I-Choanal atresia

I-**Choanal atresia** lukhubazeko ozalwa nalo olwenzeka phaya ngasemva komzila wempumlo (obizwa ngokuba yi-choana) kutsho kuvaleke mba lo mzila, oko ke kudla ngokwenzeka xa kuthe kwakho ithambo elingaqhelekanga mhlawubi eli thambo linobudalwa obuthile, okanye  xa kuye kwakho i-tissue ethambileyo (enjengenwebu okanye into ebukhumbarha) ngenxa yokusilela kwe-recanalization yawo omabini amagumbi empulo (iimbobo zempulo esiphefumla ngazo) ngexesha lokukhula kwemveku isesesiswini sesilwanyana.  

## Ubume bayo
Isenokuba unilateral okanye ibe-bilateral.
* Ngamanye amaxesha, i-unilateral choanal atresia ingangabonwa de umntwana abemdala ngenxa yokokuba ede wabe uyaqhela ukuphefumla ngaloo mpumlo inye.  
* I-Bilateral choanal atresia yimeko engumngcipheko omkhulu kubomi bomntwana kuba kaloku uyakusuka angakwazi kuphefumla ngokupheleleyo emva kokuba ezelwe njengoko iimveku zizalwa zinyanzelekileyo ukuba ziphefumle ngeempumlo (ziphefumla ngeempumlo kuphela).  Kwezinye iimeko, oku kuvela njengokuxinana kweempumlo imfuxane namanye amazwi, ebonakala ngakumbi xa umntwana encanciswa, kuba indlela ehamba umoya ivalwe lulwimi, ize ithi indlela le inciphe ngakumbi umoya ungabi nakuhamba. Oku kuxinana ke kungangcono xa elila umntwana, kuba kaloku kulapho umoya ohamba ngomlomo usetyenziswa ngalo lonke ixesha.  Ezi mveku zingancedwa ngothi zithi zigqitywa nje ukuzalwa zibe sele zixhaswa ngomoya.  

## Iimeko ezinxulumene nayo
Ngamanye amaxesha iimveku zizalwa ne-choanal atresia ziba nezinye iimpawu zobudalwa:
* I-coloboma
* Ukusisela kwentliziyo
* ukudodobala kwengqondo
* Ukungakhuli
* nezinye (jonga nakwi-CHARGE syndrome)
Kanti ke neemeko ezenza uxinzelelo olumandla kwibhulorho yempulo okanye kwithanjana elahlula iimpulo zombini zinganxulunyaniswa ne-choanal atresia.  Imizekelo ibandakanya i-craniosynostosis syndromes ezifana ne-Crouzon syndrome, Pfeiffer syndrome, Treacher Collins kunye ne-Antley-Bixler syndrome.

## Singabonwa njani esi sifo
I-choanal atresia ingakrokrelwa xa kungenakufakelwa ithyubhu yempumloebizwa ngokuba yi-catheter yempumlo.
Kwakhona, ukuba kubonakala ukunkcenkceza kwemifinya okuvela kwenye okanye kuzo zombini iimpumlo, oko kungaluphawu lwe- atresia. Olunye uphawu oluxhaphakileyo kukuvaleka kweempulo okubizwa ngokuba yi-cyanosis ebakwimveku xa incanciswa ngunina, njengoko xa ikule meko ukuphefumla kwayo kuxhomekeke kwiimpumlo. Olu phawu lungqinwa nge-radiological imaging, edla ngokwenziwa nge-CT scan.

## Iimeko ezinokudala okokuba kubekho esi sifo

## Iimeko ezenza okokuba ubani abesemngciphekweni wokuba nesi sifo.
Zibalwa kakhulu iimeko esethe zabonwa ezinokudala okokuba umntu abekumngcipheko we-choanal atresia.    Nangona unobangela wesi sifo ungekaziwa, ufuzo neemeko zendalo ziyakrokrelwa. Esinye isifundo sibonisa okokuba iikhemikhali ezisebenza njenge-endocrine interrupters zingayibeka emngciphekweni imveku engekazalwa. Isifundo se-epidemiological sango-2012 saqwalasela kwi-atrazine, i-herbicide exhaphakileyo kwelase-U.S., kwafunyaniswa okokuba abafazi abahlala kwiingingqi zolwawulo lwase Texas ezinale khemikhali ekwizinga eliphezulu nesetyenziselwa ukuncothula ukhula, kwaafunyaniswa okokuba aba malunga nama- 80 amathuba okuzala iintsana ezinale  choanal atresia okanye i-stenosis xa kuthelekiswa nabafazi abahlala kwiingingqi zolwawulo apho liphantsi izinga lale khemikhali.   Enye ingxelo ye-epidemiological yango-2010 yafumanisa unxulumano olungaphezulu phakathi kokwanda kwezi meko ze-choanal atresia kwanokuvelela kwisandla sokutshaya, ekuphungeni ifofu, nakubantu abaphila ngokuthatha i-maternal zinc ne-B-12 kwanokuvelela kumayeza a-anti-infective urinary tract.

## Unyango
Ukungxengwa kwayo okwethutyana kungayimpumelelo xa kunagfakelwa umzila wokuhamba komoya emlonyeni.  Kodwa ke olona nyango lupheleleyo luqhaqho ukuze kulungiswe undonakele ngokuthi kombiwe i-atresia ngeenjongo zokudala indlela yokuhamba komoya obizwa ngokuba yi-nasopharyngeal. Ukuba uxinano lwenziwa lithambo lempumlo, elo thambo liyaqhawulwa kuze kufakelwe i-stent (ithyubhu yep-plastiki) fakelwa phakathi kweempumlo. Kufuneka ifunxwe yonke le nto kwisigulane, ikhutshelwe ngaphandle ngomatshini wombhobho womoya. Uyakuthi ke ugulayo ebudaleni bakhe xa kanye aselula okanye xa efikelela kumashumi amabini eminyaka, uphinde uvulwe ngakumbi ke lo mngxuma.  

I-stent singafakelwa ngeenjongo   zokugcina le ndlela intsha yokuhamba komoya iselungelweni lokwenza oko,  okanye kusenokuphindwa kwa olwa qhaqho.

## Ngokwesiko lesiqhelo
Kumdlalo bhanya-bhanya othi City of Angels, Ugq. Maggie Rice (odlalwa ngu-Meg Ryan) uye wawuchana unobangela wokokuba iimveku zisilele ukuba zibenokuphila ngokupheleleyo ngenxa ye-  choanal atresia.

## Funda nalapha

## Unxulumano lwangaphandle
* Great Ormond Street Hospital for Children