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All Journal Jurnal Dunia Kesmas
Ramadhani, Zerlina Norberta
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Environmental Science Public Health

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Immunological and Clinical Approaches in Determining Indications for Tonsillectomy: A Literature Review Anantasya, Arum Widya; Adji, Iwan Setiawan; Megaranti, Ardhini Tyas; Ramadhani, Zerlina Norberta; Mukti, Gavin Editya; Devano, Mohammad Alifiya
Jurnal Dunia Kesmas Vol 15, No 2 (2026): Volume 15 Nomor 2
Publisher : Persatuan Dosen Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jdk.v15i2.25317

Abstract

The palatine tonsils play a key role in mucosal immune defense; however, chronic tonsillitis leads to structural and immunological impairment, resulting in loss of protective function and persistent infection. Current indications for tonsillectomy rely mainly on infection frequency and anatomical findings, which may be insufficient. This literature review aims to evaluate tonsillar immune dysfunction and the role of clinical parameters in establishing a more comprehensive indication for tonsillectomy. A PRISMA-based literature review of studies published between 2010 and 2025 was conducted. The findings demonstrate impaired lymphocyte maturation, reduced secretory IgA production, chronic inflammatory activity, and bacterial biofilm formation in chronic tonsillitis. Clinical parameters including the Centor score, McIsaac score, FeverPAIN score, Paradise criteria, tonsillar hypertrophy, airway obstruction such as obstructive sleep apnea, and quality-of-life assessment using the Tonsillectomy Outcome Inventory-14 (TOI-14) provide objective evaluation of disease severity and functional burden. In conclusion, tonsillectomy should be considered based on an integrated assessment of clinical, anatomical, immunological, and quality-of-life parameters to support evidence-based surgical decision-making.
Rhinosinusitis Kronis Dextra dengan Polip Antrokoanal pada Wanita Usia 23 Tahun Adjie, Iwan Setiawan; Mukti, Gavin Editya; Anantasya, Arum Widya; Megaranti, Ardhini Tyas; Ramadhani, Zerlina Norberta; Devano, Mohammad Alifiya
Jurnal Dunia Kesmas Vol 15, No 2 (2026): Volume 15 Nomor 2
Publisher : Persatuan Dosen Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jdk.v15i2.25332

Abstract

Rhinosinusitis kronis dengan polip antrokoanal merupakan bentuk rhinosinusitis kronis unilateral yang relatif jarang, berasal dari mukosa sinus maksilaris dan umumnya mengenai anak-anak serta dewasa muda. Kondisi ini ditandai oleh inflamasi kronik lokal yang menyebabkan gangguan ventilasi dan drainase sinus, sehingga sering bersifat refrakter terhadap terapi medikamentosa. Dilaporkan kasus seorang perempuan berusia 23 tahun dengan keluhan obstruksi hidung kanan progresif sejak ±6 bulan, disertai rinorea purulent, nyeri wajah, post-nasal drip, dan penurunan fungsi penciuman. Pemeriksaan rhinoskopi anterior menunjukkan polip pada meatus media dextra, sedangkan CT-scan sinus paranasal memperlihatkan gambaran pansinusitis kanan dengan kecurigaan polip antrokoanal yang berasal dari sinus maksilaris. Pasien didiagnosis sebagai rhinosinusitis kronis dengan polip antrokoanal dextra yang tidak responsif terhadap terapi konservatif dan selanjutnya menjalani tindakan operatif dengan prosedur Caldwell-Luc. Rhinosinusitis kronis dengan polip antrokoanal memerlukan evaluasi diagnostik yang komprehensif untuk menyingkirkan penyebab sinonasal unilateral lainnya serta penatalaksanaan bedah sebagai terapi definitif. Prosedur Caldwell-Luc masih memiliki peran pada kasus terpilih dengan keterlibatan dominan sinus maksilaris dan kegagalan terapi medikamentosa.
Co-Authors Adji, Iwan Setiawan Adjie, Iwan Setiawan Anantasya, Arum Widya Devano, Mohammad Alifiya Megaranti, Ardhini Tyas Mukti, Gavin Editya