
fibromatosis kooli

fibromatosis kooli (fmc), dheenini saisavamloni sternoclidomastoid tumour, saisavamloni sudotumer, mariyu saisava sternoclidomastoid sudotumer anie kooda pilustaaru, idhi asaadhaaranamainadi (sambhavamh 0.4%-1.3% sajeeva jananaalu), rendu sternoclidomastoid meda kandaraalalo okadaanilo puttukatho vachhe kaniti, arudaina sandarbhaallo rendu sternoclidomastoid kandaraalalo fmc kanitini kaligi unnappatikee. kanitini ikkada saadhaarana chuttupakkala kanajaalamtho samanvayam cheyani kanajaalam perugudalugaa nirvachinchaaru mariyu daani perugudalaku asalu trigger tolaginchabadinappatiki perugutuu untundi. fmc kanitulu haanikaramaina perugudhala, ivi vaikalyalaku kaaranamavutaayi conny cancerlu kaavu mariyu metastasize kaavu (i.ii. vyaapti) suduura kanajaalaalaku.
suukshmadarshini kanajaala vislaeshanhala dwara nirnayinchabadinatlugaa, fibromatosis kooli kanitulu spindle aakarapu fibroblastlanu kaligi untaayi (i.ii. bandhana kanajaalamlo atyanta saadhaarana kana rakam) collagen fibers nepathyamlo untundi, asthipanjara kandaraala fibers kullipotayi mariyu konni sandarbhaallo, asthipanjara kandaraala fibersnu punarutpatti chestaayi. fibroblastlu puurtigaa saadhaarana roopaanni kaligi untaayi, avi praanaantakamainavani soochinche aadharalu laevu. prapancha aarogya samstha, 2020, fibromatosis kooleeni nirapaayamaina fibroblastic mariyu myophybroblastic kanitula vibhaagamlo vargeekarinchindi.
chaalaa sandarbhaalalo, fmc kanitulu parimaanamlo taggutaayi mariyu navjata sisuvu rendava samvatsaram natiki puurtigaa parishkarinchabadataayi. ayithe, chikitsa cheyakunda vadilesthe, gananeeyamaina saatam kesulu puttukatho vachhe kandaraala torticolis, antey.ii. asaadhaaranamaina, asamaana thala ledhaa meda sthaanam saadhaaranamgaa vrai neck anie pilustaaru. chikitsa cheyani fmc kanitulu kooda mukha asamaanata, plagiocephaly (i.ii. chadunaina thala), meda kadalika shaashwata nashtam, paarshvaguuni (i.ii. vennemuka yokka pakkaki vakrata), ledhaa parihara yantraamgaala phalitamgaa vachhe itara nirmaanaatmaka vaikalyalu.
pradarsana.
fmc kanitulu saadhaaranamgaa delivery ayina 8 varalalo (sagatunah 24 rojulu) sisuvula sternoclidomastoid kandaraalalo moodinta rendu vantula diguva bhaagamlo nemmadigaa perugutunna, drudamaina, kadile, naan-tender, spindle aakarapu dravyaraasulugaa untaayi. rooga nirdhaarana samayamlo, eee sisuvula talalu dravyaraasitoe pakkaki vangi undavacchu, ayithe vaari gaddalu vyatiraeka, sambandham laeni vaipuku vangi untaayi. eee vampu sternoclidomastoid kandaraala sankocham kaaranamgaa untundi. fmc kanitulu purushulalo mariyu kudi sternoclidomastoid kandaraalalo sarvasaadhaaranam, ayithe dwaipaakshika kanitulato chaalaa arudaina kesulu untaayi. chikitsa cheyakapothe, puttuka tarvaata vaaraala paatu dravyarashi perugutuunae undavacchu, conny taruvaata sthireekarinchabadutundi, 4-8 nelala jeevitam tarvaata tirigi ravadam praarambhistundi, mariyu taruvaati 1-2 samvatsaraalalo saadhaaranamgaa puurtigaa parishkarinchabadutundi. moodu adhyayanaalalo, 25 saatam, 50 saatam, 80 saatam kante ekkuva mandhi sisuvulaku breach jananam, forceps avasaramayye delivery, premigravida jananam (antey.ii. talli modati bidda), sudeerghamaina, kashtataramaina prasava ledhaa sijerian vibhagam dwara prasavinchadam. fibromatosis kooli unna navjata sisuvulalo 6-20% nundi hip dysplasia ledhaa takkuva saadhaaranamgaa, mukha asamaanata vanti itara puttukatho vachhe gaayaalato kooda untundi.
pathology.
biopsy cheyabadina fmc kaniti kanajaalaala suukshma hystopathological vislaeshanhalu saadhaaranamgaa nirapaayamaina, spindle aakarapu fibroblastlu, kullina asthipanjara kandaraala fiberlu mariyu konni sandarbhaallo, collagen fiber kaligina nepathyamlo asthipanjara kandaraala fiberlanu punarutpatti chestaayi. avasaramaite, eee kanitulanu saadhaaranamgaa kaniti biopsy namuunaa yokka marinta haanikaramaina vidhanam kante suukshma-suudi aspiration namuunaala suukshma pareeksha dwara nirdhaaristaaru. asperatelu madhyastamgaa cellular, chellacheduruga, oval aakaaramlo nundi spindle aakaaramlo unna fibroblastlu, nagna kendrakaalanu (i.ii. sell nucleus luu vaastavamgaa cytoplasm vanti itara kana muulakaalu laenivi), collagen yokka visips, atrophic, ksheeninche kandaraala fibers, punarutpaadaka kandaraala fibers mariyu bahula nucleus lanu kaligi unna chekkuchedarani asthipanjara kandaraala kanaalu. vaapu, raktasraavam, kana necrosis ledhaa vaegamgaa vibhajinche mariyu/ledhaa kanaalu vistarinche aadharalu laevu.
etiology.
fmc kaniti dravyarashi anedi prasava samayamlo sambhavinche kanajaala gaayam valla kalige hematoma yokka avasheshamani pratipaadinchabadindi. ayithe, hematomas yokka lakshanaalu laevu (udhaa.zii. roganirdhaarana samayamlo eee gayalalo maranistunna erra rakta kanaala dwara vidudalayye haemosiderine) mariyu gaayam (udhaa.zii. taruvaata fmc kanitulato unna sisuvulalo puttinapudu charmam meeda unde maarpulu ledhaa rangu maaradam). garbhasayam loe unnappudu ledhaa prasava samayamlo pindamlo sambhavinche sirala pravaaha avarodham sternoclidomastoid kandaraala fibers ksheenataku mariyu debbatinna praantaala tadupari fibrosisku daariteestundani kooda soochinchabadindi. chivaraga, garbhasayam loe pindam thala paelavamaina sthaanam kaaranamgaa gaayam sternoclidomastoid kandaraalaku compartment syndrome vanti ottidi-prerita gayanni utpatti chestundani soochinchabadindi, dheeni phalitamgaa kandaraala kanaalu maranistaayi, taruvaata kanajaala fibrosis mariyu fmc kanitula saadhaarana pathology.
rooga nirdhaarana.
navjata sisuvulo sternoclidomastoid dravyaraasini vaidyaparamgaa gurtinchina tarvaata sifaarsu cheyabadina modati dasha doppler ultrasonography, duplexes ultrasonography kalipi untundi. eee paddhati saadhaaranamgaa sistlu ledhaa itara ultrasonography-gurtinchina asaadhaaranatalu laeni sternoclidomastoid kandaraala vyaapti ledhaa kendra vistarana yokka roganirdhaarana (100% sunnitatva raetlu varaku) phalitaalanu velladistundi. eee imaging phalitaalu roganirdhaarana kakapothe, magnetic resonance imaging roganirdhaarananu spashtam cheyavachu. phalitaalu inca aspashtamgaa unte, kaniti nundi teesukunna suukshma suudi asperatela suukshmadarshini pareeksha, imaging phalitaalato kalipinappudu, gaayam yokka sahaja charitra mariyu daani clinical presentation, daadaapu anni sandarbhaallo fmc rooga nirdhaarananu nirdhaaristundi.
chikitsa mariyu rooga niruupana.
shaashwata mukha asamaanata, chadunaina thala, meda kadalika kolpovadam mariyu paarshvaguuni vanti sisuvu thala deerghakaalika tappu sthaanaanni anusarinche balaheenatalanu nivaarinchadaaniki efms yokka sheeghra roganirdhaarana mariyu chikitsa keelakam. thala yokka chalanaseelatalo kaneesa parimitulu unna 95 saatam mandhi sisuvulu churukaina gruha uddeepana karyakramam (antey 4 vaaraala tarvaata) tarvaata eee chalanaseelatalo merugudalalanu chuuputaaru.ii. pariseelana, mardana, mariyu kriyaaseela mariyu nishkriyaatmaka saagadeeyadam) ayithe marinta teevramaina kadalika parimitulu unna sisuvulalo 3-4 nelala vyavadhilo lakshyita physiotherapy yokka 3 sessionla tarvaata manchi phalitaalanu chooputundi. 1 samvatsaram saareeraka chikitsa tarvaata chalanaseelatalo etuvanti merugudalalu choopinchani ledhaa praarambhamlo 12 nelala kante ekkuva vayassulo unna sisuvulaku sifaarsu cheyabadina chikitsa shastrachikitsa tenotomy (antey.ii. kattirinchadam) sternoclidomastoid kandaraalapai snaayuvulalo okati. tenotomy open sarjikalnu upayoginchavacchu (i.ii. charmam kattirinchadam) vidhanam ledhaa endoscopic (i.ii. percutaneous) vidhanam. eee chikitsa charyalanu upayoginchi efms kanitula yokka mottam rooga niruupana manchidi.
fms unna sisuvulanu hip dysplasia uniki kosam pareekshinchaali.

