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Diagnosis dan Tatalaksana Limfoma Non Hodgkin Tipe Sel B Sinonasal Tri Aryati Octavia; Dolly Irfandy; Bestari Jaka Budiman; Pamelia Mayorita
Majalah Kedokteran Andalas Vol 46, No 6 (2023): Online Oktober
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i6.p1103-1117.2023

Pendahuluan: Limfoma Non Hodgkin (LNH) sinonasal merupakan tumor ganas ekstranodal yang jarang terjadi. Lokasi paling sering adalah sinus maksilaris, sinus ethmoid dan rongga hidung. Diagnosis pasti imfoma ditegakkan berdasarkan hasil pemeriksaan histopatologi dan imunohistokimia. Tatalaksana kasus berdasarkan stadium dengan menggunakan stagging Ann Arbor. Laporan Kasus: Dilaporkan satu kasus LNH sinonasal pada laki–laki usia 56 tahun dengan keluhan hidung kanan tersumbat dan keluar darah dari hidung kanan. Pemeriksaan kavum nasal dekstra ditemukan adanya massa yang memenuhi kavum nasal disertai sekret mukopurulen. Kemudian dilakukan tindakan medial maksiektomi dengan pendekatan endoskopik dan didapatkan hasil histopatologi limfoma maligna tipe sel sedang serta imunohistokimia (IHK) dengan hasil limfoma maligna tipe sel B. Kesimpulan: Dilaporkan satu kasus LNH sinonasal pada laki–laki usia 56 tahun dengan keluhan hidung kanan tersumbat dan keluar darah dari hidung kanan. Pemeriksaan kavum nasal dekstra ditemukan adanya massa yang memenuhi kavum nasal disertai sekret mukopurulen. Kemudian dilakukan tindakan medial maksiektomi dengan pendekatan endoskopik dan didapatkan hasil histopatologi limfoma maligna tipe sel sedang serta imunohistokimia (IHK) dengan hasil limfoma maligna tipe sel B.Kata kunci: Limfoma Non Hodgkin sinonasal, Limfoma tipe Sel B, Kemoterapi.

Impacted "Button Battery" in The Nose - a Time Management Comparison Rizki Saputra; Dolly Irfandy; Bestari Jaka Budiman
Majalah Kedokteran Andalas Vol 46, No 2 (2023): Online April 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i2.p445-453.2023

Introduction: Foreign body in the nose can increase morbidity if not managed properly and correctly. Button battery containing alkaline substances can cause liquefactive necrosis. Management removes the button battery immediately. Case report: Two cases of a 4-year-old boy and a 5-year-old girl with a foreign body button battery were reported in the right and left nasal cavity, removed the button battery and debridement under general anesthesia. Conclusion: Button battery in the nasal cavity can cause various complications in the form of nasal perforation, this depends on the length of mucosal contact with the battery, the age of the battery and it must be removed immediately. Prevention plays an important role in preventing foreign bodies in the nose.

Endoscopic Sphenopalatine Artery Ligation in Recurrent Epistaxis with Hypertensio Aini Zhann; Dolly Irfandy; Bestari Jaka Budiman; Deka Viotra
Majalah Kedokteran Andalas Vol 46, No 4 (2023): Online Juli 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i4.p736-744.2023

AbstractBackground: Epistaxis is the most common case in ORL-HNS emergencies. One of the risk factors of recurrent epistaxis is hypertension. Epistaxis in hypertension usually originates from the posterior vessels. This requires more invasive procedures such as sphenopalatine artery ligation. Case Report: A 58-year-old woman with complaints of recurrent epistaxis from the right nose. The results of the blood pressure examination showed the results of 190/120 mmHg. The patient underwent sphenopalatine artery ligation to prevent recurrence. Conclusion: One of the factors for recurrent epistaxis is hypertension. Initial management of epistaxis with recurrent hypertension can be done in a conservative way followed by surgery and keeping blood pressure stable. Endoscopic sphenopalatine artery ligation is the definitive treatment according to the epistaxis management algorithm. Endoscopic sphenopalatine artery ligation provides satisfactory results and minimal complications.Keywords: Recurrent epistaxis, hypertension, sphenopalatine artery ligation

Perbedaan Ekspresi Transforming Growth Factor Beta 1 antara Rinosinusitis Kronis dengan Polip dan Tanpa Polip Rahmadona Rahmadona; Bestari Jaka Budiman; Effy Huriyati; Hirowati Ali; Hafni Bachtiar
Jurnal Otorinolaringologi Kepala dan Leher Indonesia Vol. 1 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jokli.v1i1.23

Latar belakang: Rinosinusitis kronis (RSK) merupakan inflamasi pada mukosa hidung dan sinus paranasal. Rinosinusitis kronis berdasarkan perbedaan ekspresi sitokin dan pola remodeling inflamasi dibedakan menjadi dua fenotipe, RSK dengan polip dan RSK tanpa polip. Transforming growth factor–?1 (TGF–?1) merupakan salah satu sitokin yang berperan pada remodeling jaringan. Tujuan: Mengetahui ekspresi gen TGF–?1 pada RSK dengan polip dan RSK tanpa polip. Metode: Penelitian analitik komparatif menggunakan desain potong lintang (cross sectional comparative study) pada 12 responden RSK dengan polip dan 12 responden RSK tanpa polip. Sampel diambil saat operasi Bedah Sinus Endoskopi Fungsional (BSEF) pada jaringan polip dan mukosa sinus etmoid atau maksila. Semua sampel dilakukan pemeriksaan ekspresi gen dengan metode Real Time Polymerase Chain Reaction (RT-PCR). Data dianalisis dengan SPSS, dikatakan bermakna jika p<0,05. Hasil: Ekspresi TGF-?1 pada RSK tanpa polip lebih tinggi (18,63±24,58) dibandingkan RSK dengan polip (2,82±4,02). Secara statistik perbedaan antara RSK polip dan RSK tanpa polip ini bermakna (p<0,05). Kesimpulan: Terdapat peningkatan ekspresi TGF-?1 pada RSK tanpa polip yang bermakna secara statistik dibandingkan dengan RSK dengan polip.

Caldwell-Luc approach for odontogenic maxillary sinusitis Irfandy, Dolly; Budiman, Bestari Jaka; Ivanny, Putri Sari
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 2 (2022): VOLUME 52, NO. 2 JULY - DECEMBER 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i2.500

ABSTRACTBackground: Maxillary odontogenic sinusitis is a maxillary sinusitis of dental origin. Odontogenic origin of infection must be suspected in those sinusitis patients who have symptoms of unilateral maxillary sinusitis, sinonasal symptoms such as nasal obstruction, rhinorrhea, and/or foul odour, a history of dental pain or dental/oral surgical treatment, and in those who are resistant to conventional treatment of sinusitis. Purpose: To report and analyze the result of Caldwell-Luc approach for odontogenic maxillary sinusitis. Case report: One case of odontogenic maxillary dextra sinusitis treated by Caldwell-Luc approach. After 2 months of follow-up, there was no thick and smelly discharge coming out of the nose, no complaints of pain in the nose, nor swelling and numbness of the cheeks and gums. Clinical question: “Does Caldwell-Luc approach provide good result for odontogenic maxillary sinusitis?” Review method: Literature searching was performed through Cochrane database, PubMed, ClinicalKey, and Google Scholar using keywords “Caldwell-Luc” and “odontogenic sinusitis.” Result: The search obtained 76 literatures which were related to clinical question. Afterwards filtered with eligible criteria, had resulted 21 relevant literatures. Conclusion: The choice of Caldwell-Luc approach for treating odontogenic maxillary sinusitis is a less invasive procedure and gave a satisfying result. Overlooking to identify a dental cause of maxillary sinusitis could lead to persistent symptoms, and failure of medical, as well as surgical intervention. ABSTRAKLatar belakang: Sinusitis maksilaris odontogenik adalah sinusitis maksilaris yang bersumber dari infeksi gigi. Sumber infeksi odontogenik harus dipikirkan ketika ditemukan gejala sinusitis maksila unilateral, gejala sinonasal seperti obstruksi hidung, rinorea dan bau busuk, riwayat infeksi gigi sebelumnya, trauma atau karena prosedur bedah pada tatalaksana gigi, dan pada pasien yang resisten terhadap pengobatan konvensional sinusitis. Tujuan: Melaporkan dan menganalisis hasil pendekatan Caldwell-Luc pada kasus sinusitis maksilaris odontogenik. Laporan Kasus: Satu kasus sinusitis maksilaris odontogenik dekstra yang ditatalaksana dengan pendekatan Caldwell-Luc. Setelah 2 bulan follow-up, tidak ada ingus kental dan berbau busuk yang keluar dari hidung, tidak ada keluhan nyeri di hidung, bengkak dan mati rasa pada pipi dan gusi. Pertanyaan klinis: “Apakah prosedur Caldwell-Luc memberikan hasil terbaik untuk kasus sinusitis maksilaris odontogenik?” Telaah literatur: Dilakukan pencarian melalui database Cochrane, PubMed, CinicalKey dan Google Scholar, menggunakan kata kunci “Caldwell-Luc” dan “sinusitis odontogenic”. Hasil: Diperoleh 76 literatur yang terkait dengan pertanyaan klinis. Setelah disaring dengan kriteria riset, terdapat 21 literatur yang relevan. Kesimpulan: Pemilihan tatalaksana sinusitis maksilaris odontogenik dengan pendekatan Caldwell-Luc merupakan prosedur invasif minimal, dan memberikan hasil yang memuaskan. Bila sumber infeksi dari gigi pada sinusitis maksilaris tidak terdeteksi, hal itu akan menyebabkan gejala persisten, dan kegagalan dalam tatalaksana medikamentosa maupun intervensi bedah.

Ko-Insiden Rhinosinusitis Kronis dengan Polip Hidung dan Neurofibroma Irfandy, Dolly; Budiman, Bestari Jaka; Ikhlas, Khairani Ayunanda; Mayorita, Pamelia
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.v53i2.611

Background: Nasal polyps are painless inflammatory lesions originated from around the middlemeatus or paranasal sinus cavity; while neurofibroma is benign peripheral nerve sheath tumor. Purpose:To report a rare case of neurofibroma concurrently with nasal polyps in chronic rhinosinusitis. Casereport: A 64-year-old female with chief complaint congestion on the right nose cavity. There was a mass on both nasal cavities. Patient diagnosed with benign mass at right nasal cavity and chronic rhinosinusitis with nasal polyps at left nasal cavity; with a differential diagnosis of chronic rhinosinusitis with bilateral nasal polyps. Computer tomography scan results showed homogeneous isodense lesion in the right nasal cavity, and mucosal thickening in left nasal cavity and maxillary sinus. Patient was managed with total extirpation of the bilateral nasal cavity mass and functional endoscopic sinus surgery. Pathological examination revealed neurofibroma in the right nasal cavity and polyps in the left nasal cavity. Clinical question: “How to differentiate inflammation with tumor of nasal and paranasal sinuses? Is there a causal relationship?” Review method: Literature searching was performed with the keywords “nasal cavity neurofibroma”, AND “nasal polyps”, AND ”chronic rhinosinusitis” through database Google Scholar, PubMed, and hand searching/e-book. Result: There were 11 literatures published in the last 5 years, and 7 articles relevant with the subject. Conclusion: Chronic rhinosinusitis with nasal polyps, along with neurofibroma on nasal cavity is a rare co-incidence, and there was no correlation between those lesions. Pathological examination is a gold standard in differentiating a definite diagnosis of neurofibromas and polyps.Keywords: nasal cavity neurofibroma, nasal polyps, chronic rhinosinusitis

OVERVIEW OF PATIENTS WITH CHRONIC RHINOSINUSITIS UNDERGOING SURGERY IN PADANG, WEST SUMATRA, 2018-2022 Irfandy, Dolly; Handayani, Tuti; Budiman, Bestari Jaka; Megananda, Cahaya
The Indonesian Journal of Public Health Vol. 19 No. 3 (2024): THE INDONESIAN JOURNAL OF PUBLIC HEALTH
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijph.v19i3.2024.466-478

Introduction: Chronic rhinosinusitis (CRS) remains a health problem that affects the quality of life of patients and often requires surgery. Approximately >60% of CRS patients undergo surgery. Aims: This study aims to identify an overview of patients with chronic rhinosinusitis undergoing surgery in Padang, West Sumatra, 2018-2022. Methods: This type of study is a descriptive observational study conducted by observing the medical records of CRS patients at the ENT-HNS Outpatient Department of RSUP Dr. M. Djamil Padang for the period January 2018 – December 2022 with a total sample of 138 patients. Samples were collected using a total sampling technique and then analyzed univariately. Results: The results of this study showed that CRS patients were found mostly (21.7% each) in the 41-50 years and 51-60 years age groups, more than half (52.2%) were male, and most (86.2%) lived in West Sumatra area. Most (89.9%) patients presented with nasal congestion and more than half (55.1%) had CRSwNP. Staphylococcus epidermidis was the most common microbe type (29.8%) found in patients. Most total Lund-Mackay scores (24.6%) were found in the 5-8 score range. Most (83.3%) patients visited postoperatively for ≤ 3 months with an average of 3.6 visits per patient. Conclusion: This study provides an overview of CRS patients who underwent surgery, which is crucial for determining the most appropriate management strategies to prevent the worsening of patient symptoms. Furthermore, this study may provide an overview of the duration of post-sinus surgery control.

Sakit Kepala pada Variasi Anatomi Hidung dan Sinus Paranasal Hakikah, Tika; Irfandy, Dolly; Budiman, Bestari Jaka
Jurnal Kesehatan Andalas Vol. 10 No. 3 (2021): Online November 2021
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v10i3.1919

The anatomical variations of the nasal and sinus paranasal can cause headaches. The most common variants have deviated septum, concha bullosa, and agger nasi cells. These variations can cause narrowing of the osteomeatal complex. Computed tomography was the primary modality for evaluating anatomical variations of the nasal and paranasal sinuses in diagnosis and management. Functional endoscopic sinus surgery was generally performed to restore the sinuses' drainage and ventilation in anatomical variations. It has been reported a 45-year-old woman with a congested left nostril and headache that has gotten worse since 2 months ago and computed tomography of the paranasal sinuses show thickening of the bilateral maxillary sinus mucosa, bilateral anterior ethmoid, left septum deviation, concha bullous, and right inferior turbinate hypertrophy. Functional Endoscopy Sinus Surgery was performed, found anatomical variations namely, deviation septum, concha bullosa, agger nasi cells and supra agger cells. The operation gave satisfactory results. Correct evaluation of anatomical variations based on history, physical examination and investigations can assist in patient management and avoid errors during surgery. The operation gave a satisfactory result for managing symptoms on patient with anatomical variation of nasal and paranasal sinuses when compared with medicamentosa.Keywords: anatomical variations,Â agger nasi cells , concha bullosa,Â deviated septum, headache, supra agger cell

Rinosinusitis Kronis dengan Polip Nasal Inflamatori Bilateral serta Elongated Unsinatus Budiman, Bestari Jaka; Irfandy, Dolly; Qurniawan, Mohd Redza
Jurnal Kesehatan Andalas Vol. 12 No. 1 (2023): Online March 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v12i1.2162

Chronic rhinosinusitis (CRS) is defined as chronic inflammation of the nose and paranasal sinuses with two or more symptoms, one of which can be nasal congestion/obstruction/congestion or rhinorrhea (anterior/postnasal drip), and/or with facial pain, reduced or loss of smell. Elongated uncinate is one of the anatomical variants of the uncinate process where the uncinate process is curved or bent, which causes sinus problems and is one of the risk factors for CRS. It has been reported a 19-year-old man with the diagnosis of chronic rhinosinusitis with third-grade bilateral nasal polyp from computed tomography of the paranasal sinusitis. There was an impression of the sinonasal polyp with inverted papilloma as a differential diagnosis. The patient was treated through microdebrider-assisted functional endoscopic sinus surgery. This was chronic rhinosinusitis with grade III bilateral nasal polyps, and microdebrider-assisted fungsional endoscopic sinus surgery was performed with great results.Keywords: chronic rhinosinusitis, elongated unsinatus, Â functional endoscopic sinus surgery, nasal polyp

Endoscopic Sphenopalatine Artery Ligation in Recurrent Epistaxis with Hypertensio Zhann, Aini; Irfandy, Dolly; Budiman, Bestari Jaka; Viotra, Deka
Majalah Kedokteran Andalas Vol. 46 No. 3 (2023): Online Juli 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i4.p736-744.2023

AbstractBackground: Epistaxis is the most common case in ORL-HNS emergencies. One of the risk factors of recurrent epistaxis is hypertension. Epistaxis in hypertension usually originates from the posterior vessels. This requires more invasive procedures such as sphenopalatine artery ligation. Case Report: A 58-year-old woman with complaints of recurrent epistaxis from the right nose. The results of the blood pressure examination showed the results of 190/120 mmHg. The patient underwent sphenopalatine artery ligation to prevent recurrence. Conclusion: One of the factors for recurrent epistaxis is hypertension. Initial management of epistaxis with recurrent hypertension can be done in a conservative way followed by surgery and keeping blood pressure stable. Endoscopic sphenopalatine artery ligation is the definitive treatment according to the epistaxis management algorithm. Endoscopic sphenopalatine artery ligation provides satisfactory results and minimal complications.Keywords: Recurrent epistaxis, hypertension, sphenopalatine artery ligation

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