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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

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.

A survey of Indonesian otolaryngologist behavior in medical service during the CoVid-19 pandemic Indra Zachreini; Jenny Bashiruddin; Susyana Tamin; Harim Priyono; Ika Dewi Mayangsari; Respati Ranakusuma; Natasha Supartono; Fikri Mirza Putranto; Dewo Aksoro; Selfiyanti Bimantara; Yussy Afriana Dewi; Kote Noordhianta; Bintang Napitupulu; Sagung Rai Indrasari; Nyilo Purnami; Tengku Siti Hajar Haryuna; Juliandi Harahap; Eka Savitri; Tjandra Manukbua
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.v51i1.444

Background: World Health Organization (WHO) announced a newly discovered virus that first identified in Wuhan, China on December 2019, namely SARS-CoV-2 as the cause of corona virus disease (COVID-19) which had become global pandemic. Doctors as medical practitioners are categorized as vulnerable group to be infected by corona virus, and many otorhinolaryngologists had been infected and even died in performing medical services. Among the causative factors why otorhinolaryngologists could get infected by corona virus is their behavior. Purpose: To assess the behavioral level of otorhinolaryngologists in medical services during Covid-19 pandemic. Method: Descriptive study with a cross sectional design. Research samples were otorhinolaryngologists in Indonesia who met the inclusions criteria. The samples were selected by consecutive sampling method, and obtained 1299 subjects. Behavioral level was assessed from 3 aspects: knowledge, attitude, and practice, which comprised of 12 questions. Result: It was found that 461 respondents had a good behavioral level (35.5%), 677 respondents had moderate levels (52.1%) and 161 respondents had low level (12.4%). There was a statistically significant correlation between knowledge with behavioral level, attitude with behavioral level, and practice with behavioral level (p=0.001). Conclusion: The study of behavioral level of otorhinolaryngologists in medical service during Covid-19 pandemic obtained the highest number was moderate level 677 respondents (57.2%), and there was a statistically significant correlations between the variable of knowledge with behavioral level, the variable of attitude with behavioral level, and the variable of practice with behavioral level (p=0.001).ABSTRAK Latar belakang: Organisasi kesehatan dunia (WHO) mengumumkan virus baru yang pertama kali muncul di Wuhan China, pada Desember 2019, yaitu SARS-CoV-2 sebagai penyebab corona virus disease 19 (Covid 19) dan menyatakan sebagai pandemi. Dokter sebagai tenaga kesehatan merupakan kelompok yang rentan terinfeksi virus corona dan berdasarkan laporan, sudah banyak dokter Telinga Hidung Tenggorok - Bedah Kepala Leher (THT-KL) yang terinfeksi bahkan meninggal dunia dalam pelayanan medis. Salah satu faktor penyebab dokter THT-KL terinfeksi oleh virus corona adalah tingkat perilaku dokter THT-KL. Tujuan: Mengetahui tingkat perilaku dokter THT-KL dalam melakukan pelayanan medis saat pandemi Covid 19. Metode: Penelitian deskriptif dengan rancangan studi potong lintang. Sampel penelitian adalah dokter THT-KL di Indonesia yang memenuhi kriteria inklusi. Teknik pengambilan sampel secara berurutan, dan mendapatkan 1299 sampel. Tingkat perilaku dinilai dari 3 aspek yaitu dimulai dari pengetahuan, sikap dan tindakan yang terdiri dari 12 pertanyaan. Hasil: Didapatkan tingkat perilaku responden dokter THT-KL dalam pelayanan medis pada pandemi Covid 19, tingkat perilaku baik sebanyak 461 responden (35,4%), tingkat sedang 677 responden (52,1%), dan tingkat kurang 161 responden (12.4%). Terdapat hubungan yang signifikan antara pengetahuan dan tingkat perilaku, sikap dengan tingkat perilaku dan tindakan dengan sikap perilaku (p=0,001). Kesimpulan: Didapatkan tingkat perilaku dokter THT-KL dalam pelayanan medis pada pandemi covid 19, terbanyak adalah tingkat perilaku sedang sebanyak 677 responden (57,2%), dan terdapat hubungan yang bermakna antara variabel pengetahuan dengan tingkat perilaku, variabel sikap dengan tingkat perilaku dan variabel tindakan dengan tingkat perilaku dokter THT-KL dalam pelayanan medis pada pandemi Covid 19, dimana nilai p = 0,001. Kata kunci: perilaku, dokter THT-KL, pandemic, Covid-19

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

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.

Financing hearing aids for patients with congenital deafness in Indonesia Indra Zachreini; Jenny Bashiruddin; Semiramis Zizlavsky; Susyana Tamin; Harim Priyono; Ika Dwi Mayangsari; Widayat Alviandi; Natasha Supartono; Damayanti Soetjipto; Respati Ranakusuma; Heditya Damayanti; Dina Alia; Tengku Siti Hajar Haryuna; Juliandi Harahap; Nirza Warto; Hidayatul Fitria
Oto Rhino Laryngologica Indonesiana Vol 52, No 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.550

ABSTRACTBackground: The appropriate management of patients with congenital deafness is installing hearing aids, either external hearing aids or implanted in the ear (cochlear implant), aiming to reduce the medical and social burden, besides improving the quality of life of the sufferers. Objective: To ascertain the cost of hearing aids in patients with congenital deafness, in the form of external hearing aids or cochlear implants. Method: A descriptive study with cross-sectional design using questionnaires through interviews. The sample size was 535 mothers whose children had congenital deafness at 24 hospitals with facilities for establishing a diagnosis of congenital deafness in 17 provinces in Indonesia. Result: Most respondents were aged 30-39 years (55%), occupations were housewives (71.8%), and education level was high school (52.5%). The type of hearing aid used mostly was external (92.7%), with 45.9% paid by personal expense. The surgically planted hearing aids in 22 children was mostly cochlear implants (95.5%), which were financed by the Indonesian Healthcare and Social Security Agency (BPJS) plus personal costs (50%). Discussion: This study found that the most common type of hearing aid used by children with hearing impairments was external hearing aids (92.7%) through independent financing (45.9%). Only 7.3% of patients chose surgery in hearing habilitation, and 95.5% were cochlear implants. The small percentage of surgery were due to the high-priced of cochlear implants, and the government did not cover all financial expenses. Conclusion: Most external hearing aids were paid independently-out-of-pocket, while cochlear implant surgeries were funded by BPJS, plus extra costs independently. ABSTRAKLatar belakang: Penatalaksanaan terbaik untuk penderita tuli kongenital adalah pemasangan alat bantu dengar (ABD), baik berupa ABD eksternal maupun ABD yang ditanam dalam telinga (implan koklea), dengan tujuan untuk mengurangi beban medis dan sosial, serta meningkatkan kualitas hidup penderita. Tujuan: Untuk mengetahui seberapa besar biaya pemasangan ABD pada penderita tuli kongenital, baik berupa ABD eksternal maupun implan koklea. Metode: Penelitian deskriptif dengan rancangan cross sectional study menggunakan kuesioner melalui wawancara. Besar sampel 535 ibu yang anaknya menderita tuli kongenital pada 24 rumah sakit yang memiliki fasilitas penegakkan diagnosis tuli kongenital di 17 provinsi di Indonesia. Hasil: Sebagian besar responden berusia 30-39 tahun (55%), pekerjaan terbanyak adalah ibu rumah tangga (71.8%), dan tingkat pendidikan SMA (52.5%). Jenis ABD yang terbanyak adalah ABD eksternal (92,7%) dengan pembiayaan secara mandiri 45,9%. Pemasangan ABD dengan tindakan operasi dilakukan pada 22 anak, yang terbanyak adalah implan koklea (95,5%) yang dibiayai oleh Badan Penyelenggara Jaminan Sosial (BPJS) ditambah dengan biaya sendiri (50%). Diskusi: Penelitian ini mendapati bahwa ABD yang terbanyak digunakan oleh anak dengan gangguan pendengaran adalah ABD eksternal (92,7%) dengan biaya mandiri (45,9%). Habilitasi pendengaran dengan tindakan operasi hanya dilakukan pada 7,3% pasien, berupa implantasi koklea 95,5%. Kecilnya persentase habilitasi bedah dikarenakan tingginya harga implant koklea, dan bantuan dari BPJS tidak meliputi keseluruhan biaya. Kesimpulan: Sebagian besar pembiayaan alat bantu dengar eksternal secara mandiri, sedangkan operasi implan koklea menggunakan biaya BPJS ditambah biaya sendiri.

Accuracy of Centor scoring system in diagnosing group a-beta haemolytic streptococcal (GABHS) infection Niken Lestari Poerbonegoro; Joanna Erin Hanrahan; Indira Amelia; Viharsyah Aulia Akbar; Raditya Putra Djohan; Ika Dwi Mayangsari; Dini Widiarni Widodo
Oto Rhino Laryngologica Indonesiana Vol 52, No 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.430

ABSTRACTBackground: At present, the standard examination for diagnosing streptococcal upper respiratory tract infection is throat culture. As throat culture is time-consuming and relatively expensive, efforts are made to develop certain criteria that will still lead to proper diagnosis and rational use of antibiotics, that is Centor score. Even so, the accuracy of Centor score is still debatable. Purpose: To provide evidence on the accuracy of Centor scoring system compared to throat culture in diagnosing GABHS upper respiratory tract infection. Case Report: A 25-years old male came to primary health care with primary complain of sore throat. Centor score was used to diagnose GABHS infection and as a guide to give antibiotics. Clinical question: “In patients with sore throat, how accurate is the Centor score compared to throat culture in diagnosing Group A Beta-Haemolytic Streptococcal (GABHS) Infection?” Methods: Literature searching was conducted through 4 databases. Critical appraisal based on the Centre of Evidence-Based Medicine (CEBM)-University of Oxford University, Diagnostic Critical Appraisal Sheet and Systematic Review Sheet. Results: All the selected studies were considered valid. They revealed a high specificity, low sensitivity, high negative predictive value (NPV), and low positive predictive value (PPV) in the importance aspect assessment. The Centor scoring system was applicable to our patient. It was available, affordable, and accurate in adult patients, yet less accurate in children. Conclusion: In conclusion,Patient with sore throat and suspicion of GABHS infection could be diagnosed with Centor scoring system as the first line diagnosis in primary care and as a guide to whether to give giving antibiotics or not.ABSTRAKLatar belakang: Saat ini, kultur tenggorok merupakan pemeriksaan baku emas yang digunakan untukmendiagnosis infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus. Namun, kulturtenggorok merupakan pemeriksaan yang mahal dan hasilnya memakan waktu yang lama, sehinggaberbagai kriteria dikeluarkan untuk dapat dipakai sebagai alat diagnostik dan sebagai panduanpenggunaan antibiotik yang rasional pada kasus infeksi saluran napas atas. Salah satunya yaitu Centorscore, tetapi akurasinya masih kontroversial. Tujuan: Menyediakan laporan kasus berbasis buktiterhadap akurasi dari Centor score sebagai alat diagnostik infeksi saluran napas atas yang disebabkanoleh bakteri Streptococcus dibandingkan dengan pemeriksaan kultur tenggorok. Laporan kasus: Seorang laki-laki berusia 25 tahun datang ke fasilitas kesehatan tingkat pertama dengan keluhan utama nyeri tenggorokan. Centor score digunakan untuk mendiagnosis pasien ini dan sebagai panduan pemberian antibiotik. Pertanyaan klinis: Pada pasien dengan radang tenggorok,seberapa akurat Centor score dibandingkan dengan kultur tenggorok dalam diagnosis GABHS? Metode: Pencarian literatur dilakukan melalui 4 database dan telaah kritis literatur menggunakan tilikan dari CEBM, University of Oxford University. Hasil: Seluruh studi yang ditelaah valid. Seluruh studi menunjukkan spesifisitas dan negative predictive value (NPV) yang tinggi, serta sensitivitas dan positive predictive value (PPV) yang rendah. Centor score dapat diaplikasikan untuk pasien pada skenario klinis karena bersifat mudah digunakan, biaya yang dikeluarkan terjangkau, dan akurat khususnya pada pasien dewasa. Kesimpulan: Pasien dengan nyeri tenggorok yang dicurigai memiliki infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus dapat ditegakkan diagnosisnya melalui penilaian Centor score di fasilitas layanan tingkat pertama, serta dapat menjadi panduan dalam pemberian antibiotik.

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

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

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.

A survey of Indonesian otolaryngologist behavior in medical service during the CoVid-19 pandemic Indra Zachreini; Jenny Bashiruddin; Susyana Tamin; Harim Priyono; Ika Dewi Mayangsari; Respati Ranakusuma; Natasha Supartono; Fikri Mirza Putranto; Dewo Aksoro; Selfiyanti Bimantara; Yussy Afriana Dewi; Kote Noordhianta; Bintang Napitupulu; Sagung Rai Indrasari; Nyilo Purnami; Tengku Siti Hajar Haryuna; Juliandi Harahap; Eka Savitri; Tjandra Manukbua
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.v51i1.444

Background: World Health Organization (WHO) announced a newly discovered virus that first identified in Wuhan, China on December 2019, namely SARS-CoV-2 as the cause of corona virus disease (COVID-19) which had become global pandemic. Doctors as medical practitioners are categorized as vulnerable group to be infected by corona virus, and many otorhinolaryngologists had been infected and even died in performing medical services. Among the causative factors why otorhinolaryngologists could get infected by corona virus is their behavior. Purpose: To assess the behavioral level of otorhinolaryngologists in medical services during Covid-19 pandemic. Method: Descriptive study with a cross sectional design. Research samples were otorhinolaryngologists in Indonesia who met the inclusions criteria. The samples were selected by consecutive sampling method, and obtained 1299 subjects. Behavioral level was assessed from 3 aspects: knowledge, attitude, and practice, which comprised of 12 questions. Result: It was found that 461 respondents had a good behavioral level (35.5%), 677 respondents had moderate levels (52.1%) and 161 respondents had low level (12.4%). There was a statistically significant correlation between knowledge with behavioral level, attitude with behavioral level, and practice with behavioral level (p=0.001). Conclusion: The study of behavioral level of otorhinolaryngologists in medical service during Covid-19 pandemic obtained the highest number was moderate level 677 respondents (57.2%), and there was a statistically significant correlations between the variable of knowledge with behavioral level, the variable of attitude with behavioral level, and the variable of practice with behavioral level (p=0.001).ABSTRAK Latar belakang: Organisasi kesehatan dunia (WHO) mengumumkan virus baru yang pertama kali muncul di Wuhan China, pada Desember 2019, yaitu SARS-CoV-2 sebagai penyebab corona virus disease 19 (Covid 19) dan menyatakan sebagai pandemi. Dokter sebagai tenaga kesehatan merupakan kelompok yang rentan terinfeksi virus corona dan berdasarkan laporan, sudah banyak dokter Telinga Hidung Tenggorok - Bedah Kepala Leher (THT-KL) yang terinfeksi bahkan meninggal dunia dalam pelayanan medis. Salah satu faktor penyebab dokter THT-KL terinfeksi oleh virus corona adalah tingkat perilaku dokter THT-KL. Tujuan: Mengetahui tingkat perilaku dokter THT-KL dalam melakukan pelayanan medis saat pandemi Covid 19. Metode: Penelitian deskriptif dengan rancangan studi potong lintang. Sampel penelitian adalah dokter THT-KL di Indonesia yang memenuhi kriteria inklusi. Teknik pengambilan sampel secara berurutan, dan mendapatkan 1299 sampel. Tingkat perilaku dinilai dari 3 aspek yaitu dimulai dari pengetahuan, sikap dan tindakan yang terdiri dari 12 pertanyaan. Hasil: Didapatkan tingkat perilaku responden dokter THT-KL dalam pelayanan medis pada pandemi Covid 19, tingkat perilaku baik sebanyak 461 responden (35,4%), tingkat sedang 677 responden (52,1%), dan tingkat kurang 161 responden (12.4%). Terdapat hubungan yang signifikan antara pengetahuan dan tingkat perilaku, sikap dengan tingkat perilaku dan tindakan dengan sikap perilaku (p=0,001). Kesimpulan: Didapatkan tingkat perilaku dokter THT-KL dalam pelayanan medis pada pandemi covid 19, terbanyak adalah tingkat perilaku sedang sebanyak 677 responden (57,2%), dan terdapat hubungan yang bermakna antara variabel pengetahuan dengan tingkat perilaku, variabel sikap dengan tingkat perilaku dan variabel tindakan dengan tingkat perilaku dokter THT-KL dalam pelayanan medis pada pandemi Covid 19, dimana nilai p = 0,001. Kata kunci: perilaku, dokter THT-KL, pandemic, Covid-19

Accuracy of Centor scoring system in diagnosing group a-beta haemolytic streptococcal (GABHS) infection Poerbonegoro, Niken Lestari; Hanrahan, Joanna Erin; Amelia, Indira; Akbar, Viharsyah Aulia; Djohan, Raditya Putra; Mayangsari, Ika Dwi; Widodo, Dini Widiarni
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.430

ABSTRACTBackground: At present, the standard examination for diagnosing streptococcal upper respiratory tract infection is throat culture. As throat culture is time-consuming and relatively expensive, efforts are made to develop certain criteria that will still lead to proper diagnosis and rational use of antibiotics, that is Centor score. Even so, the accuracy of Centor score is still debatable. Purpose: To provide evidence on the accuracy of Centor scoring system compared to throat culture in diagnosing GABHS upper respiratory tract infection. Case Report: A 25-years old male came to primary health care with primary complain of sore throat. Centor score was used to diagnose GABHS infection and as a guide to give antibiotics. Clinical question: “In patients with sore throat, how accurate is the Centor score compared to throat culture in diagnosing Group A Beta-Haemolytic Streptococcal (GABHS) Infection?” Methods: Literature searching was conducted through 4 databases. Critical appraisal based on the Centre of Evidence-Based Medicine (CEBM)-University of Oxford University, Diagnostic Critical Appraisal Sheet and Systematic Review Sheet. Results: All the selected studies were considered valid. They revealed a high specificity, low sensitivity, high negative predictive value (NPV), and low positive predictive value (PPV) in the importance aspect assessment. The Centor scoring system was applicable to our patient. It was available, affordable, and accurate in adult patients, yet less accurate in children. Conclusion: In conclusion,Patient with sore throat and suspicion of GABHS infection could be diagnosed with Centor scoring system as the first line diagnosis in primary care and as a guide to whether to give giving antibiotics or not.ABSTRAKLatar belakang: Saat ini, kultur tenggorok merupakan pemeriksaan baku emas yang digunakan untukmendiagnosis infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus. Namun, kulturtenggorok merupakan pemeriksaan yang mahal dan hasilnya memakan waktu yang lama, sehinggaberbagai kriteria dikeluarkan untuk dapat dipakai sebagai alat diagnostik dan sebagai panduanpenggunaan antibiotik yang rasional pada kasus infeksi saluran napas atas. Salah satunya yaitu Centorscore, tetapi akurasinya masih kontroversial. Tujuan: Menyediakan laporan kasus berbasis buktiterhadap akurasi dari Centor score sebagai alat diagnostik infeksi saluran napas atas yang disebabkanoleh bakteri Streptococcus dibandingkan dengan pemeriksaan kultur tenggorok. Laporan kasus: Seorang laki-laki berusia 25 tahun datang ke fasilitas kesehatan tingkat pertama dengan keluhan utama nyeri tenggorokan. Centor score digunakan untuk mendiagnosis pasien ini dan sebagai panduan pemberian antibiotik. Pertanyaan klinis: Pada pasien dengan radang tenggorok,seberapa akurat Centor score dibandingkan dengan kultur tenggorok dalam diagnosis GABHS? Metode: Pencarian literatur dilakukan melalui 4 database dan telaah kritis literatur menggunakan tilikan dari CEBM, University of Oxford University. Hasil: Seluruh studi yang ditelaah valid. Seluruh studi menunjukkan spesifisitas dan negative predictive value (NPV) yang tinggi, serta sensitivitas dan positive predictive value (PPV) yang rendah. Centor score dapat diaplikasikan untuk pasien pada skenario klinis karena bersifat mudah digunakan, biaya yang dikeluarkan terjangkau, dan akurat khususnya pada pasien dewasa. Kesimpulan: Pasien dengan nyeri tenggorok yang dicurigai memiliki infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus dapat ditegakkan diagnosisnya melalui penilaian Centor score di fasilitas layanan tingkat pertama, serta dapat menjadi panduan dalam pemberian antibiotik.

Financing hearing aids for patients with congenital deafness in Indonesia Zachreini, Indra; Bashiruddin, Jenny; Zizlavsky, Semiramis; Tamin, Susyana; Priyono, Harim; Mayangsari, Ika Dwi; Alviandi, Widayat; Supartono, Natasha; Soetjipto, Damayanti; Ranakusuma, Respati; Damayanti, Heditya; Alia, Dina; Hajar Haryuna, Tengku Siti; Harahap, Juliandi; Warto, Nirza; Fitria, Hidayatul
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.550

ABSTRACTBackground: The appropriate management of patients with congenital deafness is installing hearing aids, either external hearing aids or implanted in the ear (cochlear implant), aiming to reduce the medical and social burden, besides improving the quality of life of the sufferers. Objective: To ascertain the cost of hearing aids in patients with congenital deafness, in the form of external hearing aids or cochlear implants. Method: A descriptive study with cross-sectional design using questionnaires through interviews. The sample size was 535 mothers whose children had congenital deafness at 24 hospitals with facilities for establishing a diagnosis of congenital deafness in 17 provinces in Indonesia. Result: Most respondents were aged 30-39 years (55%), occupations were housewives (71.8%), and education level was high school (52.5%). The type of hearing aid used mostly was external (92.7%), with 45.9% paid by personal expense. The surgically planted hearing aids in 22 children was mostly cochlear implants (95.5%), which were financed by the Indonesian Healthcare and Social Security Agency (BPJS) plus personal costs (50%). Discussion: This study found that the most common type of hearing aid used by children with hearing impairments was external hearing aids (92.7%) through independent financing (45.9%). Only 7.3% of patients chose surgery in hearing habilitation, and 95.5% were cochlear implants. The small percentage of surgery were due to the high-priced of cochlear implants, and the government did not cover all financial expenses. Conclusion: Most external hearing aids were paid independently-out-of-pocket, while cochlear implant surgeries were funded by BPJS, plus extra costs independently. ABSTRAKLatar belakang: Penatalaksanaan terbaik untuk penderita tuli kongenital adalah pemasangan alat bantu dengar (ABD), baik berupa ABD eksternal maupun ABD yang ditanam dalam telinga (implan koklea), dengan tujuan untuk mengurangi beban medis dan sosial, serta meningkatkan kualitas hidup penderita. Tujuan: Untuk mengetahui seberapa besar biaya pemasangan ABD pada penderita tuli kongenital, baik berupa ABD eksternal maupun implan koklea. Metode: Penelitian deskriptif dengan rancangan cross sectional study menggunakan kuesioner melalui wawancara. Besar sampel 535 ibu yang anaknya menderita tuli kongenital pada 24 rumah sakit yang memiliki fasilitas penegakkan diagnosis tuli kongenital di 17 provinsi di Indonesia. Hasil: Sebagian besar responden berusia 30-39 tahun (55%), pekerjaan terbanyak adalah ibu rumah tangga (71.8%), dan tingkat pendidikan SMA (52.5%). Jenis ABD yang terbanyak adalah ABD eksternal (92,7%) dengan pembiayaan secara mandiri 45,9%. Pemasangan ABD dengan tindakan operasi dilakukan pada 22 anak, yang terbanyak adalah implan koklea (95,5%) yang dibiayai oleh Badan Penyelenggara Jaminan Sosial (BPJS) ditambah dengan biaya sendiri (50%). Diskusi: Penelitian ini mendapati bahwa ABD yang terbanyak digunakan oleh anak dengan gangguan pendengaran adalah ABD eksternal (92,7%) dengan biaya mandiri (45,9%). Habilitasi pendengaran dengan tindakan operasi hanya dilakukan pada 7,3% pasien, berupa implantasi koklea 95,5%. Kecilnya persentase habilitasi bedah dikarenakan tingginya harga implant koklea, dan bantuan dari BPJS tidak meliputi keseluruhan biaya. Kesimpulan: Sebagian besar pembiayaan alat bantu dengar eksternal secara mandiri, sedangkan operasi implan koklea menggunakan biaya BPJS ditambah biaya sendiri.

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