I-nasal septum, noma i-nasal septum, yilolu donga olubheke phezulu oluhlukanisa izimbotshana ezimbili zamakhala ezivuleka emakhaleni. Yakhiwe ngamathambo e-osteocartilaginous, kungaba yindawo yokuchezuka noma yokugcotshwa, okunomthelela ebuqothweni bemigodi yamakhala kanye nekhwalithi yokuphefumula.

Impumulo yakhiwe ngezakhiwo ezahlukahlukene: ithambo elihlanzekile lamakhala, ingxenye enzima kunazo zonke phezulu kwekhala, uqwanga olwakha ingxenye engezansi yekhala, nezicubu ezinemicu emakhaleni. Ngaphakathi, ikhala lihlukaniswe izimbotshana ezimbili zamakhala ezihlukaniswe yi-nasal septum, ebizwa nangokuthi yi-septum. Le septum yamakhala yakhiwa ngengxenye engemuva yamathambo nengxenye yangaphakathi enentlala, futhi ifakwe ulwelwesi lwamafinyila. Yindawo enemithambo ecebile.

Iseptum yamakhala ihlukanisa ngokulinganayo izimbotshana ezimbili zamakhala, ngaleyo ndlela iqinisekise ukusakazwa okuhle komoya ohogelwayo nophefumulayo. Iphinde inendima esekelayo ekhaleni.

Ukuphambuka kwe-septum yamakhala

Cishe ama-80% abantu abadala banezinga elithile lokuphambuka kwempumulo septum, imvamisa ngokungafani. Kwesinye isikhathi, noma kunjalo, lokhu kuphambuka kungaholela ezinkingeni zezokwelapha kanye / noma zobuhle:

• ukuvinjelwa kwamakhala okungadala ubunzima ekuphefumuleni, ukuhogela, ukuvimbela i-apnea syndrome (i-OSAS);
• ukuphefumula umlomo ukunxephezela. Lokhu kuphefumula komlomo nakho kungaholela ekomeni kolwelwesi lwamafinyila, kwenyuse ubungozi be-ENT pathologies;
• i-sinus noma ngisho nokutheleleka ezindlebeni ngenxa yezicubu zamakhala ezimile;
• ikhanda elibuhlungu;
• ukungaphatheki kahle kobuhle lapho kuhlotshaniswa nokuguquguquka kwangaphandle kwekhala.

Ukuphambuka kwe-nasal septum kungaba kokuzalwa (okukhona lapho kuzalwa), kungavela ngesikhathi sokukhula noma kungenxa yokuhlukumezeka ekhaleni (umthelela, ukushaqeka).

Kungathinta kuphela ingxenye ye-cartilaginous noma nengxenye ye-bony ye-nasal septum kanye namathambo ekhaleni. Kungathinta kuphela ingxenye engenhla yokwahlukanisa, ngokuchezuka kwesokudla noma kwesobunxele, noma kube sesimeni se- “s” ngokuchezuka phezulu kolunye uhlangothi, kolunye ezansi. Kwesinye isikhathi kuhambisana nama-polyps, izicubu ezincane ezinobungozi zemigodi yamakhala, kanye ne-hypertrophy yama-turbinates, izinto ezinomthelela ekusakazeni komoya okungahambi kahle emgodini wamakhala osuvele unciphile ukuphambuka.

Ukugcotshwa kwe-septum yamakhala

Futhi okubizwa ngokuthi yi-septal perforation, ukugcotshwa kwe-nasal septum kuvame ukuhlala engxenyeni engaphambili ye-cartilaginous of the septum. Isincane ngosayizi, lokhu kungcoliswa kungahle kungabangeli zimpawu, ngakho-ke kwesinye isikhathi kutholakala kungalindelekile ngesikhathi sokuhlolwa kwamakhala. Uma ukugcotshwa kubalulekile noma kuya ngokuthi ikuphi, kungadala ukushaywa umoya lapho uphefumula, ushintsho ezwini, ukuvinjelwa kwamakhala, izimpawu zokuvuvukala, uqweqwe, ukuphuma kwamakhala.

Isizathu esiyinhloko sokugcotshwa kwe-septum yamakhala sihlala sihlinzwa ngamakhala, siqala nge-septoplasty. Ezinye izinqubo zokwelashwa kwesinye isikhathi ziyabandakanyeka: i-cauterization, ukubekwa kwepayipi le-nasogastric, njll. Imbangela nayo ingaba nemvelaphi enobuthi, bese ilawulwa ukuhogela i-cocaine. Kuyaqabukela kakhulu, lokhu kugobeka kwamanzi okubeletha kungenye yezimpawu zesifo esijwayelekile: isifo sofuba, ugcunsula, uchoko, i-systemic lupus erythematosus ne-granulomatosis ene-polyangiitis.

Ukwelashwa kwe-septum yamakhala ekhethiwe

Ngenhloso yokuqala, kuzonikezwa ukwelashwa kwezidakamizwa ukunciphisa izimpawu. Lezi izifutho zokuqeda amandla noma, uma kwenzeka ukuvuvukala kwezimbobo zamakhala, ama-corticosteroids noma ama-antihistamine.

Uma ukuphambuka kwe-nasal septum kubangela ukungakhululeki noma ubunzima (ubunzima bokuphefumula, ukutheleleka okuvamile, i-apnea yokulala), kungenziwa i-septoplasty. Lokhu kwelashwa okuhlinzekwayo kuqukethe ukulungisa kabusha kanye / noma ukususa kancane izingxenye ezikhubazekile ze-septum yamakhala ukuze "uyiqondise". Ukungenelela, okuhlala phakathi kwemizuzu engama-30 nehora eli-1 imizuzu engama-30, kwenzeka ngaphansi kwe-anesthesia ejwayelekile futhi ngokuvamile ngaphansi kwe-endoscopy nangendlela yemvelo, okusho ukuthi i-nasal. Ukuqhekeka kungu-endonasal, ngakho-ke ngeke kube khona isibazi esibonakalayo. Kwezinye izimo noma kunjalo, ikakhulukazi lapho ukuphambuka kuyinkimbinkimbi, ukuchusha kwesikhumba okuncane kungadingeka. Okuncane, kuzotholakala phansi ekhaleni. I-Septoplasty ukuhlinzwa okusebenzayo, ngakho-ke kungambozwa ukuphepha komphakathi, ngaphansi kwezimo ezithile (ngokungafani ne-rhinoplasty engeke ibe khona).

I-Septoplasty kwesinye isikhathi ihlanganiswa ne-turbinoplasty ukususa ingxenye encane ye-turbinate (ukwakheka kwamathambo acinene embozwe ulwelwesi lwamafinyila) okungenza ukuvinjelwa kwamakhala kube kubi kakhulu. Uma ukuphambuka kwe-nasal septum kuhlotshaniswa nokukhubazeka kwangaphandle kwekhala, i-septoplasty ingahlanganiswa ne-rhinoplasty. Lokhu kubizwa nge-rhinoseptoplasty.

Ukwelashwa kwe-septal perforation

Ngemuva kokwehluleka ukunakekelwa kwasendaweni futhi kuphela ngemuva kokushiswa kwesimpawu septal, kunganikezelwa ngokuhlinzwa. Ngokuvamile kusekelwe ekuxhunyelelweni kwezicucu ze-septal noma zomlomo womlomo. Ukufakwa kwe-obturator, noma inkinobho ye-septal, kungenzeka.

Izimpawu ezahlukahlukene zingaphakamisa ukuphambuka kwe-septum yamakhala: ukuminyana kwamakhala (ikhala elivalekile, kwesinye isikhathi unilaterally), ubunzima bokuphefumula, ukuphefumula ngomlomo ukukhokhela ukungabikho komoya ogeleza emakhaleni, i-sinusitis, ukopha, ukuphuma emakhaleni, ukulala okuphazamisekile ngenxa yokuphefumula kokulala noma ukuhogela, ukutheleleka kwe-ENT, njll. Uma kubizwa, kungahambisana nokuphambuka kwekhala elibonakala ngaphandle.

Ebhekene nalezi zimpawu, udokotela we-ENT uzohlola imigqa yangaphakathi yamakhala esebenzisa i-endoscope yamakhala. Ukuskena kobuso kuzonquma izinga lokuphambuka kwe-septum yamakhala.

Ukugcotshwa kwe-Septal kuboniswa yi-rhinoscopy yangaphakathi noma i-nasofibroscopy.