I-ethmoid iyithambo elincane kugebhezi, elitholakala ngemuva kwethambo emakhaleni, phakathi kwezisekelo ezimbili zamehlo. Ngokuyinhloko yakha ingxenye engenhla yezimbobo zamakhala kanye nengxenye yesono.

Leli thambo, eline-geometry eyinkimbinkimbi, libamba iqhaza ekwakhiweni kwezakhiwo eziningana zobuso:

• izimbotshana ezizungeza umzimba, okuyingxenye yodonga lwangaphakathi;
• umgodi wamakhala, owakha uphahla nengxenye yezindonga, kanye nangemuva kwe-nasal septum (ebizwa nangokuthi i-nasal septum). Le bina lamina elime mpo, elihlukanisa imigodi emibili, empeleni ngele-ethmoid;
• izono ze-ethmoid, zikhonjwe ohlangothini ngalunye lwe-ethmoid.

I-ethmoid ibuye iwele ngokuphela kwemithambo ye-olfactory, njengoba kufakazelwa izimbobo ezincane neziningi lapho ingaphezulu layo ligcwele khona. Kukuyo, eqinisweni, ukuthi ama-olfactory bulbs aphumula.

Ngaphandle kwendima yayo yezokwakha, i-ethmoid inendima yokukhulisa ekwamukelweni kwezimpawu zokuhogela. Ukuqagela okubili kwaleli thambo ezimbotsheni zamakhala, okuyizimo zamagobolondo, kwakha ama-turbinates acinene anomthwalo wokuqondisa umoya ophefumulayo ubheke kumaseli we-olfactory.

Ngakolunye uhlangothi lwe-ethmoid kukhona nezono, ezibizwa ngokuthi ama-ethmoid sinuses, akhiwa izimbotshana ezigcwele umoya. Izindonga zazo zigcwele ulwelwesi lwamafinyana olufana nolwasemakhaleni, kodwa indima yazo ngqo ayikaqondakali ngokugcwele. Sazi ngokukhethekile ubukhona bazo lapho betheleleka noma bevinjelwa.

I-Ethmoiditis

I-Ethmoid sinusitis, noma i-ethmoiditis, ukuvuvukala kolwelwesi olumboza izono ze-ethmoid, kulandela ukutheleleka ngamagciwane. Kungathinta isono esisodwa se-ethmoid noma zombili, noma ngisho nokuhlotshaniswa nokubandakanyeka kwezinye izono. Ngendlela yayo ebucayi kakhulu, ethinta izingane kaningi kunabantu abadala, ibonakaliswa yizimpawu ezilandelayo:

• ukuvuvukala kwejwabu leso eliphezulu, ezingeni lekhoneni elingaphakathi leso, eliqhubeka kancane kancane;
• ubuhlungu obunobudlova ezingeni lale edema;
• iso eliqhakazile (i-exophtalmie);
• ukuqongelela kobovu esweni, nokukhishwa ubovu emakhaleni;
• umkhuhlane omkhulu.

Ngophawu oluncane lokuvusa, kuyanconywa ukubonisana nabezimo eziphuthumayo. 

Ukwelashwa okusheshayo kuyadingeka ukugwema izingqinamba zalesi sifo:

• i-oculomotor nerve palsy;
• ukulahleka kobuzwe be-cornea;
• i-meningeal syndrome (ikhanda elibuhlungu, intamo elukhuni nokuhlanza).

Kunezinhlobo ezingapheli ze-ethmoiditis, ezinodlame oluncane kepha ezihlala ngaphezu kwezinyanga ezintathu. Phakathi kwezimbangela ezivame kakhulu: ukungalungi kwama-turbinates noma i-septum yamakhala, noma isizinda esihle sofuzo. 

I-Ethmoid adenocarcinoma

Lesi isimila esibi, esikhula kulwelwesi lwamafinyila wezono ze-ethmoid, akuvamile (cishe amacala amasha angama-200 ngonyaka eFrance). Kuxhunyaniswe nokuhogela okuvamile kokhuni, isikhumba noma uthuli lwe-nickel, imvamisa kungumsebenzi. Iphinde yamukelwe kanjalo nguMshwalense Wezempilo (kuncike esikhathini sokuchayeka seminyaka emihlanu).

Lo mdlavuza wesinus unenqubekela phambili ehamba kancane, enesigaba seminyaka eminingi. Izimpawu-ke zingabonakala ngemuva kokumisa lo msebenzi okukhulunywa ngawo, ngezindlela ezahlukahlukene. Kungenzeka: 

• ukuvinjelwa kwamakhala okungafani okungadluli, okuvame ukuhambisana nokukhishwa kwe-mucopurulent (rhinorrhea), okungenzeka kugcwele igazi;
• i-epistaxis, noma ephindaphindekayo, ephuma ngamakhala okhipha igazi, avela ngaphandle kwembangela yendawo noma yesistimu;
• ukulahleka kwephunga noma ingxenye yokuzwa, okungenzeka kuhlotshaniswe nokuphazamiseka kokugwinya;
• i-edema ebuhlungu yejwabu leso eliphezulu, engahlotshaniswa nokutheleleka kwesikhwama se-lacrimal (dacryocystitis). Ngenxa yalokhu kuvuvukala okwenzeka esikhaleni esivinjelwe se-orbit, iso lingaphuma (exophthalmos) nejwabu leso droop (ptosis). Singabona futhi ukukhubazeka kwe-ocular noma i-diplopia (ukubona ngasikhathi sinye kwezithombe ezimbili zento efanayo).

Uma kwenzeka i-ethmoiditis

Ngendlela yayo ebucayi, le sinusitis iyisimo esiphuthumayo sezokwelapha. Ukwelashwa ngama-antibiotic kufanele kunqunywe ngaphandle kokulibala ukulwa nokutheleleka, khona-ke ukuhlolwa komtholampilo okwenziwe ngemuva kwamahora angama-48 ngemuva kokuqala kokwelashwa kwenza kube lula ukuqinisekisa umphumela wayo.

Uma izinkinga sezivele, kudingeka ukwelashwa ngemithi elwa namagciwane isikhathi eside futhi okubanzi. Ingasethwa esibhedlela noma esibhedlela, futhi ihambisane nokwelashwa kwe-corticosteroid ukuqeda izinhlungu.

Amanzi okuhlinza angenziwa futhi ukususa ithumba elenziwe. Le ethmoidectomy, eyenziwa i-ENT noma i-maxillofacial surgeon, yenziwa ngomgodi wamakhala. Kuqukethe ukuvula ithambo le-ethmoid ukufinyelela kuma-sinus nokwenza ukuhlanzwa kwawo.

Uma kwenzeka i-adenocarcinoma

Uma ingekho kakhulu futhi uma isimo esijwayelekile sesiguli sikuvumela, ukwelashwa kuqukethe i-endoscopic ethmoidectomy: udokotela ohlinzayo udlulisa izinsimbi zakhe, kufaka phakathi ikhamera encane, emakhaleni ukususa ucezu lwethambo. ne-mucosa enesifo. Ukuhlinzwa kuvame ukulandela i-radiotherapy. Ukwakhiwa kabusha kungadingeka ukuvala isisekelo sogebhezi.

Lapho ukuhlinzwa kungeyona inketho, kunikezwa ukwelashwa okuhlanganisa i-chemotherapy ne-radiotherapy.

Ukuxilongwa kwe-ethmoiditis ekuqaleni kusekelwe ekuhlolweni komtholampilo. Ukuhlolwa okwengeziwe okuningana kungenziwa lapho kucelwa ochwepheshe bezempilo ababonisiwe: i-CT noma i-MRI, amasampula egciwane. Benza bakwazi ukuqinisekisa ukuxilongwa, ukukhomba uhlobo lwe-pathogenic okukhulunywa ngalo kanye / noma ukubheka izinkinga. 

Umdlavuza weSinus uvame ukuthula ngaphambi kokuzibonakalisa, ukuhlolwa okuhlelekile, ngokulandelwa kwe-ENT kanye i-nasofibroscopie, unikezwa njalo eminyakeni emibili ukuze aveze abasebenzi nalabo ababekade bevela. Ukuxilongwa kwenziwa nge-biopsy, kwenziwa, uma kwenzeka ungabaza, ngesikhathi se-fibroscopy.