Brastho Bramantyo
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia Rumah Sakit Dr. Cipto Mangunkusumo Jakarta

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Journal : Cermin Dunia Kedokteran

Efektivitas Tinnitus Retraining Therapy (TRT) sebagai Upaya Meningkatkan Kualitas Hidup Pasien Tinitus: Laporan Kasus Berbasis Bukti Ramadhany Fikri Setiawan; Kemal Akbar Suryoadji; Brastho Bramantyo; Widayat Alviandi
Cermin Dunia Kedokteran Vol 50 No 5 (2023): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i5.890

Abstract

Latar Belakang: Tinnitus retraining therapy (TRT), yang terdiri dari counseling therapy dan acoustic therapy, menjadi salah satu alternatif terapi tinitus. Namun, efektivitas TRT belum diketahui pasti. Tujuan: Mengetahui efektivitas TRT dalam meningkatkan kualitas hidup pasien tinitus. Metode: Laporan kasus berbasis bukti dengan mencari literatur dari pertanyaan klinis pada database Cochrane Library, Embase, ProQuest, PubMed, ScienceDirect, dan Scopus, dengan kata kunci sesuai pertanyaan klinis. Seleksi berdasarkan kriteria eligibilitas dan kesesuaian PICO, menghasilkan satu artikel kajian sistematik dan meta-analisis. Studi telah lolos telaah kritis sesuai pedoman Centre for Evidence-Based Medicine (CEBM) University of Oxford. Hasil: TRT memiliki overall response rate lebih tinggi dibandingkan terapi standar pada pasien tinitus (OR=7,01; IK 95%=5.16,9.53; p<0,00001; I2=0%; p=0,82). TRT memiliki skor tinnitus handicap inventory (THI) lebih rendah dibandingkan dengan terapi standar pada pasien tinitus (MD=-14.50; IK 95%=-16.65,-12.36; p<0,00001; I2= 8%; p=0,30). Simpulan: TRT efektif memperbaiki response rate terhadap tinitus dan menurunkan skor THI.   Background: Tinnitus greatly affects daily activities, which can interfere with the quality of life. Tinnitus retraining therapy (TRT) which consists of counseling therapy and acoustic therapy, is an alternative therapy for tinnitus. However, its effectiveness is not yet known. Objective: To determine the effectivity of TRT in improving the quality of life of tinnitus patients. Methods: This study is an evidence-based case report that searches the literature from clinical questions in databases from Cochrane Library, Embase, ProQuest, PubMed, ScienceDirect, and Scopus, using keywords that matched the clinical question. Studies were selected based on the PICO and eligibility criteria. The result is one systematic review and meta-analysis article. The study has been critically appraised using the Center for Evidence-Based Medicine (CEBM) University of Oxford instruments. Result: TRT has a higher overall response rate than standard therapy in tinnitus patients (OR=7.01; CI 95%=5.16, 9.53; p<0.00001; I2=0%, p=0.82). TRT has a lower tinnitus handicap inventory (THI) scale than standard therapy in tinnitus patients (MD=-14.50; CI 95%=-16.65,-12.36; p<0.00001; I2= 8%; p=0.30). Conclusion: TRT effectively improves response rate to tinnitus and lowers THI score.
Perbaikan Pendengaran Pasien Otitis Media Efusi yang Autoinflasi: Laporan Kasus Berbasis Bukti Firmansyah, Ugiadam Farhan; Suryoadji, Kemal Akbar; Bashirudin, Jenny; Bramantyo, Brastho; Alviandi, Widayat
Cermin Dunia Kedokteran Vol 51 No 6 (2024): Cardiology
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i6.1024

Abstract

Background: Otitis media with effusion (OME) is the presence of middle ear fluid without acute ear infection signs or symptoms. OME is one of the causes of hearing loss. Chronic asymptomatic OME could be managed by careful waiting for 3 months because it is a self-limiting disease. During surveillance, autoinflation is a beneficial intervention with minimal side effects and high adherence. Objective: To evaluate the effectiveness of autoinflation to improve hearing in otitis media with effusion and hearing loss. Methods: Literature searching was conducted through PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOHost with inclusion and exclusion criteria. The articles were selected and underwent critical appraisal using rapid critical appraisal of systematic review and level of evidence by the Oxford Centre for Evidence-based Medicine in 2011. Result: One systematic review and meta-analysis, or RCT, met the criteria. This article revealed a pooled estimate of RR 1.74; 95% CI [1.22-2.50] with a Z-score of 3.02 (p=0.0025). This result showed substantial significant (p=0.01) heterogeneity (I2=69%). Conclusion: OME patients with hearing loss who performed autoinflation >1 month had a 1.74 times greater chance of achieving hearing improvement than controls. Autoinflation with the Politzer method gives significant results in improving hearing loss. Large-scale RCT research is recommended to evaluate the effectiveness of autoinflation with the Politzer method or other available methods in OME patients with hearing loss.