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Hubungan derajat adenoid menggunakan teknik nasoendoskopi dengan tekanan telingah tengah Rosmini, Rosmini; Suheryanto, Rus; Surjotomo, Hendradi
Oto Rhino Laryngologica Indonesiana Vol 46, No 2 (2016): Volume 46, No. 2 July - December 2016
Publisher : PERHATI-KL

Latar belakang: Hipertrofi adenoid sering dilaporkan sebagai salah satu faktor penyebab terjadinya disfungsi tuba. Hubungan anatomi antara nasofaring dan adenoid memiliki implikasi terhadap tuba Eustachius yang terletak di sebelah lateral. Akhir-akhir ini telah digunakan secara luas alat diagnostik endoskopi, salah satu di antaranya adalah pemeriksaan nasoendoskopi, yang dapat memberikan visualisasi 3 dimensi secara jelas, sehingga dapat menentukan derajat adenoid terhadap struktur anatomi sekitarnya. Sebagian besar penyakit telinga tengah didahului oleh gangguan fungsi tuba Eustachius. Fungsi ventilasi merupakan fungsi tuba Eustachius yang paling penting, bertujuan untuk mempertahankan keseimbangan antara tekanan gas dalam telinga tengah dan udara di luar membran timpani. Salah satu cara untuk mengukur tekanan telinga tengah secara tak langsung, yaitu dengan timpanometri yang dapat menilai fungsi ventilasi tuba Eustachius. Tujuan: Mengetahui hubungan derajat adenoid menggunakan nasoendoskopi dengan tekanan telinga tengah. Metode: Penelitian observasional analitik dengan desain cross sectional, melibatkan 24 sampel yang diduga menderita hipertrofi adenoid, yang dilakukan nasoendoskopi, dan tekanan telinga tengah diukur dengan timpanometri. Data penelitian dianalisis dengan uji korelasi Spearman. Hasil: Terdapat korelasi yang cukup kuat dan signifikan antara derajat adenoid dengan tekanan telinga tengah dan tipe timpanogram (p=0,027 dan p=0,002). Kesimpulan: Semakin tinggi derajat adenoid maka tekanan telinga tengah semakin turun. Dibutuhkan penelitian lebih lanjut untuk melihat hubungan antara derajat adenoid menggunakan nasoendoskopi dengan gejala klinis dari hipertrofi adenoid.Kata kunci: Derajat adenoid, nasoendoskopi, tekanan telinga tengah ABSTRACT Background: Adenoid hypertrophy has been widely reported as one of the causes of tubal dysfunction. Anatomical relationship between the nasopharynx and adenoid has implications for the Eustachian tube which is located at the lateral wall of the nasopharynx. Recently, endoscopic diagnostic tool has been commonly used, because it provides a clear 3-dimensional visualization, to determine the degree of adenoid hypertrophy with its’ surrounding anatomical structures. Most of the middle ear disease is preceeded by Eustachian tube dysfunction. Ventilation is the most important function of the Eustachian tube which aims to maintain the balance of the gas pressure in the middle ear and the air outside the tympanic membrane. Tympanometry is one of the tools for measuring the pressure of the middle ear which indirectly assesses the function of the Eustachian tube ventilation. Purpose: To determine the relationship between the degree of adenoid using nasoendoscopy with middle ear pressure. Method: The study was observational analytic with cross sectional design. This study involved 24 patients with adenoid hypertrophy underwent nasoendoscopic examination and tympanometry for assessing middle ear pressure. Data were analyzed using Spearman test. Result: There was a fairly strong and significant correlation between adenoid hypertrophy with middle ear pressure and tympanogram type (p=0.027 and p=0.002). Conclusion: The higher the degree of adenoid hypertrophy, the lower the middle ear pressure. Further research is needed to see the relationship of the degree of adenoid with nasoendoscopy with clinical symptoms of adenoid hypertrophy.Keywords: Degree of adenoid, nasoendoscopy, middle ear pressure

Airborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang Maharani, Iriana; Suheryanto, Rus; Retnoningsih, Endang
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.146 KB)

Background: Chronic rhinosinusitis has a significant impact on the quality of life and health of adult population. Role of airborne fungi remains a controversy and have become the source of discussion for decades. Objective to know the prevalence of airborne fungi in the chronic rhinosinusitis with or without polyps patients and to know the possible effect of airborne fungi on chronic rhinosinusitis inflammation. Methods: This is a cross sectional research in the Saiful Anwar Public Hospital Malang, there were 29 patients involved. We examine fungi culture, H&E staining and DNA fungi by using PCR from sinus lavage sample. From the blood serum we examine allergen specific IgE, IgG3, IL-13 and IL-5. Results: Fungi culture there were 31,03 % of sample growth but only matches the PCR result in 3 samples (10,34 %). From PCR examinations we found all sample were positive with 2-5 species fungi, Alternaria alternata was found positive in 24,13% samples. There was an increment of IgE allergen specific and IL-5, a decrement of IL-13 and IgG3 in all of our samples regardless presence of nasal polyps and species of fungi found in PCR. Conclusions: PCR is a more reliable method compare to fungal culture. The presence of fungi in all of our samples could indicate fungi contribution to the disease pathophysiology. The increased level of Il-5 was not followed by IL-13; it may happen through PRR pathway.

Pengaruh mometasone furoate terhadap kadar Interleukin 6 serum padapenderita hipertrofi adenoid Suheryanto, Rus; Harahap, Surya Parlaungan; Maharani, Iriana
Oto Rhino Laryngologica Indonesiana Vol 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Latar belakang:Â Inflamasi adenoid ditandai dengan ditemukannya pembesaran ukuran adenoid atau hipertrofi adenoid. Telah banyak dilakukan penelitian yang mendukung IL-6 merupakan dasar patofisiologi terjadinya hipertrofi adenoid sehingga dibutuhkan terapi yang dapat mengurangi peran IL-6. Saat ini, kortikosteroid intranasal menjadi pilihan terapi pada hipertrofi adenoid karena memiliki efek anti inflamasi. Terdapat penelitian mengenai manfaat penggunaan kortikosteroid intranasal terhadap penderita hipertrofi adenoid, dimana terjadi penurunan kadar IL-6, tetapi pengaruhnya terhadap kadar IL-6 serum tidak diteliti.Â Tujuan:Â Mengetahui pengaruh pemberianÂ mometasone furoateÂ semprot hidung terhadap kadar IL-6 serum pada penderita hipertrofi adenoid.Â Metode:Â One group pre and post testÂ design ini melibatkan 16 subjek. Dilakukan pemeriksaan foto polosÂ skull lateral soft tissueÂ dan pengambilan darah tepi untuk menghitung kadar IL-6 serum. Diberikan terapiÂ mometasone furoatesemprot hidung selama 6 minggu. Setelah 2 minggu dan 6 minggu dilakukan pengambilan darah tepi untuk menghitung kadar IL-6 serum, serta evaluasi foto polosÂ skull lateral soft tissueÂ setelah 6 minggu.Â Hasil:Terdapat perbedaan bermakna antara kadar IL-6 serum sebelum dan sesudah perlakuan baik, pada minggu kedua maupun minggu keenam (p=0.00). Terdapat perbedaan bermakna antara nilai foto polosÂ skull lateral soft tissueÂ sebelum dan sesudah perlakuan (p=0.00). Berdasarkan ujiÂ Pearson, nilai kadar IL-6 serum darah berkorelasi secara signifikan yang bersifat negatif (p<0,05) dengan foto polosÂ skull lateralÂ sebelum dan sesudah perlakuan dengan hasil -0,819 dan -0,692.Â Kesimpulan:Â Mometasone furoatesemprot hidung dapat menurunkan kadar IL-6 serum pada penderita hipertrofi adenoid secara bermakna, disertai dengan mengecilnya ukuran adenoid, penurunan gejala dan keluhan penderita hipertrofi adenoid.Â Kata kunci:Â Hipertrofi adenoid, Interleukin 6,Â Mometasone FuroateABSTRACTÂ Background:Adenoid inflammation is characterized by adenoid hypertrophy (AH). Numerous studies had stated that Interleukin 6 (IL-6) is the pathophysiological basis for the occurrence of AH, thus, a therapy is needed to reduce the role of IL-6. Intranasal corticosteroid (IC) is the drug-of-choice for AH for its anti-inflammatory nature. Previous research had shown a decrease in IL-6 levels in adenoid tissue after IC administration, but its effect on IL-6 serum level had not yet been studied.Â Purpose:Â To find out the effect of Mometasone Furoate (MF) on IL-6 serum level in AH patients.Â Methods:Â One group pre and post test design, involving 16 subjects, underwent a soft tissue skull lateral plain x-ray, also a peripheral blood examination for IL-6 serum level. Afterwards, subjects were treated with MF nasal spray for 6 weeks. The IL-6 serum level was evaluated after 2 and 6 weeks, and the soft tissue x- ray was assessed after 6 weeks.Â Results:Â There were significant differences between IL-6 serum levels before and after treatment both in the second and sixth week (p = 0.00). There were significant differences between the value of soft tissue skull lateral plain x-ray before and after treatment (p = 0.00). Based on the Pearson test, IL-6 serum levels correlated significantly negatively (p <0.05) with soft tissue skull lateral plain x-ray before and after treatment with results -0.819 and -0.692.Â Conclusion:Â MF nasal spray significantly reduce IL-6 serum levels in AH patients, reducing adenoid size and decreasing symptoms of AH patients.Â Â

Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis Bobby Pardomuan Sitompul; Rus Suheryanto; Hendradi Surjotomo
Oto Rhino Laryngologica Indonesiana Vol 51, No 1 (2021): Volume 51, No. 1 January - June 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i1.409

Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration compared to fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was an experimental research with double blind randomized clinical trial (RCT) design, and pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg in the morning and oral cetirizine 10 mg in the evening, and group-2 received intranasal fluticasone furoate 110 μg and montelukast 10mg. The treatment efficacy was assessed from nasal eosinophil count and total five symptoms score (T5SS) based on visual analogue scale (VAS) before and 4 weeks after treatment. Result: Both groups showed a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). Group-2 showed a statistically significant improvement in nasal obstruction and rhinorrhea compared to group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS was higher in group-2 than group-1, however it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast was found to be more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizineABSTRAK Latar belakang: Rinitis alergi masih merupakan masalah besar secara global dengan tatalaksana yang kompleks. Terapi medikamentosa rinitis alergi persisten sedang berat (RAPSB) berdasarkan guideline yaitu pemberian kortikosteroid intranasal (INCS) dikombinasikan dengan antihistamin oral atau leukotriene receptor antagonist (LTRA). Saat ini, terapi menggunakan kombinasi LTRA masih berdasarkan ada atau tidaknya komorbiditas asma pada pasien RAPSB. Tujuan: Mengetahui pengaruh pemberian fluticasone furoate bersama cetirizine dibandingkan dengan fluticasone furoate bersama montelukast terhadap eosinofil mukosa hidung dan perbaikan klinis pada penderita RAPSB. Metode: Penelitian eksperimental murni dengan rancangan uji klinik secara acak, tersamar ganda, serta kontrol pra dan pasca perlakuan. Penderita dibagi menjadi 2 kelompok. Kelompok 1 mendapat terapi fluticasone furoate intranasal 110 μg/hari dengan cetirizine 10mg/hari dan kelompok 2 fluticasone furoate intranasal 110 μg/hari dengan montelukast 10mg/hari. Penilaian efektivitas terapi dengan menilai jumlah eosinofil mukosa hidung dan total five symptoms score (T5SS) berdasarkan visual analogue scale (VAS) pada awal penelitian dan 4 minggu setelah perlakuan. Hasil: Kedua kelompok memperlihatkan penurunan jumlah eosinofil mukosa hidung dan penurunan T5SS berdasarkan VAS antara sebelum dan setelah perlakuan (p< 0.05). Kelompok 2 lebih baik secara bermakna menurunkan keluhan hidung tersumbat dan pilek encer dibandingkan kelompok 1 (p <0.05). Jumlah eosinofil dan T5SS berdasarkan VAS kelompok 2 lebih menurun dibandingkan kelompok 1, akan tetapi secara statistik tidak terdapat perbedaan yang bermakna. Kesimpulan: Pemberian fluticasone furoate serta montelukast lebih baik secara bermakna menurunkan keluhan hidung tersumbat dan pilek encer dibandingkan pemberian fluticasone furoate serta cetirizine. Kata kunci: rinitis alergi, cetirizine, kortikosteroid intranasal, montelukast

Pengaruh vitamin D3 terhadap kadar vitamin D (25(OH)D) dan sel T Regulator pada rinitis alergi Rizki Ekaputra Handoko; Rus Suheryanto; Muhammad Dwijo Murdiyo
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah peradangan atau inflamasi pada mukosa atau selaput lendir hidung yang didasari oleh reaksi hipersensitivitas tipe 1 dan diperantarai IgE. Rinitis alergi merupakan tipe rinitis kronis yang sering dijumpai. Sebanyak 30-50% penderita rinitis memiliki pemicu alergi dan prevalensinya cenderung meningkat. Vitamin D mempunyai peran memodulasi respon imun alamiah dan adaptif. Banyaknya pengaruh vitamin D dalam sistem imun diharapkan dapat mengatur aktivitas berbagai sel kekebalan, serta fungsi kekebalan tubuh dari epitel sel pada RA, namun konsensus sebagai bagian terapi RA saat ini masih belum ada. Tujuan: Mengetahui pengaruh pemberian vitamin D3 terhadap kadar vitamin D (25(OH)D) dan sel T Regulator (T reg) pada rinitis alergi. Metode: Penelitian eksperimental murni dengan rancangan penelitian randomized clinical trial (RCT) double blind, pre and post test control group dengan perlakuan berupa pemberian terapi sesuai ARIA (Allergic Rhinitis and its Impact on Asthma) dan vitamin D3 oral diberikan selama 4 minggu. Dilakukan penilaian VAS (Visual Analogue Scale), TNSS (Total Nasal Symptom Score), serta kadar vitamin D darah dan persentase sel T reg pada awal dan 4 minggu setelah perlakuan. Hasil: Pada kelompok perlakuan terdapat perbedaan bermakna kadar vitamin D sebelum dan sesudah perlakuan (p=0,01). Terdapat perbedaan yang bermakna dari peningkatan persentase sel T reg pada kelompok perlakuan dibandingkan kelompok kontrol (p=0,02). Terdapat hubungan antara peningkatan persentase sel T reg dengan kadar vitamin D pada kelompok perlakuan (p=0,01). Kesimpulan: Vitamin D3 dapat meningkatkan kadar vitamin D dan persentase sel T reg secara bermakna pada pasien rinitis alergi persisten sedang berat. Kata kunci: Rinitis alergi, vitamin D, sel T regulator ABSTRACT Background: Allergic rhinitis (AR) is an inflammatory disease of nasal mucosa based on type 1 hypersensitivity reaction and mediated by IgE. Allergic rhinitis is the most common type of chronic rhinitis. About 30±50% of patients with allergic rhinitis have trigger factors and its prevalence is increasing. Vitamin D has a function in modulation of innate and adaptive responses. The role of vitamin D in immune system is expected to regulate various immune cells activity, and the immune function of AR epithelial cells, but there were no consensus yet about vitamin D as part of AR therapy. Objective: To identify the effect of vitamin D3 on level of vitamin D (25(OH)D) and T regulator (T reg) cells in allergic rhinitis patients. Methods: This study was purely experimental research with randomized clinical trial, double-blind, pre and post test control group treated with appropriate therapy according to ARIA (Allergic Rhinitis and its Impact on Asthma) and vitamin D3 given orally for 4 weeks. Evaluations of VAS (Visual Analogue Scale) and TNSS (Total Nasal Symptom Score) value, vitamin D levels and the percentage of T reg cells were carried out at baseline and 4 weeks after treatment. Results: In the treatment group there was a significant difference between vitamin D levels before and after treatment (p=0.01). There was a significant difference on increased percentage of T reg cells in the treatment group compared with the control group (p=0.02). There was a correlation between the increasing percentage of T reg cells with vitamin D levels in the treatment group (p=0.01). Conclusion: Vitamin D supplementation could increase the level of vitamin D and the percentage of T reg cells significantly in patients with severe persistent allergic rhinitis. Keywords: Allergic rhinitis, vitamin D, T regulatory cell

Peran β-glucan dalam diagnosis rinosinusitis kronik jamur Dhaniel Abdi Wicaksana; Rus Suheryanto; Iriana Maharani
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Latar Belakang: Rinosinusitis kronik jamur merupakan permasalahan kesehatan terutama dinegara berkembang karena prevalensinya yang semakin meningkat, sulitnya penanganan medis, sertaberdampak besar terhadap penurunan kualitas hidup. Saat ini tengah dikembangkan teknologi untukmembantu penegakan diagnosis tanpa tindakan invasif, yaitu dengan memanfaatkan β-glucan sebagaikomponen terbesar penyusun dinding sel beberapa spesies jamur. Tujuan: Mengetahui hubungan antarakadar β-glucan jaringan sinus dan serum darah untuk diagnosis rinosinusitis kronik jamur. Metode:Penelitian cross sectional ini melibatkan 20 subjek penelitian. Dilakukan pengambilan sampel darah, danpembedahan sinus maksila untuk mengambil jaringan mukosa, yang kemudian dilanjutkan pemeriksaanpolymerase chain reaction (PCR) untuk identifikasi jamur pada mukosa sinus. Bila didapatkan spesiesjamur yang memiliki β-glucan, dilakukan pemeriksaan enzyme-linked immunosorbent assay (ELISA) untukpengukuran kadar β-glucan. Hasil: Aspergillus flavus merupakan jamur yang paling banyak ditemukan.Seluruh subjek melampaui batasan positif β-glucan (≥80 pg/mL) dari spesimen mukosa, dan hanya 1subjek memberikan hasil intermediate (60-79 pg/mL) dari darah. Uji t berpasangan mendapatkan kadarβ-glucan darah tidak berbeda bermakna dengan mukosa sinus (p=0,886), sehingga pemeriksaan β-glucanpada darah dapat menggambarkan kadar β-glucan pada sinus paranasal. Kesimpulan: β-glucan dapatdimanfaatkan untuk membantu memperoleh diagnosis rinosinusitis kronik jamur, sehingga diharapkandiagnosis dapat ditegakkan dengan cepat dan tepat tanpa memerlukan tindakan invasif, namun hasil inimembutuhkan penelitian lebih lanjut, khususnya terkait uji diagnostik. ABSTRACTBackground: Chronic fungal rhinosinusitis is a major health problem particularly in developingcountries due to its increasing prevalence, difficult medical treatment, and also could make a large impacton the quality of life. The current technology to establish diagnosis without invasive procedure is byutilizing β-glucan, the largest component of fungal cell wall in some fungal species. Purpose: To discoverthe correlation of β-glucan level in paranasal sinus tissue and blood serum as a potential diagnosismarker for chronic fungal rhinosinusitis. Methods: A cross sectional study involving 20 subjects. Bloodsampling and maxillary sinus surgery were performed, then fungi identification in the sinus mucosawas done by Polymerase Chain Reaction (PCR). If a fungal species with β-glucan was found, then theexamination was continued with the measurement of β-glucan by Enzyme-Linked Immuno Sorbent Assay(ELISA) technique in sinus and blood. Results: Aspergillus flavus is the most commonly found fungus. Allsubjects passed the positive β-glucan limit (≥80 pg/mL) of the mucosal sample, and only 1 subject hadintermediate results (60-79 pg/mL) from the blood. Paired t-test result showed no significant differencebetween the level of β-glucan in blood and mucosal sinus (p=0.886), so that β-glucan blood examinationcould illustrate β-glucan levels in paranasal sinuses. Conclusion: β-glucan may be used to establishthe diagnosis of fungal chronic rhinosinusitis with one hope that the diagnosis process can be obtainedquickly and accurately without invasive procedure, although it still requires more studies, particularlyrelated to diagnostic test.

Pengaruh pemberian vitamin E terhadap eosinofil mukosa hidung dan kualitas hidup penderita rinitis alergi Nanchy Christy; Rus Suheryanto; Mohammad Dwijo Murdiyo
Oto Rhino Laryngologica Indonesiana Vol 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Latar belakang: Penyakit rinitis alergi (RA) banyak dijumpai dan memberi dampak negatif terhadap produktivitas, kualitas hidup, gangguan tidur, aktivitas di luar rumah, serta gangguan sekolah pada anak. Vitamin E bekerja sebagai antioksidan pada membran sel dan berikatan dengan radikal bebas dengan cara menghambat peroksidasi Poly Unsaturated Fatty Acid (PUFA). Tujuan: Mengetahui pengaruh vitamin E terhadap jumlah eosinofil mukosa hidung dan perbaikan klinis pada penderita rinitis alergi persisten sedang berat. Metode: Menggunakan Randomized Clinical Trial, double blind, pre and post control group dengan perlakuan pemberian terapi semprot hidung triamcinolone acetonide, cetirizine 10 mg, dan vitamin E 400IU selama 4 minggu. Dilakukan penilaian Visual Analogue Scale (VAS) dan Total Nasal Symptom Score (TNSS), serta pemeriksaan eosinofil mukosa hidung pada awal dan 4 minggu setelah perlakuan. Hasil: Didapatkan perbedaan bermakna antara jumlah eosinofil mukosa hidung sebelum dan sesudah pemberian vitamin E pada kelompok perlakuan (p=<0,001). Penurunan jumlah eosinofil mukosa hidung lebih besar dan bermakna pada kelompok perlakuan dibandingkan dengan kelompok kontrol (p=<0,001). Didapat perbaikan kualitas hidup berdasarkan perbaikan nilai VAS dan TNSS yang bermakna setelah perlakuan pada kelompok kontrol maupun perlakuan (p=<0,001), serta didapatkan perbaikan kualitas hidup berdasarkan nilai VAS dan TNSS pada kedua kelompok dengan selisih nilai perbaikan gejala yang lebih besar pada kelompok perlakuan, namun dari perhitungan statistik tidak didapatkan perbedaan yang bermakna. Kesimpulan: Vitamin E 400IU menurunkan jumlah eosinofil mukosa hidung secara bermakna pada pasien rinitis alergi persisten sedang berat. Perbaikan nilai TNSS pada penggunaan vitamin E 400IU lebih baik dibandingkan subjek yang mendapat plasebo, walaupun tidak berbeda secara bermakna.Kata kunci: rinitis alergi, Vitamin E, Total Nasal Symptom Score ABSTRACT Background: Allergic rhinitis (AR) is an allergic disease frequently found and has a negative impact on productivity, quality of life, sleep disorder, outdoors activities, and school disruption in children. Vitamin E works as an antioxidant in cell membranes through binding free radicals by inhibiting peroxidation of Poly Unsaturated Fatty Acids (PUFA). Purpose: To find out the effect of vitamin E administration on nasal mucosa eosinophil counts and the clinical improvement in patients with moderate severe persistent AR. Methods: A double blind randomized clinical trial, pre and post control group, given therapy of triamcinolone acetonide nasal spray, cetirizine 10 mg, and vitamin E 400 IU orally for 4 weeks. Evaluation by Visual Analogue Scale (VAS) and Total Nasal Symptom Score (TNSS), as well as nasal mucosal eosinophils count at baseline and 4 weeks after treatment. Results: There was a significant difference on the number of nasal mucosal eosinophils before and after vitamin E administration in the treatment group (p = <0.001). A greater and more significant decrease in the number of nasal mucosal eosinophils in the treatment group compared to control group (p = <0.001). Significant improvement of VAS and TNSS after treatment in the control and treatment groups (p = <0.001) and quality of life improvement based on VAS and TNSS values in both control and treatment groups, but the statistical calculations showed no significant differences between the two groups. Conclusion: Vitamin E 400IU significantly reduce the number of nasal mucosal eosinophils in patients with moderate severe persistent AR.

Mometasone furoate effect on interleukin-6 of adenoid surface and serum in adenoid hypertrophy patients Zainul Mujahid; Rus Suheryanto; Iriana Maharani
Oto Rhino Laryngologica Indonesiana Vol 51, No 1 (2021): Volume 51, No. 1 January - June 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i1.362

Background: Adenoid hypertrophy is one of the most common problems in children resulting in obstruction of the posterior nasal cavity. Interleukin-6 (IL-6) is a pleiotropic cytokine that plays a role in acute and chronic infections, hematopoesis, T cells and B cells formation. Purpose: To determine the effect of intranasal mometasone furoate administration on IL-6 level of adenoid surface and serum and the adenoid size in patients with adenoid hypertrophy. Method: A one group pre- and post-test design involving 17 patients aged 5 to 12 years. The subjects underwent nasoendoscopic examination to determine the adenoid size, also measurement of IL-6 level of adenoid surface and serum before and after 6 weeks treatment with intranasal mometasone furoate. Results: There were a significant decrease of the adenoid surface IL-6 level, serum IL-6 level, and adenoid size with p value <0.05. There was a significant positive correlation between the levels of adenoid surface IL-6 and serum IL-6 (r=0.517; p=0.033). A significant positive correlation was obtained between the decrease of adenoid surface and serum IL-6 levels with the decrease of adenoid size (p<0.05). Conclusion: The use of intranasal mometasone furoate could decrease the IL-6 levels of adenoid surface and serum, and the adenoid size in patients with adenoid hypertrophy.ABSTRAK Latar belakang: Hipertrofi adenoid merupakan salah satu masalah tersering pada anak-anak yang mengakibatkan obstruksi pada rongga hidung posterior. Interleukin-6 merupakan sitokin pleiotropik yang berperan pada infeksi akut maupun kronis, hematopoesis, pembentukan sel T dan sel B. Tujuan: Mengetahui pengaruh pemberian mometason furoat intranasal terhadap kadar IL-6 permukaan adenoid dan serum, serta ukuran adenoid pada penderita hipertrofi adenoid. Metode: Suatu one group pre- and post-test design melibatkan 17 subjek berusia 5 sampai 12 tahun. Subjek menjalani pemeriksaan nasoendoskopi, pengukuran kadar IL-6 serum, dan IL-6 permukaan adenoid sebelum dan setelah pemakaian mometason furoat intranasal selama 6 minggu. Hasil: Didapatkan penurunan kadar IL-6 permukaan adenoid, IL-6 serum, dan penurunan ukuran adenoid yang bermakna dengan nilai p<0,05. Didapatkan korelasi positif yang signifikan antara kadar IL-6 permukaan adenoid dengan IL-6 serum (r=0,517; p=0,033). Didapatkan korelasi positif yang signifikan antara penurunan kadar IL-6 permukaan adenoid dan IL-6 serum dengan pengecilan ukuran adenoid (p<0,05). Kesimpulan: Penggunaan mometason furoat intranasal dapat menurunkan kadar IL-6 permukaan adenoid dan IL-6 serum, serta ukuran adenoid pada penderita hipertrofi adenoid. Kata kunci: hipertrofi adenoid, interleukin-6, mometason furoat intranasal

Pengaruh mometasone furoate terhadap kadar Interleukin 6 serum padapenderita hipertrofi adenoid Rus Suheryanto; Surya Parlaungan Harahap; Iriana Maharani
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.314

Latar belakang: Inflamasi adenoid ditandai dengan ditemukannya pembesaran ukuran adenoid atau hipertrofi adenoid. Telah banyak dilakukan penelitian yang mendukung IL-6 merupakan dasar patofisiologi terjadinya hipertrofi adenoid sehingga dibutuhkan terapi yang dapat mengurangi peran IL-6. Saat ini, kortikosteroid intranasal menjadi pilihan terapi pada hipertrofi adenoid karena memiliki efek anti inflamasi. Terdapat penelitian mengenai manfaat penggunaan kortikosteroid intranasal terhadap penderita hipertrofi adenoid, dimana terjadi penurunan kadar IL-6, tetapi pengaruhnya terhadap kadar IL-6 serum tidak diteliti. Tujuan: Mengetahui pengaruh pemberian mometasone furoate semprot hidung terhadap kadar IL-6 serum pada penderita hipertrofi adenoid. Metode: One group pre and post test design ini melibatkan 16 subjek. Dilakukan pemeriksaan foto polos skull lateral soft tissue dan pengambilan darah tepi untuk menghitung kadar IL-6 serum. Diberikan terapi mometasone furoatesemprot hidung selama 6 minggu. Setelah 2 minggu dan 6 minggu dilakukan pengambilan darah tepi untuk menghitung kadar IL-6 serum, serta evaluasi foto polos skull lateral soft tissue setelah 6 minggu. Hasil:Terdapat perbedaan bermakna antara kadar IL-6 serum sebelum dan sesudah perlakuan baik, pada minggu kedua maupun minggu keenam (p=0.00). Terdapat perbedaan bermakna antara nilai foto polos skull lateral soft tissue sebelum dan sesudah perlakuan (p=0.00). Berdasarkan uji Pearson, nilai kadar IL-6 serum darah berkorelasi secara signifikan yang bersifat negatif (p<0,05) dengan foto polos skull lateral sebelum dan sesudah perlakuan dengan hasil -0,819 dan -0,692. Kesimpulan: Mometasone furoatesemprot hidung dapat menurunkan kadar IL-6 serum pada penderita hipertrofi adenoid secara bermakna, disertai dengan mengecilnya ukuran adenoid, penurunan gejala dan keluhan penderita hipertrofi adenoid. Kata kunci: Hipertrofi adenoid, Interleukin 6, Mometasone FuroateABSTRACT Background:Adenoid inflammation is characterized by adenoid hypertrophy (AH). Numerous studies had stated that Interleukin 6 (IL-6) is the pathophysiological basis for the occurrence of AH, thus, a therapy is needed to reduce the role of IL-6. Intranasal corticosteroid (IC) is the drug-of-choice for AH for its anti-inflammatory nature. Previous research had shown a decrease in IL-6 levels in adenoid tissue after IC administration, but its effect on IL-6 serum level had not yet been studied. Purpose: To find out the effect of Mometasone Furoate (MF) on IL-6 serum level in AH patients. Methods: One group pre and post test design, involving 16 subjects, underwent a soft tissue skull lateral plain x-ray, also a peripheral blood examination for IL-6 serum level. Afterwards, subjects were treated with MF nasal spray for 6 weeks. The IL-6 serum level was evaluated after 2 and 6 weeks, and the soft tissue x- ray was assessed after 6 weeks. Results: There were significant differences between IL-6 serum levels before and after treatment both in the second and sixth week (p = 0.00). There were significant differences between the value of soft tissue skull lateral plain x-ray before and after treatment (p = 0.00). Based on the Pearson test, IL-6 serum levels correlated significantly negatively (p <0.05) with soft tissue skull lateral plain x-ray before and after treatment with results -0.819 and -0.692. Conclusion: MF nasal spray significantly reduce IL-6 serum levels in AH patients, reducing adenoid size and decreasing symptoms of AH patients.

Pengaruh pemberian vitamin E terhadap eosinofil mukosa hidung dan kualitas hidup penderita rinitis alergi Nanchy Christy; Rus Suheryanto; Mohammad Dwijo Murdiyo
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.316

Latar belakang: Penyakit rinitis alergi (RA) banyak dijumpai dan memberi dampak negatif terhadap produktivitas, kualitas hidup, gangguan tidur, aktivitas di luar rumah, serta gangguan sekolah pada anak. Vitamin E bekerja sebagai antioksidan pada membran sel dan berikatan dengan radikal bebas dengan cara menghambat peroksidasi Poly Unsaturated Fatty Acid (PUFA). Tujuan: Mengetahui pengaruh vitamin E terhadap jumlah eosinofil mukosa hidung dan perbaikan klinis pada penderita rinitis alergi persisten sedang berat. Metode: Menggunakan Randomized Clinical Trial, double blind, pre and post control group dengan perlakuan pemberian terapi semprot hidung triamcinolone acetonide, cetirizine 10 mg, dan vitamin E 400IU selama 4 minggu. Dilakukan penilaian Visual Analogue Scale (VAS) dan Total Nasal Symptom Score (TNSS), serta pemeriksaan eosinofil mukosa hidung pada awal dan 4 minggu setelah perlakuan. Hasil: Didapatkan perbedaan bermakna antara jumlah eosinofil mukosa hidung sebelum dan sesudah pemberian vitamin E pada kelompok perlakuan (p=<0,001). Penurunan jumlah eosinofil mukosa hidung lebih besar dan bermakna pada kelompok perlakuan dibandingkan dengan kelompok kontrol (p=<0,001). Didapat perbaikan kualitas hidup berdasarkan perbaikan nilai VAS dan TNSS yang bermakna setelah perlakuan pada kelompok kontrol maupun perlakuan (p=<0,001), serta didapatkan perbaikan kualitas hidup berdasarkan nilai VAS dan TNSS pada kedua kelompok dengan selisih nilai perbaikan gejala yang lebih besar pada kelompok perlakuan, namun dari perhitungan statistik tidak didapatkan perbedaan yang bermakna. Kesimpulan: Vitamin E 400IU menurunkan jumlah eosinofil mukosa hidung secara bermakna pada pasien rinitis alergi persisten sedang berat. Perbaikan nilai TNSS pada penggunaan vitamin E 400IU lebih baik dibandingkan subjek yang mendapat plasebo, walaupun tidak berbeda secara bermakna.Kata kunci: rinitis alergi, Vitamin E, Total Nasal Symptom Score ABSTRACT Background: Allergic rhinitis (AR) is an allergic disease frequently found and has a negative impact on productivity, quality of life, sleep disorder, outdoors activities, and school disruption in children. Vitamin E works as an antioxidant in cell membranes through binding free radicals by inhibiting peroxidation of Poly Unsaturated Fatty Acids (PUFA). Purpose: To find out the effect of vitamin E administration on nasal mucosa eosinophil counts and the clinical improvement in patients with moderate severe persistent AR. Methods: A double blind randomized clinical trial, pre and post control group, given therapy of triamcinolone acetonide nasal spray, cetirizine 10 mg, and vitamin E 400 IU orally for 4 weeks. Evaluation by Visual Analogue Scale (VAS) and Total Nasal Symptom Score (TNSS), as well as nasal mucosal eosinophils count at baseline and 4 weeks after treatment. Results: There was a significant difference on the number of nasal mucosal eosinophils before and after vitamin E administration in the treatment group (p = <0.001). A greater and more significant decrease in the number of nasal mucosal eosinophils in the treatment group compared to control group (p = <0.001). Significant improvement of VAS and TNSS after treatment in the control and treatment groups (p = <0.001) and quality of life improvement based on VAS and TNSS values in both control and treatment groups, but the statistical calculations showed no significant differences between the two groups. Conclusion: Vitamin E 400IU significantly reduce the number of nasal mucosal eosinophils in patients with moderate severe persistent AR.

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