Komang Soniananda Pradnyana Putri
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Head and Neck Cancer in Bali: A Retrospective Study on Patient Characteristics, Predominant Sites, and Histopathology at a Tertiary Referral Hospital Komang Soniananda Pradnyana Putri; I Gde Ardika Nuaba; I Ketut Suanda
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.757

Abstract

Head and neck cancers (HNCs) represent a significant global health burden, with distinct epidemiological patterns observed across different geographical regions. In Indonesia, HNCs are among the leading malignancies, yet detailed regional data, particularly from areas like Bali, remain limited. This study aimed to delineate the characteristics of HNC patients at a tertiary referral hospital in Denpasar, Bali. A retrospective descriptive study was conducted using medical records of patients diagnosed with head and neck malignancies at Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar, between January 1st, 2021, and December 31st, 2023. Data collected included age, gender, occupation, primary tumor site, and histopathological findings. A total sampling method was employed. Descriptive statistics were used for analysis. A total of 290 patient records were analyzed. Males comprised 69% (n=201) of cases, and females 31% (n=89). The predominant age group was 45–65 years (63%, n=183). Farmers were the most common occupational group (27%, n=77). Nasopharyngeal cancer was the most prevalent malignancy, accounting for 80% (n=232) of cases. Nonkeratinizing squamous cell carcinoma was the most frequent histopathological diagnosis (80%, n=231). In conclusion, head and neck malignancies in this Balinese cohort predominantly affected middle-aged to elderly males, with farming being a common occupation. The strikingly high prevalence of nasopharyngeal cancer, primarily nonkeratinizing squamous cell carcinoma, underscores a significant regional health concern that warrants further etiological investigation and targeted public health strategies.
Ruptured Congenital Cholesteatoma Presenting as Atticoantral Chronic Suppurative Otitis Media in a 4-Year-Old: A Diagnostic Challenge Made Lely Rahayu; I Gusti Ayu Mahaprani Danastri; I Nyoman Swardyana; Komang Soniananda Pradnyana Putri
Archives of The Medicine and Case Reports Vol. 7 No. 1 (2026): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v7i1.848

Abstract

Chronic suppurative otitis media (CSOM) of the atticoantral type is a distinct otologic pathology driven by cholesteatoma, characterized by enzymatic bone erosion and a high risk of intracranial complications. While typically acquired through retraction pockets, a subset of these cases represents congenital cholesteatomas (CC) that have silently expanded and ruptured the tympanic membrane. This presentation mimics acquired disease, creating a diagnostic blind spot. We report the case of a 4-year-old male presenting with a one-year history of persistent, foul-smelling otorrhea and otalgia in the right ear. Despite a history of recurrent cold, there was no prior trauma or otologic surgery. Physical examination revealed an attic perforation with purulent discharge. Computed tomography scan (CT-scan) identified a soft tissue mass filling the epitympanum and mesotympanum with significant erosion of the scutum and ossicles. The patient underwent a modified radical mastoidectomy with type II tympanoplasty. Intraoperative findings revealed an extensive cholesteatoma sac consistent with a congenital origin that had secondarily ruptured. In conclusion, congenital cholesteatoma must be considered in the differential diagnosis of pediatric CSOM, even in the presence of a perforation. This ruptured presentation highlights the necessity of early HRCT imaging over conventional radiography. The canal wall down approach remains a critical strategy for eradicating extensive pediatric disease to prevent recidivism.