Ukwelashwa Ngemizimba Ekuphatheni Amacala Okukhubazeka KaBell
I-Bell's palsy iwukukhubazeka okukhulu kwemizwa yobuso okuvame ukuthinta uhlangothi olulodwa lobuso. Lesi simo singabangela ukugoba kwamakhona omlomo, ubunzima bokuvala amehlo, ukwehla kwamandla okuphakamisa amashiya, kanye nokuphazamiseka kokunambitheka ngaphambili kolimi. Nakuba izimo eziningi ziphela ngokuzenzakalelayo phakathi kwamasonto kuya ezinyangeni, i-physiotherapy idlala indima ebalulekile ekusizeni ukubuyisela ukusebenza kwemisipha yobuso, ukuvimbela izinkinga ezifana nokuqina kanye nokuguquguquka kwemizwa, kanye nokuthuthukisa ikhwalithi yokuphila kwesiguli.
Ukuqonda Ukukhubazeka KukaBell kanye Nomphumela Wakho
I-Bell's palsy yenzeka ngenxa yomonakalo we-facial nerve (cranial nerve VII), elawula ukunyakaza kwemisipha yokubonakaliswa kobuso. Imbangela eqondile ayivami ukungaziwa, kodwa kusolwa kakhulu ukuthi ihlobene nokuvuselelwa kwegciwane (njenge-herpes simplex), elibangela ukuvuvukala nokuvuvukala kwe-nerve njengoba idlula emseleni omncane wamathambo. Lokhu kuvuvukala kuvimbela imizwa ye-nerve, okuholela ebuthakathakeni noma ekukhubazekeni kwemisipha yobuso.
Ngokusebenza kahle, iziguli zingase zibe nobunzima bokukhuluma ngokucacile, ukuhlafuna nokubamba ukudla emlonyeni wazo, ukuphuza ngaphandle kokuconsa, nokuvala amehlo azo ngokuphelele. Ngaphezu kwalokho, umthelela wengqondo uvame ukuba mkhulu: ukungalingani kobuso kunganciphisa ukuzethemba, kubangele ukukhathazeka, futhi kuthinte ngisho nokusebenzisana nabantu. Ngakho-ke, ukwelashwa akugxili nje ekubuyiseleni ukunyakaza kodwa futhi nasekusekelweni kwemfundo kanye namasu okuzivumelanisa nezimo nsuku zonke.
Imigomo Yokwelapha Ngokuzivocavoca E-Bell's Palsy
Imigomo ye-physiotherapy ezimweni ze-Bell's palsy ingafingqwa kanje:
1. Thuthukisa ukusebenza kwemisipha yobuso kanye nokulawula ukuze kubuyiselwe amaphethini okunyakaza alinganayo futhi ahlelekile.
2. Vimbela izinkinga ezifana nokugoba, ukuqina, kanye nokukhubazeka okubangelwa yimisipha engakanyakazi isikhathi eside.
3. Kunciphisa ubuhlungu noma ukucindezeleka ebusweni, emhlathini, nasentanyeni okuvame ukubonakala njengesinxephezelo.
4. Vimbela noma uphathe i-synkinesis, okuyizinyathelo ezingafuneki ezenzeka ngesikhathi esisodwa (isibonelo, amehlo avaleka uma emomotheka).
5. Thuthukisa amakhono okusebenza, njengokudla, ukukhuluma, ukucwayiza, kanye nokuveza imizwa.
6. Sekela izici zengqondo ngemfundo, ukuqapha inqubekela phambili, kanye namasu okuzilawula.
Ukuhlolwa Nokuhlolwa Ngudokotela Wezokwelapha Ngemizimba
Uhlelo oluhle lwe-physiotherapy luqala ngokuhlolwa okuphelele. Odokotela be-physiotherapists bavame ukuhlola:
– Izinga lobuthakathaka bemisipha yobuso, isibonelo ngesikali se-House-Brackmann noma olunye uhlelo lokuhlola imiphumela yezokwelapha.
– Ukulingana kobuso lapho uphumule futhi ushukuma, okuhlanganisa nekhono lokuphakamisa amashiya, ukuvala amehlo, ukumamatheka, ukushaya umoya, kanye nokushwabanisa ikhala.
– Ukuba khona kwe-synkinesis noma ukunyakaza okuphindaphindekile kokubuyisela.
– Izimo zezicubu ezithambile, njengokuqina kwemisipha ezihlathini, emhlathini (temporomandibular), kanye nasentanyeni.
– Izinkinga zokusebenza, njengobunzima bokudla, ukuphuza, ukukhuluma, kanye nezikhalazo zamehlo omile ngenxa yokungakwazi ukuvala kahle.
Kusukela emiphumeleni yalokhu kuhlolwa, udokotela wezokwelapha ngomzimba uzokwakha uhlelo lokwelapha oluhambisana nesigaba sokululama kwesiguli kanye nezidingo zaso.
Ukungenelela Kwe-Physiotherapy Okusekelwe Esigabeni
1) Isigaba Esiphuthumayo (usuku lokuqala kuya cishe emavikini amabili)
Esigabeni sokuqala, imigomo eyinhloko ukuvikela isakhiwo, ukunciphisa ingozi yezinkinga, nokulungiselela ukululama.
Ukufundisa amehlo nokuvikela kubalulekile. Iziguli ezingakwazi ukuvala amehlo azo zisengozini yokucasuka kwe-cornea. Odokotela bezokwelapha umzimba bazoncoma ukusetshenziswa kwamaconsi amehlo/izinyembezi zokwenziwa (njengoba kuqondiswe udokotela), imaski yamehlo ngenkathi ulele, kanye nokuzivocavoca okucwayizayo kancane uma kungenzeka.
Ukuzivocavoca okulula ngaphandle kokuphoqelela kunganikezwa, njengokuthi:
- Izindlela zokuphumula ubuso kanye nokuphefumula ukuze kuncishiswe ukucindezeleka.
– Ukunyakaza okuncane okungabangeli ubuhlungu: ukufinya kancane, ukuvala amehlo akho kancane (ngaphandle kokuwaphoqa), ukuphakamisa amakhona omlomo wakho kancane.
Kulesi sigaba, isimiso siwukugwema ukuqeqeshwa ngokweqile okungadala amaphethini okubuyisela futhi kwandise ingozi ye-synkinesis.
2) Isigaba Esincane (amasonto ama-2-6)
Uma izimpawu zokululama ziqala ukubonakala (isibonelo, imisipha ingaqala ukunyakaza kancane), ukugxila kokwelashwa kushintshela ekusebenzeni kwemisipha okuqondiswe kakhulu kanye nokuvuselela kabusha ukulawula kwemisipha.
Ukungenelela okusetshenziswa njalo:
– Ukuqeqeshwa kabusha kwemisipha yobuso: ukuvivinya umzimba okukhethekile ukuqeqesha imisipha yobuso ukuthi isebenze ngendlela efanele. Iziguli zifundiswa ukwenza ukunyakaza okuhlukile, njengokumamatheka okulinganayo ngaphandle kokuvala amehlo azo, noma ukuvala amehlo azo ngaphandle kokudonsa phansi amakhona omlomo wazo.
– Prakthiza phambi kwesibuko (impendulo yesibuko) ukuze wandise ulwazi ngokulingana nokunciphisa isinxephezelo.
– Ukuhlikihla okuthambile kanye nokunyakaza kwezicubu ezithambile ukuze kuncishiswe ukucindezeleka kwemisipha okunamandla kokubili ezinhlangothini ezinempilo nezibuthakathaka.
– Ukuzivocavoca okusebenzayo: ukuzivocavoca ukuze ubambe umoya ezihlathini, ukuphimisela onkamisa, ukuzivocavoca ukuze uphuze kancane kancane ngotshani uma kuphephile.
3) Isigaba Esingapheli (ngaphezu kwamasonto ayisithupha kuya ezinyangeni)
Kulesi sigaba, iziguli eziningi sezithuthuke kakhulu. Kodwa-ke, kwezinye izimo, kuvela izinselele ezifana nokuqina, ubuthakathaka obusele, noma i-synkinesis. Ukwelashwa nge-physiotherapy kuyasiza kakhulu ekwenzeni ngcono imiphumela.
Ukugxila kokungenelela:
– Ukulawulwa kwe-synkinesis ngokuzivocavoca kokuphumula, ukuvimbela ukunyakaza okungafuneki, kanye nokuzivocavoca kokuxhumana. Isibonelo, iziguli ziprakthiza ukumamatheka okuncane ngenkathi zigcina amehlo azo ekhululekile, kwenziwa kancane kancane futhi ngokuphindaphindiwe ngekhwalithi enhle yokunyakaza.
– Ukwelula nokukhulula izicubu ezithambile emisipheni ezwakala iqinile noma iqinile.
– Zijwayeze ukubonakaliswa kobuso okuyinkimbinkimbi njengokuhleka, ukufinya, ukufutha, noma ukubonakaliswa kwemizwelo ethile ngokugcizelela ikhwalithi, hhayi amandla.
Izindlela Ezisetshenziswa Ngezinye izikhathi Nezimpikiswano Zazo
Eminye imitholampilo isebenzisa izindlela ezifana nokuvuselela ngogesi imisipha yobuso. Kodwa-ke, ukusetshenziswa kwayo ku-Bell's palsy kusalokhu kuyimpikiswano. Kwabanye iziguli, ukuvuselela kuthwala ingozi yokubangela amaphethini okufinyela okungewona awomzimba futhi kuyesatshwa ukuthi kuzofaka isandla ku-synkinesis uma kungaboniswanga futhi kunganikezwanga umthamo ngokufanele. Ngakho-ke, uma kusetshenziswa, kufanele kukhethwe kakhulu, kuqashwe ngokucophelela, futhi ukuqeqeshwa kokulawula ukunyakaza kufanele kubekwe phambili.
Ezinye izindlela ezifana nokwelashwa ngokushisa okuncane zingasiza ekuphumzeni izicubu ezithambile, kuyilapho amasu afana ne-biofeedback (isb., i-EMG biofeedback) angasiza iziguli ukuthi zibone ukusebenza kwemisipha ngokweqile noma okungafanele.
Uhlelo Lokuziqeqesha Ekhaya
Impumelelo ye-physiotherapy ithonywa kakhulu ukuzivocavoca ekhaya okuqhubekayo. Izimiso zokuzivivinya umzimba ze-Bell's palsy:
– Ukuzivocavoca okufushane kodwa okuvamile (isib. imizuzu emi-5–10, izikhathi ezi-2–3 ngosuku).
– Beka phambili ukunyakaza okubushelelezi nokulinganayo, hhayi ukunyakaza okunamandla.
– Yeka uma kuvela ubuhlungu, ukuqaqamba, noma ukunyakaza okungafuneki “kokugxumagxuma”.
– Sebenzisa isibuko ukuqapha ukulingana nokugcina ikhwalithi yokunyakaza.
Izibonelo zezivivinyo ezivame ukunikezwa:
1. Phakamisa amashiya akho kancane, ubambe imizuzwana emi-2-3, bese uphumula.
2. Vala amehlo akho kancane sengathi “ulele”, ungabukeli phansi amehlo.
3. Momotheka ngokumomotheka okuncane, okulinganayo (ngaphandle kokubonisa amazinyo akho) bese uphumula.
4. Hlaba izindebe zakho kancane, ubambe isikhashana, bese uphumula.
Ukuzivocavoca kulungiswa ngokuya ngokuhlolwa kwezokwelapha, njengoba kungebona bonke iziguli abangenza ngokuphephile yonke intshukumo esigabeni ngasinye.
Ukubambisana Nabanye Abasebenzi Bezempilo
Ukwelashwa kwe-Bell's palsy kungcono kube yimikhakha eminingi. Odokotela bangakunikeza ukwelashwa kwezokwelapha, njenge-corticosteroids, ezigabeni zokuqala (njengoba kubonisiwe), futhi baqaphe ezinye izimbangela uma izimpawu zingavamile ku-Bell's palsy. Odokotela bamehlo badlala indima ebalulekile uma kukhona ingozi yokulimala kwe-cornea. Ezimweni ezingapheli ezine-spasms noma i-synkinesis enzima, ezinye iziguli zicabangela imijovo ye-botulinum toxin noma ezinye izinqubo, ezingahlanganiswa ne-physiotherapy ukuze kwandiswe ukulawula ukunyakaza.
Ukubikezela kanye nethemba lokululama
Iningi leziguli ezine-Bell's palsy lithola ukululama okuhle, ikakhulukazi uma ukwelashwa kokuqala kufanelekile futhi izici ezithile eziyingozi zingekho. Kodwa-ke, inqubo yokululama ingahluka. Ukwelashwa nge-physiotherapy kusiza ukuqinisekisa ukululama okugxile kakhulu, kunciphisa isinxephezelo, futhi kusiza iziguli ukuphatha noma yiziphi izimpawu ezisele. Izihluthulelo zempumelelo zifaka phakathi imfundo efanele, izivivinyo eziqondiwe, kanye nokuhlolwa okuvamile ukuze kulungiswe uhlelo.
I-Penutup
Ukwelashwa nge-physiotherapy kuyisici esibalulekile ekuphathweni kwe-Bell's palsy, kungakhathaliseki ukuthi kusesigabeni esibucayi, esingaphansi kwe-subacute, noma esingamahlalakhona. Ngokuhlola okufanele ukusebenza, ukuqeqeshwa okuqondiswe ku-neuromuscular, imfundo yokuvikela amehlo, kanye nohlelo lokuzivocavoca oluqhubekayo, i-physiotherapy ingasiza iziguli ukuthi zibuyisele ukulingana kobuso nokulawula, zivimbele izinkinga ezifana ne-synkinesis, futhi zithuthukise ikhwalithi yokuphila. Ngendlela efanele kanye nokubambisana kochwepheshe, iziguli ze-Bell's palsy zinethuba elihle lokubuyela emsebenzini omuhle emisebenzini yansuku zonke.
