Tus kab mob uas cov khoom no yuav mob siab rau tsis yog ib txwm muaj. Tab sis nyob rau tib lub sijhawm, cov tsos mob ntawm kev swb ntawm cov hlab ntsha glossopharyngeal zoo li ci ntsa iab, ua rau muaj kev ntxhov siab ntau rau tus neeg mob. Yuav ua li cas txiav txim siab tus kab mob no, vim li cas nws tuaj yeem tshwm sim, tsab xov xwm qhia. Nws kuj tseem yuav qhia tus nyeem ntawv rau qhov kev kuaj mob tseem ceeb thiab kev ntsuas kev kho mob hauv qhov no.
Qhov no yog dab tsi?
Cov tsos mob ntawm qhov txhab ntawm cov hlab ntsha glossopharyngeal yuav tau tham ntxiv. Ua ntej, cia peb txhais seb nws yog kab mob dab tsi. Qhov no yog lub npe ntawm unilateral lesion ntawm cuaj cranial paj hlwb. Nws tshwm sim los ntawm qhov mob hauv paus ntawm tus nplaig, pharynx, palate, tonsils. Feem ntau nws muab rau hauv pob ntseg.
Cov kab mob no tau paub hauv kev kho mob raws li Sicard's syndrome. Qhov no yog vim qhov tseeb tias tus kab mob no tau piav qhia thawj zaug los ntawm Sicard xyoo 1920.
cov ntaub ntawv dav dav
Cov tsos mob ntawm cov hlab ntsha glossopharyngeal yog qhov tsis txaus siab hauv lawv qhov tshwm sim, ua rau tus neeg mob lub neej zoo dua. Qhov no yog qhov ua txhaum ntawm qhov kev xav ntawm qhov kawg ntawm peb tus nplaig, txo qis hauv palatine thiab pharyngeal reflex, ua txhaum ntawm salivation.
Kev kuaj mob ntawm glossopharyngeal neuralgiaCov paj hlwb yog nqa tawm los ntawm cov kws kho mob nqaim - kws kho mob neurologist, kws kho hniav, otolaryngologist. Yeej, CT lossis MRI ntawm lub hlwb yog ua. Qee zaum, echo-EG tau qhia.
Raws li kev kho mob, qhov no yog kev saib xyuas. Anticonvulsant, tshuaj kho mob tau sau tseg. Tsis tas li ntawd, sedatives thiab hypnotics. Raws li kev pab kho mob, kho lub cev, kho cov vitamin complexes, cov tshuaj ntxiv dag zog tuaj yeem siv.
cov ntaub ntawv kho mob
Yog tias peb tig mus rau cov ntaub ntawv kho mob, peb yuav pom tias glossopharyngeal neuralgia (cov tsos mob thiab kev kho mob yuav piav qhia tom qab) yog ib qho tsis tshua muaj kab mob. Tom qab tag nrho, nws tshwm sim hauv 16 tus neeg ntawm 10 lab.
Qhov tseem ceeb ntawm cov neeg mob hauv qhov no yog cov neeg muaj hnub nyoog tshaj 40 xyoo. Feem ntau yog txiv neej.
kab mob daim ntawv
Puas mob zom? Cov tsos mob no tuaj yeem qhia ob qho teeb meem ntawm cov hniav thiab cov pos hniav, thiab kev puas tsuaj rau cov hlab ntsha glossopharyngeal. Raws li cov ntaub ntawv kawg, nws tau muab faib ua ob hom:
- Pib. Los yog idiopathic.
- Secondary. Lwm lub npe yog symptomatic. Nws tuaj yeem txhim kho nrog kev raug mob, cov txheej txheem sib kis uas tshwm sim nyob rau hauv posterior cranial fossa. Los yog thaum cov qog ua rau cov hlab ntsha no.
Ua rau thawj kab mob
Yog tias cov tsos mob ntawm glossopharyngeal paj puas zoo ib yam ntawm ob hom kab mob, ces lawv cov laj thawj yuav txawv.
Nyob rau hauv thawj daim ntawv ntawm Sicard's syndrome, neuralgia yog idiopathic nyob rau hauv cov xwm. Yog li ntawd, tseem tsis tau muaj peev xwm tsim tau nws qhov laj thawj. Txawm li cas los xij, nws ntseeg tau tias daim ntawv no ntawm glossopharyngeal paj tawg tuaj yeem tshwm sim los ntawm cov hauv qab no:
- Atherosclerosis.
- Kab mob cuam tshuam rau cov kab mob ENT. Tej yam: tonsillitis, sinusitis, otitis media, chronic pharyngitis.
- Ob leeg mob thiab mob ntev ntawm lub cev.
- kab mob kis kab mob. Ib qho piv txwv tseem ceeb yog khaub thuas.
Ua rau theem nrab pathology
Raws li rau theem nrab neuralgia, tom qab ntawd cov laj thawj tuaj yeem tsim tau raws nraim. Feem ntau yog:
- Kab mob pathology cuam tshuam rau tom qab cranial fossa. Arachnoiditis, encephalitis, thiab lwm yam.
- Ntau yam mob taub hau.
- Ua txhaum ntawm cov txheej txheem metabolic. Hauv particular, hyperthyroidism, ntshav qab zib mellitus.
- Irritation lossis squeezing ntawm cov hlab ntsha hauv ib qho ntawm nws cov lus. Hauv particular, qhov no yog universally pom nyob rau hauv intracerebral hlav ntawm lub cerebellopontine lub kaum sab xis. Ntawd yog, nrog meningioma, glioma, hemangioblastoma, medulloblastoma. Qhov ua rau tuaj yeem yog intracerebral hematomas, hypertrophy ntawm cov txheej txheem styloid, qog nqaij hlav nasopharyngeal, aneurysms ntawm cov hlab ntsha carotid, nce osteophytes ntawm jugular foramina, ossification ntawm stylohyoid ligament.
- Qee tus kws tshaj lij ntseeg tias glossopharyngeal neuralgia yog suav tias yog thawj cov tsos mob ntawm cov xwm txheej txaus ntshai xws li mob qog noj ntshav ntawm lub pharynx thiab larynx.
Symptomatics. Yuav paub li cas?
Kev txiav txim siab cov tsos mob thiab kev kho mob ntawm glossopharyngeal neuralgia. Cov tsos mob tshwm sim feem ntau yog qhov mob paroxysms, uas tuaj yeem kav ntev li ob peb feeb mus rau ob peb feeb.
Qhov no txhais li cas? Piv txwv li, tus neeg mob yuav hnov tias lub palate mob. Yog tias nws ua raws li nws txoj kev xav, nws yuav pom tias qhov mob pib ntawm lub hauv paus ntawm tus nplaig, tom qab ntawd nws nrawm nrawm mus rau lub palate, tonsils, pharynx, thiab qee zaum mus rau pob ntseg. Kev mob kuj tuaj yeem tshwm rau ntawm lub puab tsaig, caj dab, lossis qhov muag.
Kab kab mob ntawm tus nplaig tsis tshwm sim ntawm no. Txawm hais tias cov tsos mob zoo sib xws. Mob syndrome nrog neuralgia tuaj yeem ua rau cov hauv qab no:
- khw.
- Ncua.
- Yawn.
- Cuag.
- tham.
- Nyob txias lossis kub dhau.
Zoo kawg, thaum muaj kev tawm tsam, cov neeg mob qhia lub qhov ncauj qhuav, thiab tom qab nws - twb tau nce salivation. Nrog tib yam mob ntawm cov hauv paus hniav ntawm tus nplaig, qhov no tsis tshwm sim. Nws yuav tsum tau muab sau tseg tias lub qhov ncauj qhuav yuav tsis yog ib tug yam ntxwv cim ntawm xws li neuralgia, txij li thaum lub secretory insufficiency ntawm parotid salivary caj pas yog feem ntau ntse compensated los ntawm cov kev ua ntawm cov qog nqaij hlav nyob sib ze.
Raws li kev nqos cov kab mob uas tuaj yeem tshwm sim los ntawm paresis ntawm cov leeg levator pharynx, lawv tsis tau hais. Nws tau piav qhia los ntawm qhov tseeb tias lub luag haujlwm ntawm cov leeg no hauv kev ua nqos yog qhov tsis tseem ceeb. Tab sis tseem tus neeg mob yuav xav tias nyuaj zom thiab nqos cov zaub mov ntxiv. Hauv qhov no, lawv tau txuam nrogrhiab heev. Xws li proprioceptive, uas yog lub luag haujlwm rau kev xav ntawm txoj haujlwm ntawm tus nplaig hauv qhov ncauj.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qee zaum, qhov tshwm sim ntawm cov tsos mob ntawm neuralgia yog txuam nrog lub caij. Yog li, nws tseem ceeb tshaj plaws nyob rau lub caij nplooj ntoos hlav thiab lub caij nplooj zeeg.
Kuv yuav tsum hu rau tus kws tshwj xeeb twg?
Neuralgia ntawm lub paj hlwb glossopharyngeal yog txiav txim siab los ntawm tus kws kho mob nqaim - tus kws kho mob hlwb. Tab sis txhawm rau kom tsis suav nrog cov kab mob hauv caj pas, qhov ntswg, pob ntseg, kab noj hniav, yuav tsum tau kuaj ntxiv los ntawm kws kho hniav thiab kws kho mob otolaryngologist.
Neurological diagnostics
Thaum lub sijhawm kuaj, nws yog ib qho tseem ceeb rau tus kws kho mob txhawm rau txiav txim siab qhov mob analgesia (uas yog, qhov tsis muaj qhov mob rhiab heev) hauv thaj chaw xws li lub hauv paus ntawm tus nplaig, palate mos, tonsils thiab sab pharynx. Saj rhiab heev kuj raug kuaj. Ua li no, ntau yam kev daws teeb meem yog siv rau qhov sib luag ntawm tus neeg mob tus nplaig nrog lub pipette.
Nyob rau hauv cov ntaub ntawv no, nws yog qhov kev txheeb xyuas ntawm ib qho kev sib cais tsis sib haum xeeb nyob rau hauv lub posterior thib peb ntawm tus nplaig uas tseem ceeb heev. Tom qab tag nrho, kev ua txhaum ob tog ntawm saj rhiab heev qhia lwm yam pathology - kab mob ntawm lub qhov ncauj mucosa (piv txwv li, nrog ib tug ntev daim ntawv ntawm stomatitis).
Tom ntej no, tus kws kho mob tshwj xeeb tshuaj xyuas tus neeg mob lub pharyngeal reflex. Ntawm no tus kws kho mob maj mam kov lub nraub qaum phab ntsa ntawm tus neeg mob lub caj pas nrog ib daim ntawv raj. Hauv kev teb rau qhov no, kev nqhis dej yuav tsum tshwm sim, thiab qee zaum hnoos, ntuav ntuav.
Lub palatine kuj raug kuajkev xav. Kov lub twj tso kua mis rau lub palate ntawm tus neeg noj qab nyob zoo ua rau lub palate thiab uvula nce.
Yog tias tag nrho cov lus teb saum toj no tsis tuaj yeem nyob hauv ib tus neeg mob, tus kws kho mob tshwj xeeb muaj laj thawj xav tias nws yog neuralgia ntawm cov hlab ntsha glossopharyngeal. Tab sis qhov tsis muaj xws li reflexes tuaj yeem qhia tau tias pathologies ntawm lub paj hlwb vagus.
Yog tias thaum lub sijhawm kuaj mob ntawm lub pharynx thiab pharynx ntawm tus neeg mob, cov pob liab liab tau pom, qhov no yuav qhia tau tias mob ganglionitis ntawm cov leeg ntawm cov hlab ntsha glossopharyngeal. Cov tsos mob ntawm tus mob no zoo ib yam li neuralgia peb piav qhia.
Instrumental diagnostics
Txhawm rau kuaj xyuas kom raug, ntxiv rau kev kuaj mob, tus kws kho mob paj hlwb tau sau lwm cov txheej txheem kuaj mob rau tus neeg mob. Feem ntau niaj hnub no yog magnetic resonance thiab xam tomography ntawm lub hlwb.
Yog tias nws tsis tuaj yeem coj lawv, tus ncha-EG tuaj yeem raug xaiv. Nws yog dab tsi? Qhov no yog lub npe luv rau echoencephalography. Qhov no yog ib qho ultrasound diagnostic neurophysiological txoj kev. Ua ntej ntawm tag nrho cov, nws yog ib qho tseem ceeb nyob rau hauv uas nws yuav pab tau los soj ntsuam lub xub ntiag ntawm volumetric pathological txheej txheem tshwm sim nyob rau hauv cov khoom ntawm lub hlwb. Ib qho EEG thiab kev sab laj nrog kws kho qhov muag kuj yuav raug sau tseg. Raws li ib feem ntawm qhov kawg, ophthalmoscopy yog qhov yuav tsum tau kuaj - kev tshuaj xyuas ntawm fundus.
Ib txheej txheej txheem kuaj mob tso cai rau tus kws tshaj lij los txheeb xyuas qhov tseeb ntawm kev kuaj mob. Thiab tsis suav nrog qhov ua tau ntawm tus neeg mob tsim cov kab mob hauv qab no:
- pob ntseg neuralgia.
- YTrigeminal neuralgia.
- Glossalgia ntawm qhov sib txawv etiology.
- YRetropharyngeal abscess.
- Ganglionitis ntawm pterygopalatine node.
- Openheim Syndrome.
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neuralgia ntawm glossopharyngeal paj cov tsos mob thiab kev kho mob
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cov lus qhia kho mob
Raws li peb tau hais lawm, kev kho mob ntawm cov hlab ntsha glossopharyngeal yog kev saib xyuas dawb huv. Tsuas yog qhov kev zam yuav yog rooj plaub thaum nws nyem. Ntawm no, kev phais phais yog tsim nyog los tshem tawm cov compressive keeb. Piv txwv li, resection ntawm tus txheej txheem styloid loj.
Txhawm rau tshem tawm qhov mob uas ua rau tus neeg mob tsim txom, lawv tig mus rau lubricating lub hauv paus ntawm tus nplaig thiab caj pas nrog 10% tshuaj yeeb dawb. Txoj kev no yuav pab kom tsis txhob mob rau 6-7 teev. Yog tias qhov mob mob tsis tu ncua thiab mob siab rau, lawv tig mus rau qhov ntsuas hnyav dua - kev qhia txog 1-2% kev daws ntawm novocaine. Tsis tas li ntawd, kev txhaj tshuaj yog ua rau hauv paus ntawm tus nplaig.
Rau kev tswj qhov ncauj, cov tshuaj uas tsis yog tshuaj yeeb tuaj yeem raug sau tseg. Hauv particular, ibuprofen, phenylbutazone, metamizole sodium, naproxen. Hauv qee kis, cov tshuaj tiv thaiv kab mob kuj tau qhia. Tus kws kho mob tuaj yeem sau tshuaj nrog carbamazepine lossis phenytoin.
Thaum qhov mob tshwm sim nrog cov neuralgia tau tshaj tawm, nws tsim txom tus neeg mob, cov tshuaj hauv qab no yuav raug qhia:
- tshuaj tsaug zog.
- Antidepressants.
- Sedatives.
- Neuroleptic.
Nyob rau qee kis, qhov rov qab sai tshaj plaws tuaj yeem ua tiav los ntawm kev kho lub cevcov txheej txheem:
- SMT ntawm lub ntsws thiab tonsils.
- Diadynamic therapy.
- Galvanization.
Vitamins B1, multivitamin thiab cov tshuaj kho kom rov qab kho tau raug kho raws li kev kho mob ntxiv.
Qhov kev cia siab ntawm kev rov zoo nyob rau hauv cov ntaub ntawv ntawm glossopharyngeal neuralgia yog kwv yees los ntawm cov kws tshaj lij raws li kev pom zoo. Nyob rau hauv rooj plaub uas nws ua tau raug txheeb xyuas kom raug, thiab tom qab ntawd nws raug tshem tawm los yog kho. Tab sis nws yuav tsum tau muab sau tseg tias kev nyem tsis tuaj ntawm no tam sim ntawd. Qee zaum, yuav tsum tau kho ob peb xyoos.
