Mumukaha muromo uye mukanwa: chikonzero uye kururamiswa

Kuzvarwa kwemwana - a-refu akamirirwa nguva vakawanda. Asi pane nguva apo akanaka nezviitiko kuti vabereki vasina kugadzirira pachine. eventualities kwakadaro vachiberekwa anomalies uye zvikanganiso kuti rima pakuonekwa rokuzvarwa wemwana.

Mumukaha muromo uye mukanwa - vakawanda nokuberekwa urema munhu. Vanhu anomaly kunzi "zaychey muromo" (mumukaha muromo) uye "mumukaha mukanwa" (mumukaha mukanwa). inotungamirwa yavo kuitika trimester pamuviri wokutanga, kubva 5th kusvikira vhiki yechi11 embryo kukura.

etiology

"Zaychey muromo" anonzi anomaly, iyo inozivikanwa nokuva kukwana kana kwakakwana kusavapo adhesions pakati munyama rokumusoro muromo. Inogona kuva sezvo yakazvimirira mamiriro, uye rinogona pamwe akatsemuka mukanwa.

"Mumukaha mukanwa" - gwanza, akatsemuka mukanwa nechepakati kana divi mugove. Zvinogona munzvimbo imwe nharaunda (Anterior pfupa kana nyoro zvinyama posterior mukanwa), kana kuwedzera yose kureba.

On mumuviri ramai panguva yepamuviri zvinogona kukanganisika nokuda zvinhu zvinoverengeka, zvichiguma chimiro anomalies zvakadai mumukaha muromo uye mukanwa. Zvinokonzera zvinotevera pathologies:

1. Nhaka kubatwa - munhu akazvarwa aine akatsemuka, pane mukana uchatamisa ichi iri nhaka mwana wake 7-10% nyaya.
2. Zvirwere zvinokonzerwa nemavhairasi mavambo, akatamisira mai vake vari trimester pamuviri (rubella, cytomegalovirus, herpes utachiona hweHIV, toxoplasmosis) rokutanga.
3. Kutambudzika nezvakatipoteredza uye nemwaranzi mamiriro munharaunda vakadzi kurarama panguva akatakura mwana.
4. Zvirwere uye vatarisire zvinodhaka teratogenic mu dzavaigara.
5. tsika dzakaipa kwaAmai (doro, kusvuta, kushandisa marwadzo zvinodhaka).

Kupatsanura pakati mumukaha muromo uye mukanwa

Pahwaro anatomical uye vasiri zvechadenga kupatsanura pakati pemikaha yambokurukurwa. Zvivanakire, tichava kupa mashoko ari tafura.

boka	subgroups	Features subgroups
Isolated mumukaha muromo	submucous	C 1 divi 2 mativi
	Kukwana (s mhino deformation kana pasina)	C 1 divi 2 mativi
	azere	C 1 divi 2 mativi
Isolated mumukaha mukanwa	Avo kuti chokuita chete munzvimbo nyoro mukanwa	Submucous, kukwana, zvakakwana
	Avo kuti chokuita munharaunda nyoro uye zvakaoma mukanwa	Submucous, kukwana, zvakakwana
Complete mumukaha mukanwa uye alveolar mapfupa	C 1 divi 2 mativi
Mumukaha ari Anterior chikamu nyoro mukanwa, yokumusoro muromo uye alveolar mapfupa	C 1 divi 2 mativi
Looping mumukaha kukanganisa rokumusoro muromo, alveolar muitiro, zvakaoma uye akapfava mukanwa	C 1 divi	Rworudyi, neziboshwe
	C 2 mativi
Mumukaha muromo uye mukanwa (mufananidzo pazasi), atypical hunhu

Diagnostics

Zvokurwara chinorondedzerwa munguva yepamuviri. Vachiberekwa mumukaha muromo uye mukanwa nechekare mufanidziro pamusoro 16-20 vhiki embryo kukura. Kana zvose 3 makuru Ultrasound kuongororwa mwana unotsauka kubva Switch chikwata kuitira kuti zvakaoma kunzwisisa maumbirwo angava mugumisiro wenhema ongororo.

Reviews vabereki, uyo gare gare vakanga vana vachiberekwa anomalies, asimbise mukana positives zvenhema, uye muna vose nzira. Vamwe vanoti mwana anozvarwa kurwara, uye somugumisiro mwana hapana zvakasiyana nevezera ravo. Kana, nekusiyana, vabereki vakanga chivimbo utano ine simba mwana wacho, uye iye akaberekwa pamwe chirwere.

Achidyisa mwana ane abnormality

Asati totaura kugadzirisa dambudziko, unofanira kugadzirisa nyaya pamwe nembudzana-vachiwana. Kudyisa vana mumukaha muromo uye mukanwa yakasiyana, saka amai vanofanira kuomerera mitemo, izvo zvinosiyana zvichienderana muchimiro zvokurwara.

Kana mwana aine chete anomaly marongerwo nemiromo, matambudziko pamwechete kubatwa zviri munyatso uye yakayamwa miromo yake haazomiri. Mumukaha muromo uye mukanwa kana chete denga zvinoda vamwe okunatsiridza kuti mwana wacho chikafu yaunodya kubva pakuvhurwa pakati nasal uye dzaiita mhango anogona iyerere kupinda mukaka, uye hapana kumanikidzwa vanoenderana yakayamwa rikurumidze.

How mukaka anopinda nasal mhango, uye mhepo zvakafanana runoyerera mumuromo uye, naizvozvovo, mudumbu. Nendumure vanoda nguva yakareba chinjikira nzvimbo pashure kudya kwazvo mhepo matema panze. Mwedzi upenyu okutanga achiperekedzwa kakawanda colic, regurgitation, anogona ruchasvika kurutsa.

zvokudya mitemo:

1. Shandisai kana zamu kudyisa, kana achishandisa dzichifura mabhodhoro (kubva mukombe kana chipunu haumanikidzwi zvokudya).
2. Massaging mazamu vasati zvokudya. Izvi zvichaita kuwedzera uwandu mukaka kuita reflexively, uye mbudzana haana kushanda nesimba.
3. Vanochengeta mirayiro pamusoro-kudiwa dzichifura. Kazhinji kuisa mwana pazamu.
4. Muperekedzei munwe kudzvinya ari areola, izvo zvinoita kuti awedzere protrusion yacho munyatso. Kana zvakakodzera, kushandisa Mapedhi, kusarudza kukura muromo wemwana.
5. Kana mukawana unsaturated mwana mukaka residues kuunganidza zamu pombi uye okuwedzera dzichifura kubva mubhotoro. The munyatso zvakare vakasarudzwa nomumwe, kufungisisa anatomical zvinhu.

kurapwa Guidelines

Vana vane mumukaha muromo uye mukanwa vachida kuvhiyiwa. Izvi zvakakodzera kwete chete kubvisa zvizorwa kuremara, asi kuti umutse kushanda zvomudumbu turakiti uye kufema gadziriro.

Misi remapazi, nokuwanda, uwandu kupindira rinorondedzera pacharo chiremba. Mumukaha muromo uye mukanwa hwabviswa Maitiro zvinotevera:

• chiloplasty;
• rinoheyloplastika;
• rinoheylognatoplastika;
• veloplastika;
• palatoplastika;
• mapfupa kusonanidzwa.

kupindira izvi zvose zvikuru mumukaha kuvhiyiwa. Mune ramangwana kungada yechipiri akavhiyiwa kuti vari chikamu kururamiswa chitarisiko uye residual nemigumisiro.

Rinoheyloplastika

Kuvhiya uku kudzorera anatomical uye vasiri zvechadenga mhino uye yokumusoro muromo. Mumukaha muromo uye mukanwa haisi zvachose nokuda rakadaro Kupindira, asi kuti kururamiswa "miromo zaychey" rinoheyloplastika vaiona nzira resarudzo.

Mabasa vanachiremba:

• kudzoreredzwa tsandanyama ezvinhu yokumusoro muromo;
• Kururamiswa Muganhu dzvuku;
• inotungamirwa nomumhu buccal mhango;
• kudzorera yakarurama Positioning mhino;
• ari symmetry of kururamiswa;
• vanoumba pasi nasal ndima.

Kazhinji, unyanzvi izvi anoshandiswa, saka kuti mavanga kuonekwa sezvo shoma sezvinobvira. True chipingaidzo chidobi rakasarudzwa, ukuru deformation chinonyanya zvinyama uye shwashwa kuvariritira uye zvakakodzera postoperative nguva - zvinoshandiswa kusarudza kudiwa pakuvhiya yechipiri pashure kuzoita murwere zvakakwana.

Yaitsigira divi pathological muitiro kunoita kuvhiyiwa kuti vabudirire-mwedzi 3 mwana akwegura, mbiri-nzira - pashure pemwedzi mitanhatu. Mushure mwana mapurasitiki zvokudya kana ane chipunu kana kuburikidza munhu nasogastric chubhu, zvichienderana vakawanda mamiriro uye zera murwere. Pashure pemazuva 3-4, unogona kudzokera nzira rinoshandiswa nguva dzose.

Rinoheylognatoplastika

Vana vane mumukaha muromo uye mukanwa anogona kubvisa chirwere pachishandiswa yakadaro kupindira. oparesheni iyi nechinangwa kubviswa anatomical zvirwere mhino, yokumusoro muromo uye alveolar pfupa. Kunoitawo kuti kururamiswa kuburikidza urema. Bilateral mumukaha muromo uye mukanwa - mumwe zvairatidza kuti rinoheylognatoplastike.

The Zvakanyanya Kunaka Panguva Yepamuviri Nguva yokuvhiyiwa paucheche kusvikira zvachose occlusion vachigere vakanyatsosvika uye havasati chakaitika teething repamusoro canines.

Veloplastika

Mumukaha muromo uye mukanwa anodzorerwa ne panguva vachishandisa vakawanda kushanda dzokuvhiya. Vanachiremba uye aibatanidza zvinhu heylorinoplastiki veloplastiki (kururamiswa pamusoro nyoro mukanwa). The Kupindira rinoitwa pamwe anotevera zvinangwa:

• kudzorera pakuparadza basa;
• kufema kururamiswa kwacho;
• adzorere phonation uye matauriro.

Kana mwana anogona kudzidza kudya, saka kuti zvokudya hakuiti achigarira maoko pamuromo kusvika mhino, pamwe Vocal midziyo kwakaipa. kuchinja Serious pakutaura haagoni kuva kuzvipira kururamisa. Izvi zvinokosha ari mashoma okutanga, kana mwana anodzidza kutaura uye kuumba unyanzvi hwavo munhu (vachiimba, kudetemba nhetembo).

Veloplastika inoitwa kubva 8 mwedzi zera. Kazhinji Kuvhiya zvakanaka akashivirira, uye shure kwamazuva 1-2, mwana anogona kudya vakazvimiririra.

Palatoplastika

Vana vane mumukaha muromo uye mukanwa (urema vana vakadaro iri mubvunzo) kungada nzendo dzakawanda pokuvhiyiwa, iro rinoitwa panguva nenguva. Kana pakuberekwa chakaremara sei kwete chete muromo, alveolar pfupa uye akapfava mukanwa, asiwo kune mukanwa nesimba, mamiriro ichi kunoratidza kuti palatoplastiki.

Pashure kurangwa pamusoro anatomi iri nyoro mukanwa mukaha mumarudzi yakasimba kwaita kujekesa. By makore 3-4 zvinova ndizvo yakatetepa kuti unogona kudzosa akaperera pasina chinokosha yaizoitika zvirwere. Zvakadaro maviri-danho kururamiswa ane zvinotevera zvazvakanakira:

• mangwanani kupora mamiriro kuti chakaipa kukura pakutaura zvinhu;
• chipingamupinyi kukura kuvhiringidzika dzinodengenyeka yokumusoro shaya.

Mumwe-danho kupora zvinobvira, asi muchiitiko chino kunowedzera ngozi underdevelopment rokumusoro shaya.

pfupa kusonanidzwa

oparesheni Izvi kuteererwa chiremba, asi chikwata pamwe orthodontist. Kunze panguva shanduko kwenguva pfupi occlusion zvachose (makore 7-9). Panguva Kupindira kutora batanidza kubva tibia bvupa murwere, uye wakasimwa kupinda nzvimbo mumukaha alveolar pfupa. The batanidza anogona kudzorera kuvimbika pfupa rokumusoro rushaya nokusika Zvakanyanya Kunaka Panguva Yepamuviri ezvinhu kuti kuputika mazino zvachose.

kuvhiya yechipiri

Mumukaha muromo uye mukanwa - a vachiberekwa anomaly kuti anogona kusiya zvisaririra pachiso munhu muupenyu hwake hwose. Varwere vakawanda vanofanira kuitisa yechipiri mapurasitiki kuvhiya, chinangwa chiri sezvinotevera:

• kururamiswa chitarisiko;
• kuzoita kutaura basa;
• kubviswa kanganisika kukurukurirana pakati in maviri (nasal, nemumuromo);
• rwokufamba Kudzikamiswa rokumusoro shaya.

1. Upper muromo

Ruzhinji varwere vanoda kuita rakasungwa yokumusoro muromo, vanoisa pfungwa dzavo kuti pachapera kupindira yakanga tripe. Chido kuhupedza uye kunoita kuti chiremba. Zvinofanira kurangarirwa kuti chero vanga kana vanga anogona kuitwa chisanyanya kuoneka kudzikisa mari, asi hazvibviri zvachose kubvisa nayo.

Kakawanda kugozha:

• tyisa vakafugama Muganhu dzvuku;
• asymmetry;
• kutyora tsandanyama hurongwa mabasa;
• mwero kuzara.

2. Mhuno

Anomalies rokumusoro muromo pamwe nasal wakarebesa. Secondary mhino Kuvhiya inodiwa anenge varwere vose. The mwero deformation kunoenderana kwokuomerwa chirwere chikuru. Kuti agadzirise asymmetry, ari aesthetic chitarisiko, kudzorerwa nasal septum akasungwa rhinoplasty.

kuchinja Minor kuti vanoda kururamiswa anogona kuitwa muduku. Kukuru kupindira akabvumira makore chete pashure 16-17, apo marangwanda chiso zvizere kuumbwa.

3. The nyoro mukanwa

Mhedzisiro crevices akaoma uye vanonyanya kuvhiya velofaringealnaya vanogona kukwana. Zviri pathological mamiriro chokuita nasal inzwi, kunokanganisika kutaura. Nzira dzokuvhiya zvainanga kubvisa kutaura urema.

The oparesheni kutenderwa chero zera, asi vasati zvakanaka kubvunza chiremba wechikadzi achindidzidzisa kutaura, uye kuzosimbisa kusakwanisika kutaura chokuita nedzimwe nzira.

Zviri vakurumidze kuongorora mugumisiro kushanda pazuva nyoro mukanwa hazvibviri, nokuti tsandanyama hurongwa nharaunda kwazvo tisanzwe zvokunze chipingaidzo, izvo zvinoreva kuti scarring pashure chikuru Kuvhiya anogara chinokosha. Kudzorera dzichipfekeka zviri kuita zvinotevera manipulations:

• ré tsandanyama plasty pasina kana mawa elongation;
• chikweshe nyoro mukanwa uchishandisa pharyngeal kurova-rova.

A chinoratidza vachangobva postoperative kumwedzi ndiko kukurira uye unyanzvi logopedist kunzwa kutarisirwa kwounyanzvi.

4. Oronazalnye fistula

Iri idambudziko zvinowanzovapo varwere kushanda kuti mumukaha muromo uye mukanwa. Fistula ari buri pakati in maviri. Kakawanda localization - munharaunda alveolar pfupa, rurimi zvakaoma. Achiri muduku, mawindo akadaro achava chikonzero kuwana zvokudya mumba mhuno, asi vana kudzidza kudzora mamiriro. Somugumisiro anova nasal uye kunokanganisika izwi.

Kubviswa fistulas oronazalnyh kutakurwa pfupa kusonanidzwa kuumba pasi nasal ndima.

mhedziso

Mumukaha muromo uye mukanwa, umo urema unorambira mubvunzo rinoreva vachiberekwa ezvinhu. Kana ibatanidzo bilateral zvikuru zvokurwara nevamwe anomalies atore urema.

Kuvapo chirwere chete pasina kuyeuka vachiberekwa anomalies nezvounhu yakasarudzwa yakadaro, kuti hakutadzisi munhu vakazvimirira kuzvitarisira uye kwete achiperekedzwa abnormalities mune dzimwe nzvimbo (mupfungwa, mupfungwa, kutsinga dzinouya). In akadaro zvekuchipatara Muzviitiko, murwere haadi kuziva ndedzenhema.