Orbital Cellulitis, Kumbura Ido cututtuka, da Cavernous Sinus Thrombosis¶

Kumburi mai saurin gaske, ja, fatar ido mai laushi a cikin yaro ko babba, ko tafasa, pimple, ko sinus/cutar hakori Wanda ke tsakanin gadar hanci da sasanninta na baki (“Danger Triangle of the Face”), na iya karuwa cikin sa’o’i daga kamuwa da cutar fata ta sama (** preseptal ko periorbital) mai saurin kamuwa da kamuwa da cuta mai saurin kamuwa da kwayar halitta. bayan kwallin ido (postseptal ko orbital cellulitis) ko kamuwa da gudan jini a gindin kwakwalwa (septic cavernous sinus thrombosis [CST]). Domin kwalin ido na dan adam (** the bony orbit**) wani akwati ne mai kauri, rufaffiyar kwalin da ke hade kai tsaye da magudanar jini na kwakwalwa ta hanyar jijiyoyin da ba su da ruwa, majigi ko kumburi a bayan fibrous orbital septum yana saurin murkushe jijiyar gani, yana gurgunta tsokar ido, sannan ta yada kwayoyin cuta kai tsaye zuwa cikin kwanyar. Ganewa da sauri na "6 Orbital Red Flags" (ciwo tare da motsin ido, kumburin ido, hangen nesa biyu, hana motsin ido, hasarar hangen nesa, ko rashin lafiyar almajiri) da maganin rigakafi na gaggawa na asibiti na ceton hangen nesa da rayuwa.

Yi wannan yanzu¶

1. A hankali a raba fatar ido da suka kumbura (ba tare da danna kan kwayar idon kanta ba) sannan a yi gwajin gwaji na gado mai mataki 4:
2. Mataki na 1 (Duba Motsin Ido): Riƙe yatsa \(30\rubu{centimeters}\) (\(12\rubutu{inci}\)) a gaban fuskar majiyyaci kuma matsar dashi a hankali zuwa tsarin "H" (hagu, dama, sama, ƙasa). Motsin ido yana haifar da ciwo mai zurfi a bayan ido, ko kuwa kumbura ido ** baya baya ko kasa motsawa gaba daya** yana haifar da ** hangen nesa biyu**?
3. Mataki na 2 (Binciken Proptosis / Bulging): Tsaya kai tsaye a bayan mara lafiyar da ke zaune, karkatar da kawunansu kadan baya, sannan ka kalli kan goshinsu kai tsaye ga gira biyu. Shin cornea na idon da abin ya shafa ** yana fitowa gaba** fiye da lafiyayyen ido (ko kuma ana tura ƙwallon ido zuwa ƙasa da waje)?
4. Mataki na 3 (Kayayyakin Kayayyakin Kayayyakin gani & Duba Jikewar Launi): Rufe lafiyayyen ido kuma a duba idan majiyyaci na iya karanta ƙaramin bugu a sarari. Rike wani abu mai haske mai haske (kamar hular kwalbar jan kwalba) a gaban lafiyayyan ido sannan kuma idon da ya kumbura: idan launin ja ya yi kama da faded, orange, ko brown/ launin toka ("janye desaturation") a cikin idon da ya kumbura, jijin gani na gani** ana takure.
5. Mataki na 4 (Binciken Yaduwar Biyu don Ƙunƙarar Ciwon Zuciya): Duba SAI (kishiyar) ido. Idan kumburi, ja, faɗuwar fatar ido, ko ciwon ido ya fara yaɗuwa zuwa ido na biyu a cikin awanni 24 zuwa 48, tare da matsanancin ciwon kai ko zazzabi, wanda ake zargin ** Cavernous Sinus Thrombosis* nan take.
6. **Tafi da gaggawa zuwa sashin gaggawa na asibiti idan KOWANE daga cikin 6 Orbital Red Flags yana nan, ko kuma idan majiyyaci yaro ne da bai kai shekara 1 ba, ba shi da rigakafi, ko kuma ya kasa buɗe ido don a duba shi. lambobin gaggawa.
7. Kada ka taba matsi, pop, lance, ko allura-huda duk wani pimple, tafasa (furuncle), carbuncle, ko gashin hanci a cikin "Danger Triangle na Fuskar." kwanya kai. Matse tafasasshen fuska yana tura Staphylococcus aureus kwayoyin cuta da ɗigon jini zuwa baya zuwa kwakwalwa.
8. Ajiye marasa lafiya a zaune tsaye tare da ɗaga kawunansu akan \(30\rubutu{zuwa }45\rubutu{digiri}\) kuma a kiyaye su Babu wani Abu da Baki (NPO) Zama a tsaye yana rage matsewar venous da cunkoson ruwa a cikin orbit da cavernous sinus. Hana abinci da abin sha saboda ƙurji na ƙananan ƙwayoyin orbital sau da yawa yana buƙatar hoton CT na gaggawa da magudanar ruwa na endoscopic sinus/orbital a ƙarƙashin maganin sa barci na gabaɗaya.
9. **Kada a shafa zafi mai zafi zuwa ga wani da ake zargin zurfin orbital cellulitis ko kumburin fuska da sauri tare da zazzabi mai zafi, kuma KAR a sanya magungunan gida marasa lafiya a cikin ido.
10. Bincika abubuwan haɗari na fungal (Mucormycosis): Idan mai haƙuri tare da ** ciwon sukari ketoacidosis (DKA)**, rashin kulawa da ciwon sukari, neutropenia, chemotherapy, ko amfani da corticosteroid mai girma na kwanan nan yana haifar da ciwon fuska / sinus, kumburin ido, da ** baƙar fata necrotic ko a kan rufin hanci. ayyana gaggawar gaggawar Rhino-Orbital-Cerebral Mucormycosis a yanayin asibiti.

Kumbura ido da haɗari-triangle kamuwa da cuta yanke shawara itace¶

Yi amfani da wannan taswirar tafiyar asibiti don bambance kumburin fatar ido na sama daga zurfin orbital cellulitis, cavernous sinus thrombosis, da mucormycosis na fungal.

flowchart TD
    Start["M Kumbura, Ja, ko Ciwon Ido<br/>ko Ciwon Tsakiyar Fuska a cikin Alwatika Mai Hatsari"] --> OpenCheck{"A hankali Rarrabe Ido:<br/>Duba Motsin Ido, Hange, & Matsayi"}

    OpenCheck -->|"KOWANE JAN TUTAR ORBITAL MAI GABATARWA: <br/> - Jin zafi lokacin motsa ido <br/> - Ƙuntataccen motsin ido ko hangen nesa biyu<br/> - Ƙwallon ido na ci gaba (Proptosis) ko tura ƙasa <br/> - Rage gani, launin ja ja, ko RAPD<br/> - Kwallon ido ya kumbura sosai don duban ido sosai."| OrbitTrue["POSTSEPTAL (ORBITAL) CELLULITIS<br/>ko KASHIN KASHI:<br/>1. Jeka Sashen Gaggawa na Asibiti NAN GASKIYA<br/>2. Ci gaba da zama a tsaye a digiri 30 zuwa 45<br/>3. Kiyaye Komai ta Baki (NPO) don CT scan & tiyata<br/>4. Yana buƙatar maganin rigakafi na IV nan take + ENT/Ophthalmology"]

    OrbitTrue --> CSTCheck{"Shin Idanun Biyu Suna Shiga Hannu,<br/>ko Tsananin Ciwon Ciwon kai/Cranial Nerve Palsy<br/>(CN III, IV, V1/V2, VI) / High Spiking Fever?"}

    CSTCheck -->|"YES: Yada zuwa kishiyar ido tsakanin 24-48h, <br/> daskararrun ƙwallan ido, goshi/kunci, meningismus, <br/> ko kumburin hanci / fuska ko gabanin sinusitis na sphenoid"| CST["SEPTIC COVERNUS SINUS THROMBOSIS (CST): <br/>1. Kira 911 / 112 / 999 Nan da nan<br/>2. Gaggawar Ciki Mai Barazanar Rayuwa<br/>3. Yana buƙatar stat IV Vancomycin + Ceftriaxone + Metronidazole, <br/> MRV/CTV venogram na kwakwalwa, da maganin rigakafi na IV"]

    CSTCheck -->|"Ketoacidosis mai ciwon sukari (DKA), Neutropenia, <br/> ko Immunosuppression + Black Eschar a Hanci / Palate <br/> ko Face Numbness"| Mucor["RHINO-ORBITAL-CEREBRAL MUCORMYCOSIS:<br/>Debridement na gaggawa na gaggawa + IV Liposomal Amphotericin B"]

    OpenCheck -->|"NO ORBITAL JAN Tutoci: <br/> - Mara zafi, cikakken motsi ido santsi a kowane kwatance <br/> - Al'ada 20/20 hangen nesa & kintsattse ja launi jikewa <br/>- Babu kumburin ido; farin sclera yayi kama da al'ada <br/> - Kumburi mai tsauri ga fatar fatar ido ta waje"| PreseptalCheck{"Me Ya Haifar da Ƙwararriyar Ƙirar ido?"}

    PreseptalCheck -->|"Zazzabi, fatar ido mai dumi mai taushi, <br/> cizon kwaro na baya-bayan nan, karce, ko sinusitis"| Preseptal["PRESEPTAL (PERIORBITAL) CELLULITIS: <br/>Tallafin gaggawa na likita na kwana ɗaya don maganin rigakafi na baka <br/>(ko maganin rigakafi na IV idan yaro < 1 yr ko mai tsanani) <br/> Kula da kowane sa'o'i 4 don kowane Tutocin Orbital"]

    PreseptalCheck -->|"Ƙanƙara mai laushi mai laushi mai kama da kumburi dama a gefen gefen gashin ido (Stye) ko ƙaƙƙarfan fis mai zafi<br/> murfin ciki (Chalazion), babu zazzaɓi."| Stye["HORDEOLUM (STYE) KO CHALAZION:<br/>A shafa damfara mai tsabta 10-15 min 4x kullum;"]

Iyakar Halittu: Me yasa Orbital Septum shine bangon ido¶

Don fahimtar dalilin da yasa kumburin ido biyu masu kama da juna daga ko'ina cikin ɗakin na iya samun sakamako daban-daban, dole ne ku fahimci wani siririn, tauri mai tauri na na'ura mai ɗaci mai suna ** orbital septum ***:

1. The Orbital Septum: Orbital septum yana manne tare da madauwari ta kashin kwas din ido (orbital rim) kuma ya wuce zuwa faranti na sama da na kasa na fatar ido. Yana aiki a matsayin ** shingen jikin mutum na jiki (Tacewar wuta)** yana raba fata na sama da nama na fatar ido (tsarin preseptal) daga zurfin rami mai rufaffen kashin bayan idon ido (posteptal or orbital space).
2. Preseptal (Periorbital) Cellulitis (A gaban Firewall): Lokacin da kwari ya ciji a fatar ido, ko taso kusa da gira, ko toshewar gashin ido (stye) yana cutar da fata a gaban sashin orbital septum, fatun fatar ido na iya kumbura sosai, amma a bayan ido, zaunar da tsokar ido (wani lokaci) septum gaba daya ba a taba shi ba kuma ba ya ƙonewa**.
3. Postseptal (Orbital) Cellulitis (Bayan Wutar Wuta): Ta yaya kwayoyin cuta ke samun bayan septum na orbital idan ba kasafai suke buga ta kai tsaye daga fata ba? Sama da kashi 85 zuwa 90 cikin 100 na cututtukan cellulitis na orbital suna yaduwa kai tsaye daga kamuwa da sinus na paranasal kusa, musamman ethmoid sinus.
4. Bangon ciki na kwas ɗin ido wanda ke keɓance kewayawa daga ** ethmoid air cells** wani farantin ƙashi ne mai sirin takarda da ake kira lamina papyracea (a zahiri "papyrus-thin Layer"), wanda bai kai *\(0.5\text{ millimeters}\) (\(0.02\text{inci}\)) ko ramukan jijiyoyi masu kauri da jijiyoyi (foot).
5. Lokacin da m kwayan cuta ethmoid ko gaban sinusitis gina up matsa lamba, muji da kwayoyin cuta (** Streptococcus pneumoniae**, Staphylococcus aureus [ciki har da MRSA], ** Streptococcus anginosus group**, ** Haemophilus influenzae**, ko anaerobes ta hanyar papyracea ta hanyar latsawa. a ** subperiosteal orbital abscess *** ko yaduwa ** orbital cellulitis**.
6. Odontogenic (Dental) Orbital Cellulitis: Kurjin haƙoran haƙora na sama da ba a kula da shi ba zai iya bazuwa sama zuwa cikin maxillary sinus kuma ta ƙasan kewayawa zuwa cikin kwas ɗin ido.

Cikakken kwatancen yanayin kumbura-ido guda 5¶

Yi amfani da wannan tebur na asibiti don bambance kumburin fatar ido mara kyau, preseptal cellulitis, orbital cellulitis, cavernous sinus thrombosis, da rashin lafiyar angioedema:

The "Danger Triangle na Fuskar" da Septic Cavernous Sinus Thrombosis (CST)¶

Me yasa triangle daga gadar hanci zuwa kusurwoyin bakin ba shi da venous valves¶

Idan ka zana alwatika a fuskarka tare da ** saman saman gadar hancinka** (tsakanin gira) da ** kusurwoyin kasa biyu a kusurwoyin hagu da dama na bakinka** (ciki har da hancinka baki daya, rigar hancinka, lebba na sama, da hakora na tsakiya), ka yi taswirar **"Haɗarin Triangle na Face"

A kusan dukkanin jijiyoyi na jikin dan adam, tafarki daya tak valves yana hana jini ya koma baya. Duk da haka, jijiyoyin tsakiyar fuska da kewayawa (** jijin fuska, jijiya angular, da mafi girma da ƙananan jijiyoyin ido ) ** ba su da bawuloli masu aiki guda ɗaya (ko ba da izinin kwararar jini bidirectional dangane da matsa lamba): 1. A al'ada, jini daga gadar hanci da babba na lebe yana magudawa zuwa ƙasa ta jijiyar fuska zuwa cikin jijiya jugular cikin wuya. 2. Sai dai kuma jijiyar angular* dake kusurwar ciki na ido tana haduwa kai tsaye da mafificiyar jijiyar ido, wacce ke tafiya kai tsaye ta baya ta kwas din idon ta wuce ta ** fissure orbital fissure** zuwa cikin cavernous sinus dake cikin gindin kwanyar. 3. Idan mutum ya kamu da cutar bakteriya a cikin wannan triangle (mafi yawanci ** furuncle na hanci [tafasa cikin hanci daga tsinke gashin hanci ko tsince hanci]**,* kurajen kuraje ko tafasa akan hanci ko lebe na sama**, acute sphenoid ko ethmoid sinusitis, ko hakorin gaba zai buge shi,* bakteriya ta buge shi sannan ta buge shi. kamuwa da gudanwar jini ** retrograde (a baya)** ta hanyar jijiyoyin ido marasa bawul kai tsaye zuwa cikin sinus na kogo.

Ciki cikin Kogon Sinus: Matsakaicin mafi cunkoson jama'a a cikin kwakwalwar ɗan adam¶

** cavernous sinuses *** su ne guda biyu spongy, jini mai cike da venous chambers zaune a gefen hagu da dama na pituitary gland shine yake (sella turcica) a tsakiyar gindin kwanyar, hade da juna a fadin tsakiyar layi ta ** intercavernous sinuses **.

Gudu * kai tsaye ta tsakiyar * na venous jini a cikin cavernous sinus, ko sanya a cikin ta waje bango, su ne m tsarin da babu wani wuri a cikin jiki wucewa a cikin wani jijiya: - Cikin lumen na cavernous sinus: - ** Jijiyoyin Carotid na ciki** (babban jijiya da ke ciyar da kwakwalwa) da kewayen jijiya mai tausayi. - Cranial Nerve VI (Abducens Nerve): Jijiya da ke sarrafa ** tsokar dubura ta gefe** (wanda ke motsa ƙwallon ido ** waje** zuwa kunne). Saboda Cranial Nerve VI yana yawo cikin yardar kaina a cikin tsakiyar sinus na kogo maimakon a kiyaye shi a bangon waje, rashin iya juyar da ido waje (launi na gefe) kusan koyaushe shine farkon farkon alamun jijiya na Cavernous Sinus Thrombosis. - An haɗa shi a bangon gefe na sinus na kogo (daga sama zuwa ƙasa): - Cranial Nerve III (Oculomotor Nerve): Yana ɗaga fatar ido na sama (levator palpebrae), yana takura almajiri, yana motsa ido zuwa ciki, sama da ƙasa. - Cranial Nerve IV (Trochlear Jijiya): Matsar da ido zuwa ƙasa da ciki. - ** Jijiya na Cranial V1 (Rashin gani na Jijiya na Trigeminal):** Jin ji ga goshi, fatar ido na sama, hanci, da kuma cornea. - Cranial Nerve V2 (Maxillary division of Trigeminal Nerve): Jin jin zafi zuwa kunci, lebe na sama, da hakora na sama.

Tsarin lokaci na musamman na Septic Cavernous Sinus Thrombosis¶

1. **Prodrome (kwanaki na 1 zuwa 5):Majiyyaci yana da zafi mai zafi a cikin hanci ko kuma a saman lebe (sau da yawa ana matse shi kwanan nan), matsanancin sphenoid/ethmoid sinusitis, ko cellulitis na orbital, tare da mummunan ciwon kai a bayan ido daya ko a goshi wanda baya amsa maganin kashe zafi.
2. ** Cunkoso na Orbital Unilateral & Cranial Nerve Palsies (Sa'o'i):** Kamar yadda thrombus septic thrombus ke toshe sinus na kogo na farko, jinin venous daga ido ba zai iya zubewa ba. Ido ya kumbura, farin balloon ido ya fita (chemosis), kwallon ido na kara gaba (proptosis), da Cranial Nerve VI na kasa fara farawa (idon ya dan juyo a ciki ba zai iya kallon waje ba), da sauri sai Cranial Nerves III and IV (Drooping upper eyelid) kwallon ido da aka daskararre) da ** numbness ko kuna kona fil da allura a fadin goshi da kunci** (Cranial Nerves V1/V2).
3. Yaduwa ta Tsakanin Tsakanin Tsakanin Tsararru (A cikin Sa'o'i 24 zuwa 48): Saboda ana haɗe sinuses na hagu da dama a tsakiyar layi ta hanyar tashoshi masu tsaka-tsaki marasa bawul, ƙwayar cuta ta yadu zuwa ** kishiyar sinus cavernous a cikin sa'o'i 24 zuwa 48 **. Lokacin da kumburin ido bai daya da gurbacewar tsokar ido ba zato ba tsammani ya bayyana a ido na BIYU, shi ne babban alamar cavernous Sinus Thrombosis (yana bambanta shi da kwayar halitta mai sauki ta orbital, wacce ke tsayawa a ido daya).
4. ** Sepsis na Intracranial & Meningitis:** Babban "yankin shinge" spiking zazzaɓi (\(39.5^\circ\rubutu{C}\rubutu{zuwa}41^\circ\rubutu{C}\) [\(103^\circ\rubutu{F}\rubutu{zuwa}106^\circ\rubutu{F}\)]),rigitsi (daga ciki carotid artery spasm / thrombosis).

Matsayin Cututtukan Orbital: Tsarin Rarraba Chandler¶

A cikin sashen gaggawa, likitocin ophthalmologists da likitocin otolaryngologists (ENT surgeons) suna amfani da ** Chandler Classification ** akan CT scans da aka inganta na orbits da sinuses don sanin ko majiyyaci yana buƙatar maganin rigakafi na likita kadai ko aikin tiyata na gaggawa:

Gaggawa na Musamman: Sinusitis na Fungal Mai Yawa (Rhino-Orbital-Cerebral Mucormycosis)¶

Yayin da kashi 98 cikin 100 na ƙwayar ƙwayar ƙwayar cuta a cikin yara masu lafiya da kuma manya na ƙwayoyin cuta ne, mai haɗari, gaggawa na gaggawa na fungal da ake kira ** Rhino-Orbital-Cerebral Mucormycosis ** (wanda ya haifar da tsari na * Mucorales , irin su * Rhizopus * ko * Mucor , ko kuma masu cutarwa * Aspergillus musamman majiyyata. - Wane ne ke cikin haɗari: Marasa lafiya a ketoacidosis masu ciwon sukari (DKA) (inda yawan sukarin jini da jinin acidic suka saki iron kyauta wanda ke ciyar da Mucorales fungi), ciwon suga mara kyau, cutar jini/neutropenia, gabobin jiki ko marrow dashen kasusuwa, maganin deferoxamine iron-chelation therapy, ko maganin corticosteroid mai girma na kwanan nan. - Yadda Mucormycosis ke lalata nama (Angioinvasion): Ba kamar kwayoyin cuta masu haifar da jajayen huji mai dumi ba, Mucorales fungal hyphae suna mamaye bangon jijiyoyin bugun jini, suna toshe su kuma suna yanke duk wani kwararar jini. Wannan yana haifar da saurin mutuwa na ischemic tissue (infarction)** kuma yana juya nama mai ɗauke da cuta matattu fari sannan kuma baƙar fata (necrotic eschar). - Yadda ake duban Mucormycosis a gefen gado: Idan mai ciwon sukari ko wanda ba shi da maganin rigakafi yana da ciwon sinus, ciwon fuska, ko kumbura/fashewar ido, sai a haska tocila a ciki duka ** hancin hanci** (kallon hancin hanci da turbinates) da rufin baki (tauri da laushin fatar ido) Duk wani baƙar fata necrotic ɓawon burodi, ruwan hoda mai ruwan hoda/baƙar gyambo, ko patch patch a palate ko a cikin hanci gaggawa ce ta tiyata da ke buƙatar ɓata ɗakin aiki nan take da liposomal Amphotericin B a cikin sa'o'i.

Kulawa lafiya don ƙananan kumburin fatar ido (Styes & Chalazia) vs. Haɗari Dokokin aminci na Triangle¶

Don hana qananan aibun fuska daga zama cikin gaggawa na orbital ko intracranial, bi waɗannan tsauraran tsafta da ƙa'idodin taimakon farko:

1. Yadda ake samun lafiyayyen maganin fatar ido mara rikitarwa (Hordeolum) a gida¶

Idan kana da ɗan ƙaramin ja mai taushi mai laushi daidai a gindin gashin ido (** hordeolum / stye**) ko a cikin fatar ido (** hordeolum na ciki **) tare da ** zero Orbital Red Flags ** (motsin ido na yau da kullun mara zafi, hangen nesa na yau da kullun, babu zazzabi, ba yaduwa a cikin duka murfi): - A shafa mai mai tsabta, dumi (ba mai zafi ba) matsewa ** na ** mintuna 10 zuwa 15, sau 4 a rana. Dumi mai laushi yana narkewa mai kauri mai kauri (meibum) yana toshe gland don haka yana magudana da kansa. - A wanke hannaye da kyau da sabulu da ruwa kafin a shafa kusa da ido, sannan a daina sanya kayan kwalliyar ido ko lens din ido har sai an zubar da tsohuwa gurbatacciyar mascara a rika kashewa ko maye gurbin lens din ido. - KADA KA TABA matsi, tsunkule, ko lallasa stye tare da allura: Matsi yana karye ƙaramin ƙwayar ƙwayar cuta a baya zuwa cikin preseptal da veins na orbital.

2. Yadda ake magance kuraje, tafasa (furuncle), ko gashi da ya bushe a cikin Triangle mai haɗari¶

• Kada ku taɓa ko cire gashin hanci (gashin hanci) tare da tweezers: Cire gashin hanci yana yage gashin gashi mai zurfi a cikin ɗigon hanci mai wadatar ƙwayoyin cuta (inda kashi 30 cikin 100 na mutane a zahiri suna ɗaukar * Staphylococcus aureus *), yana haifar da #1 yana haifar da furuncles na hanci da Ciwon Zunubi. Koyaushe ** a datse gashin hanci lafiya tare da almakashi mai zagaye-zagaye ko na'urar rotary trimmer.
• **Idan kumburi mai radadi ko kuraje ya bayyana akan hanci,cikin hanci,ko kan lebe na sama:**Kada a matse ko bubbuga shi. Aiwatar da damfara mai tsabta mai tsabta. Idan wani ciwo mai zafi a cikin hanci ko gadar hanci ya fara yada ja (cellulitis), zafi mai zafi, kumburi zuwa kusurwar ido, ko zazzaɓi, ga likita a *ranar guda ** don samun maganin rigakafi na tsari (da kuma maganin maganin mupirocin na ciki intranasal idan an rubuta).

Daidaitaccen rubutun sadarwa na 911/112/999 da kuma bambancin asibiti¶

Domin dakunan shan magani na gaggawa na gaggawa da dakunan jirage na gaggawa sukan ɗauka cewa ido mai kumbura shine kawai "ido mai ruwan hoda (conjunctivitis)" ko cizon kwaro, yi amfani da waɗannan ainihin sharuɗɗan asibiti a lokacin da aka kwatanta:

• Ga wadanda ake zargi da cutar Cellulitis na Postseptal (Orbital):

  • "Ina cikin triage tare da [Shekaru] mai shekaru marasa lafiya wanda ke da kumburin fatar ido PLUS Orbital Cellulitis ja tutoci: mai haƙuri yana da [zurfin zafi lokacin motsi ido / ƙuntata ido tare da hangen nesa biyu / ƙumburi na idon ido / rage hangen nesa ko wanke-fita ja launi hangen nesa] biyo bayan wani [cututtukan sinus / hakori da ke zaune. suna buƙatar kimantawar likita na gaggawa nan take, maganin rigakafi na stat IV, da kuma CT scan na orbital don kawar da ƙuruciya na subperiosteal."*

• Ga wanda ake zargin Cavernous sinus Thrombosis (CST):

  • "Cikin gaggawa: wannan majiyyaci yana da [ciwon fuska na tsakiya / ciwon hanci / kamuwa da cutar sinus] kuma a yanzu yana da ciwon kai mai tsanani, zazzabi mai zafi, [faduwa fatar ido / rashin iya motsa ido a waje], da kumburi wanda yanzu ya yada zuwa na biyu (kishiyar) ido. maganin rigakafi, da gaggawa CT/MR venography."

Tambayoyin da ake yawan yi¶

Menene hanya mafi sauri don nuna bambanci tsakanin m periorbital (preseptal) cellulitis da haɗari orbital (postseptal) cellulitis?¶

A hankali ka riƙe ƙyallen idon da suka kumbura sannan ka tambayi mutumin ya bi yatsa da idanunsa zuwa hagu mai nisa, dama nisa, sama da ƙasa. A cikin m preseptal cellulitis, kamuwa da cuta yana cikin fatar ido na waje ne kawai, don haka motsi ƙwallon ido yana da 100 bisa dari santsi kuma mara zafi tare da hangen nesa na yau da kullun; a cikin kwayar cutar kwayar cutar orbital mai haɗari, kamuwa da cuta yana da zurfi a bayan bangon shinge na ido, don haka motsa ƙwallon ido yana haifar da ciwo mai tsanani, iyakacin motsi, hangen nesa biyu, ko kuma ido mai tasowa.

Ta yaya kamuwa da ciwon ethmoid sinus a cikin yaro zai juya zuwa kumbura na gaggawa na ido na dare?¶

Bangon ciki na kwas ɗin idon da ke raba ido da ethmoid sinus a cikin hanci ƙashi ne mai sirin takarda da ake kira lamina papyracea, wanda bai wuce rabin millimita kauri ba kuma wasu ƙananan tasoshin jini suka huda. A cikin yara da samari, m ethmoid sinusitis na kwayan cuta mai saurin turawa ta cikin wannan siririn kashi zuwa cikin kwas din ido, yana haifar da kurjiyar orbital na subperiosteal wanda ke danna tsokin ido da jijiyar gani cikin sa'o'i.

Shin yana da haɗari da gaske a bubbuga pimple ko toshe gashi a cikin hanci a cikin "Haɗari na Fuskar Alwatika"?¶

Ee, jijiyoyin da ke zubar da alwatika daga gadar hanci zuwa sasanninta na baki suna haɗa kai tsaye ta baya ta kwas ɗin ido ta hanyar maɗaukakin maɗaukaki mara nauyi da ƙananan jijiyoyin ido zuwa cikin sinus na kogo a gindin kwakwalwa. Domin wadannan jijiyoyi ba su da bawul guda ɗaya don dakatar da kwararar baya, matse wani tafasa ko kamuwa da ƙwayar gashi a cikin hanci ko kuma a saman leɓe na sama na iya tilasta ƙwayoyin cuta da gudanwar ciwon baya zuwa cikin kwanyar, yana haifar da muguwar ƙwayar cuta ta sinus thrombosis.

Me yasa ake gwada yadda launin ja mai haske yake kama ("janye desaturation") irin wannan muhimmin gwaji a cikin kumbura ido?¶

Zaɓuɓɓukan jijiyoyi a cikin jijiyar gani waɗanda ke watsa tsinkayen launin ja mai haske sun fi dacewa da matsa lamba na inji da ischemia. Tun kafin kumburin orbital ko kumburi ya makantar da ido gaba daya, matsawa jijiyar gani yana haifar da wani abu ja mai haske (kamar hular kwalbar ja) ya ga ya dushe, lemu mai wanke-wanke, ko launin ruwan kasa idan aka duba shi da idon da ya shafa idan aka kwatanta da lafiyayyan ido, yana fadakar da likitoci cewa ana bukatar tiyatar gaggawa nan take don ceton gani.

An duba tushe¶

• ** Cibiyar Nazarin Ophthalmology ta Amurka (AAO, Amurka):** Sharuɗɗa na asibiti da Ijma'in EyeWiki a kan Preseptal Cellulitis, Orbital Cellulitis (Chandler Classification Groups I to V), da Septic Cavernous Sinus Thrombosis.
• Hukunce-Hukunce-Hukunce-Hukunce-Hukunce-Hukunce-Hukunce-Hukunce-Gabatarwa da Kula da Cututtukan Skin da Soft Tissue Infections da *Jagoran Kula da Lafiyar Kwayoyin cuta don Mummunar Rhinosinusiis a Yara da Manya* (Cibiyoyin Kulawa da Intracranial).
• ** Cibiyar Kula da Lafiya da Ƙwararrun Kulawa ta Ƙasa (NICE, United Kingdom) da Royal College of Ophthalmologists (RCOphth, United Kingdom):** Sinusitis (Acute): Periorbital da Orbital Cellulitis Ma'anar Magana na Gaggawa (NG79).
• ** Kwalejin Ilimin Ilimin Yara na Amurka (AAP, Amurka):** * Gudanar da Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar Cutar (Periorbital/Orbital Cellulitis) a cikin Marasa Lafiyar Yara.
• European Confederation of Medical Mycology (ECMM) and Mycoses Study Group (MSG ERC): Global Guideline for the Diagnosis and Management of Mucormycosis (Rhino-Orbital-Cerebral Mucormycosis emergency recognition and surgical/liposomal Amphotericin B management).

Jagora masu alaƙa¶

• Rashin hangen nesa kwatsam, cirewar ido, da matsanancin glaucoma-ƙulli
• Raunin ido: konewar sinadarai, rauni mai shiga jiki, da hyphema
• Necrotizing fasciitis (cututtukan cin nama) da kuma cellulitis ja tutoci
• Sepsis da Septic shock ganewa
• Ketoacidosis na ciwon sukari (DKA) da hyperosmolar hyperglycemic yanayin