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All Journal Oto Rhino Laryngologica Indonesiana International Journal of Nasopharyngeal Carcinoma eJournal Kedokteran Indonesia
Mayangsari, Ika Dewi
Ear, Nose, Throat Department, Faculty Of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Bedah sinonasal endoskopik angiofibroma nasofaring belia: laporan seri kasus berbasis bukti (evidence based) Wardani, Retno Sulistyo; Mayangsari, Ika Dewi; L, Lisnawati; Pandelaki, Jacub; Prameswari, Kharisma; Mangunkusumo, Endang
Oto Rhino Laryngologica Indonesiana Vol 42, No 2 (2012): Volume 42, No. 2 July - December 2012
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (579.558 KB) | DOI: 10.32637/orli.v42i2.31

Abstract

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a histologically benign, but locally invasive neoplasm occurring most often in adolescent males. These tumors are highly aggressive andare associated with significant morbidity and mortality due to its tendency to bleed. Purpose: To presentevidence based case-report on endoscopic removal of JNA as an alternative technique besides the openapproach. Cases: Three cases of JNA managed endoscopically of their removal and the difference ofclinical symptoms based on the histopathological variation and radiological description analysis, givingbenefits in endoscopic surgical planning. Management: The classical treatment for JNA is surgery,however there are cases in which may indicate radiotherapy or even hormone therapy and gamma knifesurgery. Recent advances in technology enable ENT surgeons to use the endonasal technique as analternative in treating JNA patients. Conclusion: Endoscopic removal of JNA was successfully performedfor T1 and T2 tumor based on Fisch classification. To support a good management for JNA casesendoscopically, carefull considerations should be made to determine accesses toward the predominant attachment of the tumor to sphenopalatine foramen and pterygoid plate. Rhinologists and OncologyHeadandNecksurgeonsshouldhavedeepunderstandingofendoscopicanatomyoflateralnasalwalland mastering the art of four-hand technique of endoscopic sinonasal surgery. Keywords : angiofibroma, endoscopic surgery, sphenopalatine artery, pterygoid plate of sphenoid bone.  Abstrak :  Latar belakang: Angiofibroma nasofaring belia (ANB) merupakan tumor jinak secara histologis,namun bersifat ganas secara lokal yang terjadi terutama pada anak laki-laki usia remaja. Tumor jenis inibersifat sangat agresif dan sering dihubungkan dengan tingginya angka morbiditas dan mortalitas karenakecenderungan tumor yang mudah berdarah. Tujuan: Mempresentasikan 3 kasus dengan diagnosis klinisANB yang dilakukan ekstirpasi secara bedah sinonasal endoskopik. Telaah literatur terstruktur dilakukanuntuk menganalisis keputusan dan aplikasi pemilihan teknik bedah ini. Kasus: Tiga kasus ANB yangtelah dilakukan ekstirpasi dengan bedah endoskopik dianalisis berdasarkan variasi gejala klinis, gambaranhistopatologi dan gambaran radiologiknya yang berguna untuk perencanaan pembedahan sinonasalendoskopik. Penatalaksanaan: Tatalaksana utama ANB adalah dengan pembedahan, namun pada kasuskasustertentudapat dipilih modalitas radioterapi, terapihormon dan pembedahan dengan pisau gamma.KemajuanteknologimemudahkanparaahlibedahTHTuntukmenggunakanpendekatanendoskopisebagaialternatif pendekatan bedah pada pasien ANB.Kesimpulan:Bedah sinonasal endoskopikANBdapatdilakukanuntuktumorberukuranT1danT2berdasarkanklasifikasiFisch.Faktorlainyangharusdiperhatikanuntukkeberhasilantindakanadalahpemahamananatomiendoskopikhidungdansinusparanasal untuk penetapanakses secara sentripetalmenujuperlekatanutamaANBpada foramensfenopalatinadanlempeng pterigoid, serta kerjasama antaraahli Rinologi dengan ahli Bedah KepalaLeherOnkologi dalam teknik bedah sinonasal endoskopik 4 tangan (four-handtechnique). Kata kunci : angiofibroma, bedah endoskopik, arteri sfenopalatina, lempeng pterigoid os sfenoid.
Woakes syndrome Retno Sulistyo Wardani; Ika Dewi Mayangsari
Oto Rhino Laryngologica Indonesiana Vol 44, No 1 (2014): Volume 44, No. 1 January - June 2014
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (447.022 KB) | DOI: 10.32637/orli.v44i1.86

Abstract

Background: Extensive nasal polyp growth in the paranasal sinuses can lead to bone erosion of the sinus walls and cause facial disfigurement due to continuous pressure or chronic inflammation. This extremely rare phenomenon is called Woakes syndrome. This syndrome consist of several symptoms include the destruction of ethmoid sinus that cause broadening of the bridge of the nose, frontal sinus aplasia and bronchiectasis. Purpose: To give complete information about the diagnosis and management of Woakes Syndrome. Case: A 16-year-old boy with deformity of the left nose, nasal obstruction and frequent episodes of rhinorrhea since 4 months before admission. Nasoendoscopic evaluation showedhuge nasal polyps filling the left nasal cavity, pushing the septum and narrowing the right nasal cavity. Histopathology result was edematous polyp with necrosis and massive bleeding without signs of malignancy. Management: Patient was managed in two stages operations. First, nasal polyp removal by FESS technique in general anesthesia, and the second stage four months later, was septorhinoplasty for aesthetic bridge reconstruction. Conclusion: Nasal polyps could be related to Woakes syndrome, characterized by broadening of nasal bridge which needs functional and aesthetic surgery. Keyword: Woakes Syndrome, nasal polyps, Functional Endoscopic Sinus Surgery, Septorhinoplasty ABSTRAKLatar Belakang: Polip hidung besar yang meluas dalam sinus paranasal dapat menyebabkan erosi dinding sinus dan menyebabkan cacat wajah akibat tekanan terus-menerus atau peradangan kronis. Fenomena ini sangat langka dan disebut sebagai sindrom Woakes. Sindrom ini terdiri dari beberapa gejala termasuk kerusakan dinding sinus etmoid yang menyebabkan hidung melebar, aplasia sinus frontal dan bronkiektasis. Tujuan: Untuk memberikan informasi yang lengkap tentang diagnosis dan penatalaksanaan Woakes Syndrome. Kasus: Seorang anak laki-laki 16 tahun dengan deformitas hidung kiri, hidung tersumbat dan pilek berulang sejak 4 bulan. Evaluasi nasoendokopi menunjukkanpolip hidung masif mengisi rongga hidung kiri, mendorong septum dan menyempitkan rongga hidung kanan. Pemeriksan histo-patologi memperlihatkan polip edematosa dengan nekrosis dan perdarahan masif tanpa tanda-tanda keganasan. Penatalaksanaan: Pada pasien dilakukan dua tahap tindakan. Pertama, dilakukan Bedah Sinus Endoskopik Fungsional (BSEF) dan polipektomi dalam anestesi umum, dan empat bulan kemudian pasien menjalani septorinoplasti untuk rekonstruksi wajah. Kesimpulan: Polip hidung pada kasus ini kemungkinan terkait dengan sindrom Woakes, ditandai dengan pelebaranpyramid hidung yang membutuhkan tindakan operasi fungsional dan estetika.Kata kunci: sindroma Woakes, polip hidung, Bedah Sinus Endoskopik Fungsional, Septorinoplasti.
POST-TREATMENT FOLLOW-UP OF NASOPHARYNGEAL CARCINOMA PATIENTS: A REVIEW Ika Dewi Mayangsari
INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA Vol. 1 No. 01 (2019): International Journal of Nasopharyngeal Carcinoma
Publisher : TALENTA PUBLISHER

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (665.465 KB) | DOI: 10.32734/ijnpc.v1i1.956

Abstract

Introduction Locoregional failure of nasopharyngeal carcinoma (NPC) occurs despite the aggressive treatment that has been done. Optimal and accurate follow-up schedule after the radiotherapy or chemoradiotherapy sessions could improve the patient's quality of life (QoL). Discussion Kwong et al. reported complete histological remission within 3 months after therapy and positive histological signs at >12 weeks considered a persistent disease. Kong et al. (2017) showed that the pathological treatment response using CT scan and MRI and stated that the median time to full regressions is 4.9 months. Some studies also reported that primary tumor continuously regressed >4 months after treatment and delayed remission >12 weeks is not a prognostic factor for poor survival. The use of MRI is superior to CT scan to detect residual or recurrent NPC. MRI showed good results in differentiating mature scar and tumor, whereas CT scan could not differentiate fibrosis and tumor because of the radiation therapy-induced inflammation. On the other hand, PET-CT has higher sensitivity compared to CT scan and MRI, but poor cost-effectiveness. Various studies and NCCN 2018 guidelines recommend the use of imaging between the third and sixth months after therapy to evaluate treatment response. Conclusion Assessment of treatment-related late toxicities also an important factor to improve patient’s QoL. Evaluation of nutrition, speech difficulties, swallowing, hearing, dental care should be done annually and peer support groups can help improve patient’s QoL. Assessment of residual disease should be done at the minimum of 10 weeks after the completion of the therapy and long-term follow-up is a must because locoregional recurrences of NPC are common within the first two to three years after the treatment.
Factors Affecting Adverse Events Following SARS-CoV-2 Vaccine among Indonesian Ear, Nose, and Throat Specialist, and Residences Susyana Tamin; Jenny Bashiruddin; Indra Zachreini; Harim Priyono; Ika Dewi Mayangsari; Respati Ranakusuma; Natasha Supartono; Khoirul Anam; Anggina Diksita; Yussy Afriana Dewi; Sagung Rai Indrasari; Nyilo Purnami; Tengku Siti Hajar Haryuna; Juliandi Harahap; Eka Savitri; Tjandra Manukbua
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.165.129-37

Abstract

This study’s objectives were to investigate factors affecting the adverse events of the COVID-19 vaccine in Indonesia among health care workers and compare adverse events following SARS-CoV-2 vaccine using CoronaVac as the first and second dose and Moderna used as the booster third dose. A cross-sectional study was conducted using the Self-reporting Online Survey Platform (Google Form) from August to October 2021. Subjects included in the study were ENT specialists and residents all over Indonesia who had been vaccinated with both doses of CoronaVac COVID-19 vaccine and Moderna COVID-19 vaccine as a booster dose. Among a total of 1394 participants, 51.2% and 43.7% of subjects experienced adverse events following the first and second dose of the CoronaVac vaccine. Adverse events are significantly higher following the third dose of Moderna vaccine (95.3%) with p-value <0.001, odds ratio (OR) 26.63 (95% CI 19.87-35.7). Adverse events following the CoronaVac vaccine were significantly higher in females and individuals with comorbidities in the first dose (p=0.002 and p=0.04), and the second dose (p=0.008 and p=0.042). Adverse events following the Moderna vaccine were significantly higher in females (p=0.01) and lower in individuals ≥40 years of age (p=0.017). Comorbidity status did not affect adverse events following the Moderna vaccine. Keywords: adverse events, SARS-CoV-2, COVID-19, vaccine, otorhinolaryngology.   Faktor yang Mempengaruhi Efek Samping Vaksin SARS-CoV-2 terhadap Dokter Spesialis dan Residen Telinga, Hidung, dan Tenggorok di Indonesia Abstrak Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi efek samping vaksin COVID-19 di Indonesia pada petugas kesehatan dan membandingkan efek samping setelah vaksin SARS-CoV-2 menggunakan CoronaVac sebagai dosis pertama dan kedua dan Moderna sebagai booster dosis ketiga. Studi potong lintang dilakukan dengan menggunakan self-reporting survei online (Google Form) dari Agustus-Oktober 2021. Subjek yang termasuk dalam penelitian adalah dokter residen dan spesialis THT di Indonesia yang telah divaksinasi dengan kedua dosis vaksin CoronaVac COVID-19 dan vaksin Moderna COVID-19 sebagai dosis tambahan. Dari total 1394 peserta, 51,2% dan 43,7% subjek mengalami efek samping setelah dosis pertama dan kedua vaksin CoronaVac. Efek samping secara signifikan lebih tinggi setelah dosis ketiga vaksin Moderna (95,3%) dengan p-value <0,001, rasio odds (OR) 26,63 (95% CI 19,87-35,7). Efek samping setelah vaksin CoronaVac secara signifikan lebih tinggi pada wanita dan individu dengan penyakit penyerta pada dosis pertama (p=0,002 dan p=0,04), dan dosis kedua (p=0,008 dan p=0,042). Efek samping setelah vaksin Moderna secara signifikan lebih tinggi pada wanita (p=0,01), dan lebih rendah pada individu ≥ 40 tahun (p=0,017). Status komorbiditas tidak mempengaruhi efek samping setelah vaksin Moderna. Kata kunci: efek samping, SARS-CoV-2, COVID-19, vaksin, otorinolaringologi.
Peran radioterapi lokoregional pada kasus karsinoma nasofaring dengan metastasis jauh: laporan serial kasus berbasis bukti Mayangsari, Ika Dewi; Rahman, Muhammad Ade; Adham, Marlinda; Prajogi, Gregorius Ben; Cahyanur, Rahmat; Safitri, Eka Dian
Oto Rhino Laryngologica Indonesiana Vol. 53 No. 2 (2023): VOLUME 53, NO. 2 JULY - DECEMBER 2023
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v53i2.638

Abstract

Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy
Disfagia pasca kemoradiasi pada karsinoma nasofaring Mayangsari, Ika Dewi; Rachmawati, Elvie Zulka Kautzia; Az Zahra, Amira
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 1 (2024): VOLUME 54, NO. 1 JANUARY - JUNE 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i1.679

Abstract

Background: Dysphagia is one of the early and long-term consequences of nasopharyngeal carcinomamanagement. Chemotherapy with radiation may improve the local control and survival rate but also canlead to serious dysphagia caused by radiation damage, and chronic alteration of tissues leading to fibrosisthat can happen during or soon after the radiation therapy. Dysphagia can result in dehydration andmalnutrition, place people at risk of aspiration, and reduce the quality of life by increasing anxiety anddepression. Purpose: Identifying causes, relevant factors, clinical presentation, and management of postchemoradiation dysphagia in nasopharyngeal cancer patients. Literature review: Structures demonstratingpost-therapy changes were deemed as dysphagia aspiration-related structures (DARS). Management ofnasopharyngeal carcinoma is radiotherapy with fibrosis found in 38.2% of the nasopharyngeal carcinomapatients on at least one side of the neck post-treatment. The presence of fibrosis in the pharyngeal andlaryngeal muscles impacted hyoid bone anterior movement and upper esophageal sphincter relaxationcontributed to dysphagia. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is utilised to detectdysphagia in these patients. The treatment algorithm for dysphagia after chemoradiation consists of historytaking, clinical evaluation, instrumental examination, and management. The management options may bebehavioral, medical, surgical, or combination. Conclusion: Identifying the cause, the components of thedeficit, and the relevant patient factors has prime importance in managing dysphagia besides consideringthe options and weighing the risks versus benefits.   Keywords: Dysphagia, chemoradiation, nasopharyngeal carcinoma, dysphagia aspiration-related structures, fiberoptic endoscopic evaluation of swallowing
Co-Authors Aminuyati Anggina Diksita Az Zahra, Amira Eka Savitri Haryuna, Tengku Siti Hajar Indra Zachreini Jenny Bashiruddin Juliandi Harahap L, Lisnawati Mangunkusumo, Endang Marlinda Adham Natasha Supartono Nyilo Purnami Pandelaki, Jacub Prajogi, Gregorius Ben Prameswari, Kharisma Priyono, Harim Rachmawati, Elvie Zulka Kautzia Rahman, Muhammad Ade Rahmat Cahyanur Respati Ranakusuma Retno Sulistyo Wardani Safitri, Eka Dian Sagung Rai Indrasari Susyana Tamin Tjandra Manukbua Wardani, Retno Sulistyo Yussy Afriana Dewi