous, multiple sclerosis, ukulimala ebusweni, noma ukulimala kokuhlinzwa kwamazinyo kungabangela lesi simo. Ukwelashwa kugxile ekulawuleni kokubili isimo esiwumsuka kanye nobuhlungu.
- I-Idiopathic Trigeminal Neuralgia: Le neuralgia imelela izimo lapho odokotela bengakwazi ukuthola imbangela ethile. Lokhu kuhlukaniswa kuqondisa odokotela ukuthi bakhe amasu okwelapha afanelekile naphezu kokungaziwa komsuka.
Odokotela baphinde babone izinhlobo ezimbili ezihlukene ezisekelwe emaphethini obuhlungu:
- I-Paroxysmal TN: Iziqephu ezibukhali, eziqinile zisuka kumasekhondi ukuya emizuzwini emibili, nezikhawu ezingenabuhlungu phakathi kokuhlasela.
- I-TN enobuhlungu obuqhubekayo: Ubuhlungu obungapheli, obuthambile buyaqhubeka nokuzwa okubuhlungu nokuvutha
Odokotela Abahlinzayo Be-Trigeminal Neuralgia Abangcono Kakhulu eNdiya
I-Trigeminal Neuralgia Izimbangela
- I-Blood Vessel Disorder: Ukucindezelwa komkhumbi wegazi eduze nesiqu sobuchopho kubangela izimo eziningi ze- trigeminal neuralgia. I-cerebellar artery ephakeme kakhulu ibeka ingcindezi kumpande we-trigeminal nerve, obala amacala angama-75% kuya ku-80%. Lokhu kucindezelwa kwenzeka ngaphakathi kwamamilimitha endaweni yokungena kwenzwa emaphonini.
- Ukukhula ngokweqile: Izilonda eziningi ezithatha isikhala zingadala lesi simo:
- Meningiomas
- I-acoustic neuromas
- Ama-cysts e-epidermis
- Ukukhubazeka kwe-Arteriovenous
- I-aneurysms ye-saccular
- I-Multiple Sclerosis (MS): I-MS idlala indima ebaluleke kakhulu cishe ku-2% kuya ku-4% wamacala. Lesi simo silimaza isembozo se-myelin esivikelayo senucleus ye-trigeminal nerve futhi sibangele izimpawu zobuhlungu.
Izimpawu ze-Trigeminal Neuralgia
Uphawu oluyinhloko lwe- trigeminal neuralgia ubuhlungu obubukhali obuzwakala njengokushaqeka kukagesi. Lobu buhlungu bobuso buhlasela ngokuzumayo futhi ngamandla ohlangothini olulodwa lobuso.
Ubuhlungu bubonakala ngezindlela eziningi:
- Imizwa ehlabayo ebukhali esihlathini noma emhlathini
- Imizwa evuthayo noma yokushaywa
- Ama-spasms emisipha yobuso
- Ukuba ndikindiki noma izinhlungu ezibuhlungu
Lezi ziqephu ezibuhlungu zingaqala emisebenzini yansuku zonke. Into elula njengokugeza ubuso, ukuzigcoba, ukuxubha amazinyo, ukudla, ukuphuza, noma umoya opholile kungabangela ukuhlasela.
Isiqephu sobuhlungu ngasinye sihlala phakathi kwamasekhondi ambalwa kuya emizuzwini emibili. Lesi simo sinephethini efana nomjikelezo. Izikhathi zokuhlasela okuvamile zilandelwa amasonto noma izinyanga ezinobuhlungu obuncane.
Lezi zinhlungu zivame ukuza nokunyakazisa ubuso, yingakho kubizwa nangokuthi 'tic douloureux'. Ubuhlungu bungase buhlale endaweni eyodwa noma busakazeke ebusweni. Kungathinta izihlathi, imihlathi, amazinyo, izinsini, izindebe, amehlo, nebunzi.
I-Trigeminal Neuralgia Diagnosis
- Ukuhlolwa Komzimba Nomlando Womtholampilo: Odokotela bahlola iziguli futhi babuyekeze umlando wabo wezokwelapha ukuze baqonde ubuhlungu bazo bobuso kangcono. Ukuhlolwa okuphelele kwe-neurological kubonisa ukuthi yimaphi amagatsha e-trigeminal nerve athintekayo. Ithimba lezokwelapha lenza ukuhlolwa kwe-reflex ukubona ukuthi izinzwa ezicindezelweyo ziyazibangela yini izimpawu.
- Izindlela Zanamuhla Zokuthwebula: Lezi zivivinyo zizonikeza isithombe esicacile sezinqubo:
- I-Magnetic Resonance Imaging (MRI) enesithombe esinesisindo esiphezulu se-T2 ukuthola ukucindezelwa komkhumbi wegazi.
- Izindlela ezithuthukisiwe ze-MRI zokubona ngeso lengqondo inzwa ye-trigeminal nezindawo ezizungezile
- Izikena zobuchopho ezikhethekile ukuze kukhishwe izimila noma i-multiple sclerosis
- Ukuhlolwa kwegazi ukuhlola izimo ezifana nalezi ukungahambi kahle kweshukela egazini kanye nesifo seLyme
Izinketho Zokwelapha I-Trigeminal Neuralgia
Odokotela basebenzisa izindlela eziningi zokuphatha ubuhlungu be-neuralgia ye-trigeminal.
- Imithi: Indlela yokwelapha yomugqa wokuqala:
- Izidakamizwa ze-Anticonvulsant: I-Carbamazepine kusewumuthi okhethwa kuqala okhulula amaphesenti angama-80 kuye kwangama-90 eziguli. Eminye imithi efana ne-oxcarbazepine, gabapentin, Futhi i-topiramate ngokuvamile ukuthuthukisa uhlelo lokwelapha.
- Iziphumuli zemisipha: Imithi ephumuza imisipha njenge-baclofen ingasetshenziswa njengendlela yokwelapha ezimele noma ihlanganiswe ne-carbamazepine.
- Botox Imijovo: Yehlisa ubuhlungu obuvela ku- trigeminal neuralgia
- Ukuhlinzwa: Iziguli zidinga ukungenelela kokuhlinzwa lapho imithi ingasebenzi. Izinketho eziyinhloko zokuhlinzwa zihlanganisa:
- I-Microvascular decompression: Inikeza ukukhululeka kwezinhlungu zesikhathi eside ngezinga lempumelelo elingu-80%.
- I-Stereotactic radiosurgery: Ilawula ubuhlungu ngempumelelo kuma-80% wamacala futhi ithatha izinyanga ezi-4-8 ukuthola impendulo ephelele.
- I-Radiofrequency lesioning: Iletha ukukhululeka kobuhlungu ngokushesha ku-90% weziguli
Inqubo ye-Trigeminal Neuralgia
Iziguli ezine-neuralgia ye-trigeminal zingathola ukukhululeka okuhlala njalo ngezinqubo zokuhlinzwa. Lokhu kubandakanya:
- I-Microvascular decompression (MVD): I-MVD isalokhu iyinketho yokuhlinzwa ephumelela kakhulu futhi inikeza ukukhululeka kobuhlungu ku-80% weziguli. Phakathi nale nqubo, udokotela ohlinzayo uhambisa imithambo yegazi kude nenzwa ye-trigeminal futhi abeke umcamelo othambile phakathi kwayo.
- I-Gamma Knife radiosurgery: Le ndlela yokwelapha engahlanyisi isebenzisa imishayo yemisebe egxilile kumthambo we-trigeminal. Lokhu kwelashwa kusiza i-70% yeziguli zithole ukukhululeka okuphelele kobuhlungu ekuqaleni, futhi i-40-55% iqhubeka nokuthola impumuzo ngemva kweminyaka emithathu.
- Indlela Yokwelapha Ehlasela Kancane: Izinketho ezimbalwa ezihlasela kancane ziyatholakala ezigulini:
- Umjovo weGlycerol: Inalithi iletha umuthi ebusweni ukuze kwehlise ubuhlungu
- Ukucindezelwa kwebhaluni: I-catheter enebhaluni icindezela inzwa ukuze ivimbe izimpawu zobuhlungu
- I-Radiofrequency lesioning: I-electrode idala umonakalo olawulwayo wokumisa ukudluliswa kobuhlungu
Izinqubo ze-Pre Trigeminal Neuralgia Surgery
- Ukuhlola okuphelele ukuze kukhishwe izimbangela zokucindezelwa kwe-nerve trigeminal
- Ukubuyekezwa kwemithi kanye nokulungiswa, njengemithi engeyona i-steroidal eqeda ukuvuvukala kanye nezidakamizwa zegazi
- Iziguli ezihlelelwe ukuhlinzwa kwe-microvascular decompression kumele zinamathele emithethweni eqinile yokuzila ukudla. Abakwazi ukudla noma ukuphuza noma yini phakathi kwamabili ngaphambi kokuhlinzwa ukuze bagweme izinkinga ze-anesthesia. Imithetho yokuzila ayisondeli nakancane ezigulini ezihlinzwa ngomsakazo we-Gamma Knife.
Phakathi nezinqubo ze-Trigeminal Neuralgia
Ama-X-ray asiza ukuqondisa ukubekwa kwezinaliti phakathi nezinqubo ze-percutaneous kuyilapho iziguli zisahleli kakhulu. Odokotela babeka iziguli emihlane yazo ngamakhanda ngaphakathi kwengalo ye-C ukuze bathole isithombe esinembile ngesikhathi sokwelashwa kwama-radiofrequency.
I-Microvascular decompression idinga ukuqapha ngokucophelela isiqu sobuchopho. Ochwepheshe manje basebenzisa izimpendulo ezivezwa yi-brainstem auditory ukuhlola ukusebenza kwezinzwa. Ithimba labahlinzayo lixhumana njalo futhi lilungisa amasu abo ngokusekelwe empendulweni esheshayo.
Izinqubo ze-Post Trigeminal Neuralgia
Iziguli ezithola ukuncipha kwemithambo yegazi emincane zidinga usuku olulodwa egunjini labagula kakhulu ngaphambi kokuthuthela egumbini elivamile lasesibhedlela. Baqala ukuhamba besuka embhedeni baye kwesinye isihlalo bebodwa engakapheli amahora angama-24.
Ukuphathwa Kwezinhlungu kanye Nokubuyiselwa Kwangempela: Iziguli zidinga imithi amaviki angu-2-4 ngemva kokuwohloka kwe-microvascular. Lokhu kusiza ukuphatha ukungakhululeki nokuvuvukala futhi kuvimbele ukutheleleka. Odokotela basusa imithungo ngemva kwezinsuku eziyi-10. Abantu bangabuyela emsebenzini ngemva kwamasonto amathathu uma umsebenzi wabo uhlanganisa imisebenzi elula.
Izinyathelo ezibalulekile zokutakula zihlanganisa:
- Ukuhamba ngokuzimela ngosuku lwesibili
- Ukuqalisa kabusha umsebenzi ojwayelekile wasendlini phakathi nesonto elilodwa
- Ukubuyela emsebenzini wokuziphilisa ngemva kwamasonto amathathu
- Ukubuyiselwa komsebenzi ogcwele phakathi kwamaviki angu-4-6
Kungani ukhethe Izibhedlela ze-CARE ngenqubo ye-Trigeminal Neuralgia?
Indlela yokwelapha esibhedlela ye-trigeminal neuralgia ihlanganisa:
- Izikhungo zokuxilonga ezisezingeni eliphezulu eziqinisekisa ukuhlola okunembile
- Odokotela abahlinzayo abanekhono ngerekhodi eliqinisekisiwe
- Gcwalisa izinketho zokwelapha kusukela emithini kuya ekuhlinzweni
- Izinhlelo zokunakekela ngokwezifiso zesiguli ngasinye
- Imithetho eqinile yokulawula ukutheleleka
HyderabadIzibhedlela ze-CARE, eBanjara Hills I-CARE Outpatient Centre, e-Banjara Hills CARE Izibhedlela, HITEC City CARE Hospitals, Nampally Izibhedlela zaseGurunanak CARE, Musheerabad I-CARE Hospitals Outpatient Centre, i-HITEC City CARE Hospitals, Malakpet
Raipur
Bhubaneshwar
Visakhapatnam
Nagpur
esilengayo
Chh. Sambhajinagar
Imitholampilo Nezikhungo Zezokwelapha
