Laryngectomy

ʻO Laryngectomy kahi ʻoki e wehe i nā mea āpau a ʻāpana paha o ka larynx (pahu leo).

ʻO Laryngectomy kahi hana nui i hana ʻia ma ka haukapila. Ma mua o ke kaha ʻana e loaʻa iā ʻoe ka anesthesia ākea. E hiamoe ʻoe a ʻaʻohe ʻeha.

Lawe ka total laryngectomy i ka larynx holoʻokoʻa. Hiki ke lawe ʻia i waho o kāu pharynx. ʻO kāu pharynx ka mucous membrane-lined ala i waena o kāu mau ihu ihu a me kou esophagus.

• Eʻokiʻoki ke kaukōkō i kou ʻāʻī e wehe i ka wahi. Mālama ʻia e mālama i nā kīʻaha koko nui a me nā hanana koʻikoʻi ʻē aʻe.
• E hoʻoneʻe ʻia ka larynx a me nā mea a puni. Hiki ke hoʻoneʻe ʻia nā lymph nodes.
• A laila e hana ka mea lapaʻau i kahi wehe i kāu trachea a me kahi puka i mua o kou ʻāʻī. Hoʻopili ʻia kāu trachea i kēia lua. Kapa ʻia ka lua he stoma. Ma hope o ke kaha ʻana e hanu ʻoe ma o kāu stoma. ʻAʻole hiki ke hemo.
• E pani ʻia kou esophagus, nā mākala, a me kou ʻili me nā humuhumu a i ʻole nā ​​kiʻi. Loaʻa paha kāu mau paipu mai kou ʻeha no kekahi manawa ma hope o ke kaha ʻana.

Hiki i ke kauka ke hana i kahi puncture tracheoesophageal (TEP).

• ʻO kahi TEP kahi puka liʻiliʻi i kāu puka makani (trachea) a me ka paipu e hoʻoneʻe i ka meaʻai mai kou puʻu i kou ʻōpū (esophagus).
• E hoʻokau kāu kauka lāʻau i kahi ʻāpana i hana ʻia e ke kanaka i loko o kēia wehe. ʻAe ka prostesis e ʻōlelo iā ʻoe ma hope o ka hemo ʻana o kāu pahu leo.

Nui a hewahewa nā ʻōkuhi invasive e hoʻoneʻe i kahi hapa o ka larynx.

• ʻO nā inoa o kekahi o kēia mau kaʻina hana he endoscopic (a i ʻole transoral resection), pākaha hapa laryngectomy, papamoe a supraglottic hapa laryngectomy, a me supracricoid hapa laryngectomy.
• Hiki ke hana i kēia mau kaʻina hana no kekahi poʻe. ʻO ke ʻoki āu i pili ai i ka nui o kāu maʻi ʻaʻai i hohola aku ai a me ke ʻano o ka maʻi ʻaʻai āu.

Hiki ke ʻoki kino i 5 a 9 mau hola.

ʻO ka pinepine, hana ʻia ka laryngectomy e mālama ai i ka maʻi ʻaʻai o ka larynx. Hana ʻia ia e mālama:

• Hoʻopilikia ʻino, e like me ka ʻeha pū a i ʻole nā ​​ʻeha ʻē aʻe.
• ʻO ka hōʻino koʻikoʻi i ka larynx mai ka mālama ʻana i ka radiation. Kapa ʻia kēia ʻo radiation nekrosis.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Nā hopena āpau i nā lāʻau
• Nā pilikia hanu
• Nā pilikia puʻuwai
• Kahena
• Maʻi kīnā

ʻO nā pilikia no kēia ʻoki kino penei:

• Hematoma (kahi kūkulu o ke koko ma waho o nā kīʻaha koko)
• Ka maʻi hōʻeha
• Fistulas (nā pilina pili i pili i waena o ka pharynx a me ka ʻili ʻaʻole maʻamau ma laila)
• Liʻiliʻi paha a paʻa paha ka wehe ʻana o ka stoma. Kapa ʻia kēia he stalosis stal.
• Ke hele a puni ka punchure tracheoesophageal (TEP) a me ka prostesis
• Ka hōʻino i nā wahi ʻē aʻe o ka esophagus a i ʻole trachea
• Pilikia i ka ale ʻana a me ka ʻai ʻana
• Pilikia i ka ʻōlelo ʻana

E kipa ʻia nā hoʻokolohua ma mua o kāu ʻoki ʻana. ʻO kekahi o kēia mau mea:

• ʻO kahi hoʻokolohua kino piha a me nā hoʻokolohua koko. Hana ʻia paha nā noiʻi kiʻi.
• ʻO kahi kipa me kahi haʻi ʻōlelo a me kahi mea hoʻopōʻai e ale no ka hoʻololi ʻana ma hope o ke kaha ʻana.
• ʻLelo aʻoaʻo kino.
• Papu-puhipaka - aʻoaʻo aʻoaʻo. Inā he puhipaka ʻoe a ʻaʻole i haʻalele.

E haʻi mau i kāu mea mālama ola:

• Inā ʻoe a hāpai paha
• He aha nā lāʻau āu e lawe nei, a ʻo nā lāʻau paha, nā mea hoʻopili, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau
• Inā inu nui ʻoe i ka waiʻona, ʻoi aku ma mua o 1 a 2 paha inu i ka lā

I nā lā ma mua o kou ʻoki kino:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i ka aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), a me nā lāʻau ʻē aʻe paʻakikī i kou koko ke ʻū.
• E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.

I ka lā o kou ʻoki kino:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai paha i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki kino ʻana.
• E lawe i nā lāʻau i haʻi aku ai kāu mea lawelawe iā ʻoe e lawe me kahi wai liʻiliʻi.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Pono ʻoe e noho i ka haukapila no kekahi mau lā ma hope o ke kaha ʻana.

Ma hope o ke kaʻina hana, groggy ʻoe a ʻaʻole hiki ke ʻōlelo. Aia kahi mask o oxygen ma kāu stoma. He mea nui e hāpai i kou poʻo, hoʻomaha nui, a neʻe i kou mau wāwae i kēlā me kēia manawa e hoʻomaikaʻi i ke kahe o ke koko. ʻO ka mālama ʻana i ke koko e hoʻoliʻiliʻi i kou makaʻu i ka loaʻa ʻana o ke koko.

Hiki iā ʻoe ke hoʻohana i nā compresses mehana e hōʻemi i ka ʻeha a puni kāu mau ʻokiʻoki. E loaʻa iā ʻoe ka lāʻau ʻeha.

E loaʻa ʻoe i ka meaʻai ma o ka IV (kahi paipu e hele i loko o ke aa) a me ka hānai ʻana o ka paipu. Hāʻawi ʻia nā hānai Tube ma o ka paipu e hele i loko o kou ihu a i loko o kāu esophagus (pūʻai hānai).

ʻAe paha ʻoe e ale i ka meaʻai ke hiki ke 2 a 3 mau lā ma hope o ke kaha ʻana. Eia nō naʻe, ʻoi aku ka maʻamau ke kali i 5 a 7 mau lā ma hope o kou ʻoki ʻana e hoʻomaka e ʻai ma o kou waha. Loaʻa paha iā ʻoe kahi noi ʻolo, kahi i lawe ʻia kahi x-ray ke inu ʻoe i nā mea hoʻohālikelike. Hana ʻia kēia e hōʻoia ʻaʻohe leakage ma mua o ka hoʻomaka ʻana e ʻai.

Lawe ʻia paha kāu kahawai i 2 a 3 mau lā. E aʻo ʻia ʻoe pehea e mālama ai i kāu Tube laryngectomy a me ka stoma. E aʻo ʻoe pehea e ʻauʻau ai me ka palekana. Pono ʻoe e makaʻala i ʻole e komo ka wai i loko o kāu stoma.

ʻO ka hoʻoponopono hou ʻana i ka haʻiʻōlelo me kahi mea hoʻoponopono ʻōlelo e kōkua iā ʻoe e aʻo hou pehea e ʻōlelo ai.

Pono ʻoe e hōʻalo i ka hāpai hāpai ʻana a i ʻole ka hana ikaika ma kahi o 6 mau pule. Hoʻomoe mālie paha ʻoe i kāu hana maʻamau, māmā.

E hāhai me kāu mea hoʻolako e like me ka mea i haʻi ʻia iā ʻoe.

Lawe ʻia kou mau ʻeha ma kahi o 2 a 3 mau pule e hoʻōla ai. Hiki iā ʻoe ke manaʻo i ke ola hou ʻana ma kahi o hoʻokahi mahina. I nā manawa he nui, ʻo ka hemo ʻana o ka larynx e lawe aku i nā maʻi ʻaʻai āpau a i ʻole nā ​​mea i hōʻeha ʻia. E aʻo ka poʻe pehea e hoʻololi ai i ko lākou nohona a ola me ka ʻole o kā lākou pahu leo. Pono ʻoe i nā lāʻau ʻē aʻe, e like me radiotherapy a chemotherapy.

Hoʻopau laryngectomy; Laryngectomy hapa

• Pilikia i nā pilikia

Lorenz RR, Couch ME, Burkey BB. ʻO ke poʻo a me ka ʻāʻī. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier Saunders; 2017: chap 33.

ʻO Posner MR. Maʻi ʻaʻai Head a me ka ʻāʻī. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 190.

ʻO Rassekh H, Haughey BH. Huina Laryngectomy a me nā laryngopharyngectomy. I: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ke poʻo poʻo a me ka ʻāʻī. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2015: chap 110.