Številni avtorji navajajo pomen interdisciplinarne obravnave kratkega jezičnega frenuluma ter vlogo zdravnika kot zadnjega, ki odloča o morebitni potrebi po kirurškem posegu. V prispevku želimo ...osvetliti trenutno znanje o jezičnem frenulumu po svetu. Vključeni so podatki iz prispevkov v slovenskem, angleškem in italijanskem jeziku, ki so bili objavljeni do aprila 2021. Opisane so obstoječe klasifikacije in ocenje-valni protokoli jezičnega frenuluma pri novorojenčkih, otrocih in mladostnikih ter pri odraslih. Vključeni so tudi podatki dveh histoloških raziskav, ki prinašata nov predlog poimenovanja omenjene ustne strukture. V strokovni literaturi glede kirurških posegov jezičnega frenuluma obstaja veliko različnih, tudi nasprotujočih si mnenj. Če se zdravnik odloči za operacijo, moramo opraviti predhodno in nadaljnjo obravnavo – miofunkcionalno zdravljenje pri ustrezno izobraženem strokovnjaku. Če strokovnjaki ne poskušajo zdraviti jezičnega frenuluma, obstaja možnost, da bolnik razvije kompenzatorne gibe artikulatorjev med govorom glede na anatomsko strukturo jezičnega frenuluma, vidimo pa tudi vpliv na celotno telo.
SHORT CERVIX – WHAT NOW? Faris Mujezinović
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2018, Volume:
78
Journal Article
Peer reviewed
Open access
Background: It is possible to predict preterm delivery (PD) before 34 weeks by ultrasound measurement of uterine cervical length (CL). This is the reason why this screening method is more frequently ...used in clinical practice. Methods: I extracted from PubMed database Crane’s sistematic review and articles about association of CL with PD and instructions what is necessary to take into consideration and what to do in case of a short cervix. Results: Majority of studies suggested CL of 25 mm as a cut-off point for selecting pregnancy as high risk for PD. Minority of studies also used 15 mm as a cut-off point. This inconsistency in selecting an unique cut-off point, as some authors showed, is a result of ignoring gestational age when measurement of CL is made. CL is usually measured until 24 weeks of pregnancy and value of US measurement of CL made later in pregnancy or role of follow-up measure- ments are still unclear. In cases with threatened preterm labour where CL is measured there was 66 % reduction of unnecessary tocolysis. US measurement of CL is of a little value if there is a progressive dilatation of cervix (Bishop score > 6). Shirodkar cerclage in women with short cervix does not reduce the risk for PD. Vaginal progesteron causes a 50 % decrease of incidence of PD in women with short cervix (CL < 15 mm). We do not know which form of vaginal progesteron is most effective. Progesteron is uneffective in women with PD in previous pregnancy and CL > 25 mm. Conclusions: US measurement of CL becomes reliable criteria for detecting pregnancies with increased risk for PD before 34 weeks of pregnancy. It enables individual risk calculation for PD with consideration of other risk factors.
