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Anna Mailasari Kusuma Dewi
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine of Diponegoro University/ Kariadi Hospital, Semarang

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Risk Factors for Orbital Complication in Odontogenic Rhinosinusitis Anna Mailasari Kusuma Dewi; Nourma Wahyu Andriani; Desy Iriani
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.1062

Abstract

Background: Orbital involvement is the most common complication in rhinosinusitis presenting about 60-75%. The manifestation of orbital complications such as eyelid edema, proptosis, eye movement disorder and loss of vision. The potential risk factors for developing complications are described in several studies. Purpose: To examine the risk factors for orbital complication in odontogenic rhinosinusitis. Methods: A retrospective case control study of 34 patients from July 2022 to July 2023 based on medical records. The subjects were classified into two groups, the case group involving odontogenic rhinosinusitis patients with orbital complication and the control group involving patients without orbital complications. Risk factors were sex, onset of odontogenic sinusitis, sinonasal symptoms, diabetes, histopathological findings, laboratory findings and CT scan images of sinus. The characteristics of orbital complications and the types of pathogenic bacteria cultivated were recorded. Results: There number of patients in each group were 17, with the female to male ratio of 2,4:1, aged 8 to 81 years were enrolled in this study. The most common orbital complication was sub periosteal abscess (41%). We found 64% positive bacterial growth from tissue culture dominated by Staphylococcus sp. (54.5%). Histopathological examination showed the main inflammatory cell of the sinus mucosal epithelium was neutrophil in both groups. The logistic regression test showed that the risk factors for orbital complication were absolute neutrophil count p 0.008, OR 81.062, mucopurulent discharge p 0.009, OR 0.006 and sinus involvement p 0.027, OR 0.152. Conclusion: Orbital complications were associated with sinus involvement with main symptom involving mucopurulent discharge and higher absolute neutrophil count.
Correlation Between the Severity Of Chronic Rhinosinusitis and The Degree of Osteitis Based On Computerized Tomography Evaluation Ardiga Israchmadi; Farah Hendara Ningrum; Nurdopo Baskoro; Anna Mailasari Kusuma Dewi
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.1070

Abstract

BACKGROUND: The incidence of chronic rhinosinusitis (CRS) is increasing every year, characterized by inflammation of the nasal and paranasal sinuses mucoperiosteum for more than 12 weeks. The inflammatory process of CRS sometimes spreads to the surrounding bone tissue resulting in osteitis. Computerized tomography scan (CT scan) can assess the degree of mucosal inflammation using the Lund-Mackay score (LMS) while the degree of bone thickening and remodelling are assessed with Global osteitis score (GOS) and Kennedy osteitis score (KOS). AIMS: To evaluate the correlation between CRS severity assessment using LMS and osteitis severity assessment using GOS and KOS METHODS: A retrospective analysis using a cross-sectional design was conducted that included 63 CT scans of the paranasal sinus of CRS patients. The spearman rank test was used to analyze data. RESULTS: Assessment using LMS showed 44% patients were classified as severe, while 29% and 27% patients were classified as moderate and mild respectively. Global osteitis score showed 2% patients were categorized as severe, while 22% and 46% patients were categorized as moderate and mild respectively, and 30% patients were not significant. Based on KOS assessment, it was found that 3% patients were classified as severe, while 38% and 59% patients were classified as moderate mild respectively. There was a significant correlation between CRS severity using LMS and GOS (p 0.000) with rho= 0.951. There was a significant correlation between CRS severity using LMS and KOS (p 0.000) with rho value= 0.452. CONCLUSION: This study shows a significant correlation between CRS severity assessment using LMS and bone thickening and remodelling assessment using GOS and KOS. In comparison with KOS, GOS has stronger relationship with LMS.