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Microbiota profile in sinonasal mucosa of chronic rhinosinusitis as an indicator for therapeutic outcome Imam Megantara; Muhammad Fadhil Ihsan Yazid; Gita Widya Pradini; Melati Sudiro; Chrysanti Murad
Oto Rhino Laryngologica Indonesiana Vol 51, No 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.423

ABSTRACTBackground: Chronic rhinosinusitis (CRS) is characterized by persistent inflammation of the sinonasal mucosa, which often requires surgical and additional post-operative therapy. Microbial dysbiosis due to the imbalance of commensal bacteria and pathogens plays a crucial role in the inflammatory process within the sinonasal mucosa and in therapy outcome. Further knowledge about the microbiota profile in CRS is needed to improve the management strategy for CRS patients. Purpose: To review recent studies on the microbiota profile in sinonasal mucosa of CRS patients, and its potential as an indicator for therapeutic outcome. Literature review: Recent data from several studies has documented increased microbiota richness and diversity in post-operative CRS patients’ sinonasal mucosa, as well as good post-operative outcomes. Increased genus Corynebacterium abundance was also consistently associated with good post-operative outcomes. Conclusion: There was a difference in microbiota profiles in pre and post-operative CRS patients, indicating an association with clinical improvement. Corynebacterium was associated with better post-operative outcomes. Thus, the presence of these bacteria potentially could be used as an indicator for therapeutic outcome.Keywords: chronic rhinosinusitis, microbiota, endoscopic sinus surgery, therapeutic outcomeABSTRAKLatar belakang: Rinosinusitis kronis (RSK) merupakan kondisi inflamasi yang menetap pada mukosa sinonasal dan sering memerlukan operasi dan terapi tambahan pasca-operasi. Kondisi disbiosis mikrobiota akibat ketidakseimbangan bakteri komensal dan patogen diduga memengaruhi proses inflamasi pada mukosa sinonasal dan luaran terapi. Diperlukan pengetahuan tentang profil mikrobiota pada RSK sehingga diharapkan dapat meningkatkan strategi penanganan pasien RSK. Tujuan: Mempelajari studi terkini tentang profil mikrobiota pada mukosa sinonasal pasien RSK, dan potensinya sebagai indikator luaran terapi. Tinjauan pustaka: Data terkini dari beberapa penelitian menemukan peningkatan kekayaan dan keragaman mikrobiota pada mukosa sinonasal pasien RSK pasca-operasi dan memiliki hubungan dengan luaran operasi yang baik. Peningkatan kelimpahan genus Corynebacterium ditemukan secara konsisten berkaitan dengan luaran operasi yang baik. Kesimpulan: Terdapat perbedaan profil mikrobiota pada pasien RSK pra dan pasca-operasi yang mengindikasikan kaitannya dengan perbaikan klinis. Corynebacterium adalah bakteri yang ditemukan memiliki hubungan dengan luaran operasi yang lebih baik, sehingga keberadaan bakteri ini berpotensi untuk dapat dimanfaatkan sebagai indikator luaran terapi.Kata kunci: rinosinusitis kronis, mikrobiota, operasi sinus endoskopik, luaran terapi

Efektivitas imunoterapi terhadap gejala, temuan nasoendoskopik dan kualitas hidup pasien rinosinusitis alergi Yuwan Pradana; Teti Madiadipoera; Melati Sudiro; Arif Dermawan
Oto Rhino Laryngologica Indonesiana Vol 42, No 2 (2012): Volume 42, No. 2 July - December 2012
Publisher : PERHATI-KL

Background: Rhinosinusitis is one of major health problems which increased the economic burden. With symptoms include nasal congestion, rhinorrhea, facial pain, and sometimes reduced or loss of smell, this condition may impair work productivity and quality of life (QOL). Rhinosinusitis is one of the comorbidity of allergic rhinitis. Allergen specific immunotherapy provides protection against the occurence of allergic symptoms and inflammatory reactions due to allergen exposure, that results in improvement of QOL of allergic rhinosinusitis patients. To assess the effectiveness of immunotherapy in the severity of the disease, nasal symptoms, nasoendoscopic findings, drugs intake, and the QOL in allergic rhinosinusitis patients treated with specific immunotherapy. Methods: A retrospective descriptive study conducted at the Rhinology-Allergy Clinic of ORL-HNS Department, Dr.Hasan Sadikin General Hospital, Bandung, on January - December 2011, towards 25 patients, by anamnesis, severity of the disease using Visual Analogue Scale (VAS), nasal symptoms from Weeke, Davis and Okuda, nasoendoscopic findings from Lund-Kennedy, drug intake score, and QOL assesment using Rhinoconjuctivitis Quality of Life Questionaire. Results: There was a significant correlation (p<0,05) between specific immunotherapy for 1 year observed by reduced disease severity, reduced nasal symptoms, nasoendoscopic findings improvement, reduced drug intake, and increased Quality of Life which shows significant results from 3 months after immunotherapy using Wilcoxon differential test (p<0,001). Conclusion: Immunotherapy for 1 year was significantly reduced disease severity, reduced nasal symptoms, improved nasoendoscopic findings, reduced drug intake, and improvement of QOL in patients with allergic rhinosinusitis began from 3 months after immunotherapy and maintained afterwards. Key words: allergic rhinosinusitis, nasal symptoms, nasoendoscopy, specific immunotherapy, quality of life Abstrak : Latar belakang: Rinosinusitis merupakan salah satu masalah kesehatan yang semakin meningkat sehingga menjadi beban besar terhadap perekonomian masyarakat. Dengan gejala berupa hidung tersumbat, rinore, nyeri pada wajah dan dapat disertai berkurang atau hilangnya penciuman, kondisi ini dapat menurunkan produktivitas kerja dan kualitas hidup. Rinosinusitis merupakan salah satu komorbiditas dari rinitis alergi. Imunoterapi alergen spesifik bertujuan untuk memberikan perlindungan terhadap timbulnya gejala alergi dan reaksi inflamasi akibat pajanan alergen, sehingga dapat meningkatkan kualitas hidup pasien rinosinusitis. Tujuan: Membuktikan efektivitas imunoterapi terhadap tingkat beratnya penyakit, gejala hidung, nasoendoskopi, penggunaan obat dan kualitas hidup pasien rinosinusitis alergi yang diberikan pengobatan imunoterapi selama 3, 6, dan 12 bulan. Metode: Dilakukan penelitian deskriptif retrospektif, di Poliklinik Rinologi Alergi Ilmu Kesehatan THT-KL RSHS Bandung, dalam periode JanuariDesember 2011 pada 25 pasien, menggunakan anamnesis, tingkat berat penyakit berdasarkan Visual Analogue Scale (VAS), gejala hidung berdasarkan Weeke, Davis dan Okuda, pemeriksaan nasoendoskopi berdasarkan Lund-Kennedy, penggunaan obat dan penilaian kualitas hidup dengan Rhinoconjuctivitis Quality of Life Questionaire. Hasil: Didapatkan hubungan bermakna berdasarkan uji chi-kuadrat-Friedman antara imunoterapi selama 1 tahun (p<0,05) terhadap penurunan tingkat berat penyakit, penurunan gejala hidung, perbaikan temuan nasoendoskopi, penurunan penggunaan obat, serta peningkatan kualitas hidup. Didapat perbaikan secara bermakna sejak 3 bulan pasca imunoterapi (p<0,001) berdasarkan uji beda Wilcoxon. Kesimpulan: Imunoterapi selama 1 tahun efektif terhadap penurunan tingkat berat penyakit, penurunan gejala hidung, perbaikan temuan nasoendoskopi, penurunan penggunaan obat, serta peningkatan kualitas hidup pada pasien rinosinusitis alergi, dengan perbaikan sejak 3 bulan dan bertahan hingga 1 tahun pasca-imunoterapi. Kata kunci: rinosinusitis alergi, gejala hidung, nasoendoskopi, imunoterapi, kualitas hidup

Gambaran Klinis Pasien Laringomalasia di Poliklinik Telinga Hidung Tenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung Periode Januari 2012 - Maret 2015 Ayu Hardianti Saputri; Melati Sudiro; Sinta Sari Ratunanda; Wijana Wijana
Tunas Medika Jurnal Kedokteran & Kesehatan Vol 3, No 1 (2016): Tunas Medika Jurnal Kedokteran & Kesehatan
Publisher : Tunas Medika Jurnal Kedokteran & Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar

Latar Belakang: Laringomalasia merupakan salah satu kelainan kongenital yang terjadi akibat jatuhnya struktur supraglotik selama inspirasi sehingga menyebabkan stridor. Laringomalasia terdiri dari 3 tipe. Faktor risiko laringomalasia adalah lahir prematur, kelainan neurologik dan lesi jalan nafas. Faktor komorbid laringomalasia adalah bronkopneumonia, kelainan jantung bawaan dan kelainan neurologik. Laringomalasia diduga memiliki hubungan yang erat dengan refluks isi lambung. Tujuan: memberikan informasi mengenai gambaran klinis laringomalasia berdasarkan tipe laringomalasia, faktor risiko, faktor komorbid, dan gambaran refluks laringofaring sehingga diharapkan penatalaksanaan yang lebih terpadu. Metode: penelitian deskriptif retrospektif dengan pendekatan potong lintang, di Poliklinik THT-KL RSHS Bandung periode Januari 2012-Maret 2015, berdasarkan data rekam medis, dan pemeriksaan laringoskopi serat lentur. Hasil: Terdapat 84 pasien (55 laki-laki dan 29 perempuan). Tipe laringomalasia terdiri dari tipe 1 (63,1%), tipe 2 (23,8%) dan tipe 3 (13,1%). Faktor risiko terbanyak adalah cerebral palsy (13%). Faktor komorbid berupa bronkopneumonia (53,6,5%), dan kelainan jantung bawaan (4,8%). Terdapat 2 gambaran refluks laringofaring, yaitu mukus kental endolaring (48,8%), dan hipertrofi komisura posterior (10,7%). Kesimpulan: Laringomalasia banyak terjadi pada laki-laki dibandingkan perempuan, tipe laringomalasia terbanyak adalah tipe 1 epiglotis berbentuk omega. Faktor risiko kelainan neurologik (cerebral palsy), faktor komorbid bronkopnemonia dan gambaran refluks laringofaring berupa mukus kental endolaring yang banyak terjadi.Kata Kunci : Laringomalasia, Laringoskopi Serat LenturBackground : Laryngomalacia is a congenital anomalies caused by the collapse of the supraglottic structures during inspiration and causing of stridor. Laryngomalacia consists of 3 types. Laryngomalacia risk factor is premature birth, neurological disorders and lesions of the airway. Laryngomalacia comorbidities was bronchopneumonia, congenital heart disease and neurological disorders. Laryngomalacia expected to have close links with the laryngopharyngeal reflux (LPR). Aim: provide information on the clinical manifestation of Laryngomalacia based on type Laryngomalacia, risk factors, comorbidities, and laryngopharyngeal reflux so expect a more unified management. Methods : retrospective descriptive study with cross-sectional approach in the outpatient of Otolaryngology-Head and Neck Surgery, Hasan Sadikin Hospital, Padjadjaran University, period January 2012-March 2015 from the medical sheats records and record video flexible fiberoptic laryngoscopy (FFL). Results : Eighty four patients were included in the study (59 males and 29 females). Risk factor in this study is cerebral palsy (13%) and the comorbid factor is bronchopneumonia (53,6,5%), cerebral palsy and congenital heart diseases (4,8%). The two clinical findings from LPR is endolaring mucus (48,8%), posterior commissure hypertrophy (10,7%). Conclusions : Laryngomalacia more common in men than women, the most Laryngomalacia type is type 1 omega-shaped epiglottis. Risk factors is neurological disorders (cerebral palsy), comorbidities bronchopneumonia and laryngopharyngeal reflux picture in form of viscous mucus that frequently occurred.Keyword : Laryngomalacia, Flexible Fiberoptic Laryngoscopy.

Microbiota profile in sinonasal mucosa of chronic rhinosinusitis as an indicator for therapeutic outcome Imam Megantara; Muhammad Fadhil Ihsan Yazid; Gita Widya Pradini; Melati Sudiro; Chrysanti Murad
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.423

ABSTRACTBackground: Chronic rhinosinusitis (CRS) is characterized by persistent inflammation of the sinonasal mucosa, which often requires surgical and additional post-operative therapy. Microbial dysbiosis due to the imbalance of commensal bacteria and pathogens plays a crucial role in the inflammatory process within the sinonasal mucosa and in therapy outcome. Further knowledge about the microbiota profile in CRS is needed to improve the management strategy for CRS patients. Purpose: To review recent studies on the microbiota profile in sinonasal mucosa of CRS patients, and its potential as an indicator for therapeutic outcome. Literature review: Recent data from several studies has documented increased microbiota richness and diversity in post-operative CRS patients’ sinonasal mucosa, as well as good post-operative outcomes. Increased genus Corynebacterium abundance was also consistently associated with good post-operative outcomes. Conclusion: There was a difference in microbiota profiles in pre and post-operative CRS patients, indicating an association with clinical improvement. Corynebacterium was associated with better post-operative outcomes. Thus, the presence of these bacteria potentially could be used as an indicator for therapeutic outcome.Keywords: chronic rhinosinusitis, microbiota, endoscopic sinus surgery, therapeutic outcomeABSTRAKLatar belakang: Rinosinusitis kronis (RSK) merupakan kondisi inflamasi yang menetap pada mukosa sinonasal dan sering memerlukan operasi dan terapi tambahan pasca-operasi. Kondisi disbiosis mikrobiota akibat ketidakseimbangan bakteri komensal dan patogen diduga memengaruhi proses inflamasi pada mukosa sinonasal dan luaran terapi. Diperlukan pengetahuan tentang profil mikrobiota pada RSK sehingga diharapkan dapat meningkatkan strategi penanganan pasien RSK. Tujuan: Mempelajari studi terkini tentang profil mikrobiota pada mukosa sinonasal pasien RSK, dan potensinya sebagai indikator luaran terapi. Tinjauan pustaka: Data terkini dari beberapa penelitian menemukan peningkatan kekayaan dan keragaman mikrobiota pada mukosa sinonasal pasien RSK pasca-operasi dan memiliki hubungan dengan luaran operasi yang baik. Peningkatan kelimpahan genus Corynebacterium ditemukan secara konsisten berkaitan dengan luaran operasi yang baik. Kesimpulan: Terdapat perbedaan profil mikrobiota pada pasien RSK pra dan pasca-operasi yang mengindikasikan kaitannya dengan perbaikan klinis. Corynebacterium adalah bakteri yang ditemukan memiliki hubungan dengan luaran operasi yang lebih baik, sehingga keberadaan bakteri ini berpotensi untuk dapat dimanfaatkan sebagai indikator luaran terapi.Kata kunci: rinosinusitis kronis, mikrobiota, operasi sinus endoskopik, luaran terapi

Management of Deep Neck Abscess Cases Accompanied by Comorbid Renal Failure Sari Ratunanda, Sinta; Alkatirie, Sania Taufik; Sudiro, Melati
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.741

Background: Deep neck abscess is a life threatening disease as its complications. Some comorbidities affect the successful management of deep neck abscess. Kidney failure is one of comorbidities causing uremia which in turn affecting imbalance of pro and anti inflammatory mediators. Aims: To describe the proper management of deep neck abscess comorbids with kidney failure.Case Report: To report series of deep neck abscess comorbids with kidney failure being administered therapies with various outcomes.Method: Evidence based -literature review about deep neck abscess comorbids with kidney failure was conducted in Pubmed, Clinical Key, and Google Scholar. Retrieved articles were then critically appraised.Results: Three evidence based-articles meeting criteria were included. The management of neck abscess comorbids with renal failure starts from kidney management according to Kidney disease: Improving Global Outcome (KDIGO) year 2012, and followed by management of deep neck abscess except in emergency situation. Diagnose and management of kidney disease need series examination of serume creatinine and urine monitoring.Conclusion: The management of deep neck abscess comorbids with kidney failure commences with therapy for renal failure followed by management of deep neck abscess.

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