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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

Maternal Hyperthyroidism and Delayed Diagnosis of Bilateral Choanal Atresia in a 4-Month-Old Infant: A Case Report on Stentless Endoscopic Reconstruction Meilia Ghinasari; Bestari Jaka Budiman; Dolly Irfandy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1543

Background: Bilateral choanal atresia (BCA) is a life-threatening congenital anomaly typically presenting as a neonatal respiratory emergency. Survival beyond the neonatal period without surgical intervention is exceptionally rare. While the etiology is multifactorial, emerging evidence implicates maternal thyroid dysregulation in craniofacial malformations. This study reports a rare case of BCA diagnosed in a 4-month-old infant and evaluates the efficacy of stentless endoscopic repair using laterally-based mucoperiosteal flaps. Case presentation: A 4-month-old female infant presented with failure to thrive (weight 5.2 kg, less than the 3rd percentile) and cyclical respiratory distress. Perinatal history revealed the mother had Graves' disease and discontinued methimazole at 6 weeks gestation. Retrospective analysis of maternal serum indicated uncontrolled thyrotoxicosis during the critical organogenesis window (TSH less than 0.01 mIU/L; fT4 2.8 ng/dL at 7 weeks). Diagnostic imaging confirmed mixed bony-membranous atresia. The patient underwent transnasal endoscopic choanoplasty using a laterally-based mucosal preservation technique. A 10-Fr silicone feeding tube was placed transnasally but did not function as a structural stent. Conclusion: The intervention resulted in immediate airway patency. Quantitative outcomes showed an increase in oxygen saturation from 96% to 99% on room air and significant weight gain from 5.2 kg to 6.7 kg over two months. Follow-up at six months showed no restenosis. This case suggests a potential dual-hit teratogenic mechanism involving early methimazole exposure and subsequent uncontrolled maternal hyperthyroidism. Furthermore, it supports the efficacy of stentless repair in minimizing granulation tissue formation.

Maternal Hyperthyroidism and Delayed Diagnosis of Bilateral Choanal Atresia in a 4-Month-Old Infant: A Case Report on Stentless Endoscopic Reconstruction Meilia Ghinasari; Bestari Jaka Budiman; Dolly Irfandy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1543

Background: Bilateral choanal atresia (BCA) is a life-threatening congenital anomaly typically presenting as a neonatal respiratory emergency. Survival beyond the neonatal period without surgical intervention is exceptionally rare. While the etiology is multifactorial, emerging evidence implicates maternal thyroid dysregulation in craniofacial malformations. This study reports a rare case of BCA diagnosed in a 4-month-old infant and evaluates the efficacy of stentless endoscopic repair using laterally-based mucoperiosteal flaps. Case presentation: A 4-month-old female infant presented with failure to thrive (weight 5.2 kg, less than the 3rd percentile) and cyclical respiratory distress. Perinatal history revealed the mother had Graves' disease and discontinued methimazole at 6 weeks gestation. Retrospective analysis of maternal serum indicated uncontrolled thyrotoxicosis during the critical organogenesis window (TSH less than 0.01 mIU/L; fT4 2.8 ng/dL at 7 weeks). Diagnostic imaging confirmed mixed bony-membranous atresia. The patient underwent transnasal endoscopic choanoplasty using a laterally-based mucosal preservation technique. A 10-Fr silicone feeding tube was placed transnasally but did not function as a structural stent. Conclusion: The intervention resulted in immediate airway patency. Quantitative outcomes showed an increase in oxygen saturation from 96% to 99% on room air and significant weight gain from 5.2 kg to 6.7 kg over two months. Follow-up at six months showed no restenosis. This case suggests a potential dual-hit teratogenic mechanism involving early methimazole exposure and subsequent uncontrolled maternal hyperthyroidism. Furthermore, it supports the efficacy of stentless repair in minimizing granulation tissue formation.

Perbedaan Ekspresi Transforming Growth Factor Beta 1 antara Rinosinusitis Kronis dengan Polip dan Tanpa Polip Rahmadona, Rahmadona; Budiman, Bestari Jaka; Huriyati , Effy; Ali, Hirowati; Bachtiar, Hafni
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.

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