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Oto Rhino Laryngologica Indonesiana
Published by Perhimpunan Dokter Spesialis Telinga Hidung dan Tenggorok Bedah Kepala Leher Indonesia
ISSN : 02163667     EISSN : 25983970     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Journal Othorhinolaryngologica Indonesiana is a peer-reviewed and open access journal that focuses on promoting otorhinolaryngology-head and neck surgery that publishes research reports, case reports, and literature reviews, to increase knowledge and updating diagnostics procedurs on otorhinolaryngology-head and neck surgery.
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Hubungan Derajat Kolesteatoma dengan Keberhasilan Mastoidektomi Radikal pada Otitis Media Supuratif Kronis dengan Kolesteatoma Edi Handoko; Dyah Indrasworo; Akhmad Harun Nursalim
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.302

Abstract

Latar belakang: Mastoidektomi radikal merupakan salah satu terapi pembedahan pada OMSK dengan kolesteatoma. Kolesteatom dapat diklasifikasikan melalui sistem TMC (tympanum-mastoid-complication). Telinga yang kering merupakan indikator keberhasilan operasi. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara derajat kolesteatoma pada penderita OMSK dengan kolesteatoma dengan keberhasilan operasi. Metode: Penelitian ini menggunakan desain analitik deskriptif dengan melibatkan 14 penderita OMSK dengan kolesteatoma yang menjalani mastoidektomi radikal di RSUD. Dr Saiful Anwar Malang periode 1 Januari 2017-31 Desember 2018. Derajat kolesteatoma dinilai dari pemeriksaan otoskopi dan atau mikroskop, pemeriksaan foto Schuller, dan temuan operasi. Keberhasilan operasi dilihat dari telinga kering saat evaluasi 2 bulan paska operasi. Analisa statistik  yang digunakan adalah uji Kolmogorov Smirnov dan Mann Whitney. Hasil: Evaluasi hasil mastoidektomi radikal antara derajat kolesteatoma 3 dan 4 memiliki perbandingan frekuensi yang sama dengan p = 1,00 (> 0,05).  Hasil operasi telinga kering adalah 85,6% dan basah 14,4%. Kesimpulan: Tidak terdapat hubungan signifikan antara derajat kolesteatoma pada penderita OMSK dengan kolesteatoma dengan keberhasilan operasi mastoidektomi radikal. Perlu penelitian lebih lanjut dengan sampel yang lebih besar, jenis operasi yang beragam dan periode observasi yang lebih lama untuk mengetahui tingkat rekurensi kolesteatoma.
Hubungan asfiksia perinatal dengan gangguan fungsi sel rambut luar koklea Novi Primadewi; Dewi Pratiwi; Diah Hayustiningsih
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.305

Abstract

Latar belakang: Bayi baru lahir dengan asfiksia perinatal dapat mengalami gangguan fungsi sel rambut luar  pada kokleanya. Tujuan:  Mengetahui   hubungan   asfiksia  perinatal  dengan  gangguan   fungsi  sel rambut luar koklea. Metode: Penelitian analitik observasional dengan desain Case control yang dilakukan di bagian perinatologi RSUD Dr. Moewardi Surakarta, RSUD Karanganyar,          RSUD Wonogiri, dan RSUD Sukoharjo dengan waktu penelitian  pada bulan Oktober 2014 – Januari 2015. Sampel penelitian dipilih dengan cara non probability sampling yaitu dengan teknik consecutive sampling, sebanyak 50 orang yang terdiri dari 25 kelompok kasus dan 25 kelompok kontrol. Diagnosis adanya gangguan fungsi sel rambut luar koklea  ditegakkan dari hasil pemeriksaan fisik THT dan pemeriksaan Distortion Product Otoacoustic Emissions  (DPOAE). Asfiksia perinatal dapat dilihat dengan menggunakan  skor APGAR, sedangkan faktor risiko yang lain dapat dilihat dari  catatan  medis pasien. Analisis statistik menggunakan univariat, bivariat, dengan chi square dan multivariat dengan regresi logistik ganda model faktor risiko. Hasil: Dari 25 kelompok kasus dan 25 kelompok kontrol didapatkan hasil bahwa asfiksia perinatal merupakan faktor risiko yang berpengaruh terjadinya gangguan fungsi sel rambut luar koklea.  Bayi baru lahir yang mempunyai  gangguan fungsi sel rambut luar koklea  dengan  asfiksia perinatal mempunyai faktor risiko 29 kali lebih besar daripada bayi dengan bayi baru lahir tanpa gangguan fungsi sel rambut luar koklea, setelah mengontrol pengaruh dari faktor perancu hiperbilirubinemia dan berat  badan lahir rendah. Hasil tersebut didapatkan bermakana secara statitistik (OR=29,614; CI – 95 % = 5,454 - 160,792; p<0,001). Kesimpulan: Terdapat hubungan antara asfiksia perinatal dengan  gangguan fungsi sel rambut luar koklea. Background: Newborn  with  perinatal  asphyxiae can occur disturbance of  function outer hair cell in the cochlea. Objective: was to know the relationship between the degree of perinatal asphyxiae  with impaired  function  of  outer hair cell. Methods: The study was  an analytic observational study with case control design, that  took a place in perinatology department in Doctor Moewardi hospital Surakarta, General hospital  in  Karanganyar,  General hospital in Wonogiri, General hospital in Sukoharjo. The study started from October 2014 until January 2015. The sample study were selected with consecutive sampling method, with total sample of 50 newborns which consist of 25 case group and 25 control group. Impaired function of outer hair cell  has been diagnosed from ENT examination and  examined with Distortion Product Otoacoustic Emissions  (DPOAE). Perinatal asphyxiae were measured with APGAR score and the other risk factor were collected from the medical record of the patients. Data were analyzed with univariat, bivariat (chi square) and multivariat statistic with double logistic regression. Result: From 25 case group and 25 control group, were found that perinatal asphyxiae was the influence risk factor to the occurrence of impaired function of outer hair cell. Newborns have impaired function  of  outer hair cell with   perinatal asphyxiae will have the risk of twenty nine times higher than newborns without perinatal asphyxiae, after controlling of confounding factors low birth weight, and hyperbilirubinemiae. The results  was statistically significant. (OR = 29,614; CI – 95 % = 5,454 - 160,792; p < 0,001). Conclusion: There has corellated between perinatal asphyxiae and impaired function of outer hair cell.
Communication Ability and Related Factors in Children with Hearing Aids rico doloksaribu; Wijana -
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i2.307

Abstract

Background : Hearing function is very influential on the development of speech and language. Hearing disorders in children can lead to disrupt of communication skills. Hearing aids help provide the development of the ability to hear, talk, and communicate. Some factors such as age, duration of use of hearing aids, and parental activeness in encouraging children to communicate and perform auditory verbal therapy are known have an effect on communication skills.Aim : Knowing the capabilities and related factors of communication  after using of hearing aids in children.Method : Had been done cross sectional study design at the private hearing centre in Bandung in the period January - May 2018. Inclusion criteria for this research is children who use hearing aids which control in the period January-May 2018Result : From  60 subjects that fit with research criteria. There were 35 childrens (58,33%)  who use mix communication, there were 23 childrens (38,33%) in special school. There were 37 childrens (61,67%) who have communication duration more than 6 hours. There were 45 childrens (75%) had routine  frequency of therapy. There were 23 childrens (38,33%) who use AVT&Speech Therapy. A total of 66.67% of subjects had a low PEACH score (< 60), 16.67% had a moderate PEACH score (> 60 - ≤ 75), and 16.66% had a normal PEACH score (> 75). The PEACH score in this study shows an average value of 52.63% with 16.66% had a normal PEACH score (> 75)Conclusion : Caractheristic that have a significant relationship with normal peach score, communication method, educational method, communication duration, frequency of therapy, and type of therapy used (p <0.05 )
Analisis biaya implantasi koklea bilateral simultan dan sekuensial Ratna Dwi Restuti
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.313

Abstract

Latar belakang: Implantasi koklea merupakan tatalaksana pasien dengan ketulian sensorineural bilateral derajat berat atau sangat berat yang tidak terbantu dengan alat bantu dengar konvensional. Pemasangan implan dapat bersifat unilateral atau bilateral, baik secara simultan maupun sekuensial, dengan konsekuensi biaya yang berbeda. Di Indonesia pembiayaan implantasi koklea dapat dilakukan secara pribadi, atau jaminan kesehatan baik jaminan pemerintah (BPJS) maupun non pemerintah (swasta). Tujuan: Untuk mengetahui apakah biaya yang dibutuhkan untuk implantasi koklea simultan lebih efisien dibandingkan biaya implantasi secara sekuensial.Metode: Penelitian dilakukan secara retrospektif pada seluruh pasien yang dilakukan implantasi koklea dalam kurun waktu Januari 2015 hingga September 2019. Data rekam medis dan biaya perawatan dikumpulkan serta ditelaah dan dilakukan pengolahan data secara deskriptif dan analitik. Hasil: Pada penelitian ini didapatkan hasil bahwa pada operasi implantasi koklea secara simultan biayanya lebih efisien dibanding dengan operasi secara sekuensial. Sistem paket pasien BPJS tidak membedakan antara paket biaya pemasangan secara simultan maupun sekuensial. Kesimpulan: Berdasarkan perspektif biaya, pasien implantasi koklea secara simultan lebih efisien dibanding dengan pasien implantasi secara sekuensial.Kata kunci: ketulian sensorineural, implantasi koklea, bilateral simultan, bilateral sekuensial, biayaABSTRACT Background: Cochlear implantation is the management of patients with severe or profound bilateral sensorineural deafness whose hearing capacity does not improved by the assistance of conventional hearing aids. Implants can be unilateral or bilateral, either simultaneously or sequentially inserted with different cost consequences. In Indonesia cochlear implantation costs can be covered by private funding and health insurance, both government (BPJS) and non-government (private) insurance company. Purpose: To find out the more efficient cost between simultaneous and sequential cochlear implantation. Methods: The study was conducted retrospectively on all patients undergoing cochlear implantation in the period of January 2015 to September 2019. Medical record data and treatment costs were collected and reviewed, and data were processed descriptively and analytically. Result: This study revealed that simultaneous cochlear implantation surgery costs more efficient compared with sequential surgery, because the BPJS (government) patient package system does not differentiate between simultaneous and sequential package implantation costs. Conclusion: Based on financial perspective, the simultaneous cochlear implantation was more cost-effective than the sequential surgery.Keywords: sensorineural hearing loss, cochlear implantation, bilateral simultaneous, bilateral sequential, costs
Pengaruh mometasone furoate terhadap kadar Interleukin 6 serum padapenderita hipertrofi adenoid Rus Suheryanto; Surya Parlaungan Harahap; Iriana Maharani
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.314

Abstract

Latar belakang: Inflamasi adenoid ditandai dengan ditemukannya pembesaran ukuran adenoid atau hipertrofi adenoid. Telah banyak dilakukan penelitian yang mendukung IL-6 merupakan dasar patofisiologi terjadinya hipertrofi adenoid sehingga dibutuhkan terapi yang dapat mengurangi peran IL-6. Saat ini, kortikosteroid intranasal menjadi pilihan terapi pada hipertrofi adenoid karena memiliki efek anti inflamasi. Terdapat penelitian mengenai manfaat penggunaan kortikosteroid intranasal terhadap penderita hipertrofi adenoid, dimana terjadi penurunan kadar IL-6, tetapi pengaruhnya terhadap kadar IL-6 serum tidak diteliti. Tujuan: Mengetahui pengaruh pemberian mometasone furoate semprot hidung terhadap kadar IL-6 serum pada penderita hipertrofi adenoid. Metode: One group pre and post test design ini melibatkan 16 subjek. Dilakukan pemeriksaan foto polos skull lateral soft tissue dan pengambilan darah tepi untuk menghitung kadar IL-6 serum. Diberikan terapi mometasone furoatesemprot hidung selama 6 minggu. Setelah 2 minggu dan 6 minggu dilakukan pengambilan darah tepi untuk menghitung kadar IL-6 serum, serta evaluasi foto polos skull lateral soft tissue setelah 6 minggu. Hasil:Terdapat perbedaan bermakna antara kadar IL-6 serum sebelum dan sesudah perlakuan baik, pada minggu kedua maupun minggu keenam (p=0.00). Terdapat perbedaan bermakna antara nilai foto polos skull lateral soft tissue sebelum dan sesudah perlakuan (p=0.00). Berdasarkan uji Pearson, nilai kadar IL-6 serum darah berkorelasi secara signifikan yang bersifat negatif (p<0,05) dengan foto polos skull lateral sebelum dan sesudah perlakuan dengan hasil -0,819 dan -0,692. Kesimpulan: Mometasone furoatesemprot hidung dapat menurunkan kadar IL-6 serum pada penderita hipertrofi adenoid secara bermakna, disertai dengan mengecilnya ukuran adenoid, penurunan gejala dan keluhan penderita hipertrofi adenoid. Kata kunci: Hipertrofi adenoid, Interleukin 6, Mometasone FuroateABSTRACT Background:Adenoid inflammation is characterized by adenoid hypertrophy (AH). Numerous studies had stated that Interleukin 6 (IL-6) is the pathophysiological basis for the occurrence of AH, thus, a therapy is needed to reduce the role of IL-6. Intranasal corticosteroid (IC) is the drug-of-choice for AH for its anti-inflammatory nature. Previous research had shown a decrease in IL-6 levels in adenoid tissue after IC administration, but its effect on IL-6 serum level had not yet been studied. Purpose: To find out the effect of Mometasone Furoate (MF) on IL-6 serum level in AH patients. Methods: One group pre and post test design, involving 16 subjects, underwent a soft tissue skull lateral plain x-ray, also a peripheral blood examination for IL-6 serum level. Afterwards, subjects were treated with MF nasal spray for 6 weeks. The IL-6 serum level was evaluated after 2 and 6 weeks, and the soft tissue x- ray was assessed after 6 weeks. Results: There were significant differences between IL-6 serum levels before and after treatment both in the second and sixth week (p = 0.00). There were significant differences between the value of soft tissue skull lateral plain x-ray before and after treatment (p = 0.00). Based on the Pearson test, IL-6 serum levels correlated significantly negatively (p <0.05) with soft tissue skull lateral plain x-ray before and after treatment with results -0.819 and -0.692. Conclusion: MF nasal spray significantly reduce IL-6 serum levels in AH patients, reducing adenoid size and decreasing symptoms of AH patients.  
Fungus ball paranasal sinuses: pattern of histopathology and culture characteristics Nugroho Suharsono
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.315

Abstract

Background: Fungal infection of the nose and paranasal sinuses is an uncommon condition which is now being increasingly recognized. The clinical presentation is not specific with various symptoms such as nasal obstruction, purulent nasal discharge, facial pain, and chronic cough. Only unilaterality may alert the clinician. Purpose: To find the morphological characteristics of the fungus in patients with paranasal sinus fungus ball. Methods: A retrospective study of 13 paranasal sinus fungus balls cases which underwent endoscopic sinus surgery at Department of Otorhinolaryngology Head and Neck Surgery St. Vincentius A Paulo Hospital Surabaya from March, 2012 until December, 2013. Age, sex, histopathology and fungal cultur were analysed. Histopathologic sections of all the patients were stained with hematoxylin and eosin (H&E), and Gomori methenamine silver (GMS). The specimens were then cultured on Sabouraud dextrose agar plates and incubated at 30°C for 1 month. At the end of the incubation period, the samples were evaluated microscopically to detect fungi and identify their species. Results: The age reported of the 13 patients, was ranging from 36 to 63 years old. There was a significant female predominance, 10 female patients (76.92%) and 3 male patients (23.08%). Histopathological examination showed that most causative agents were Aspergillus species 92.31% (12/13). Culture test was positive for 69.23% (9/13). Aspergillus niger (61.54%, 8/13) is the most frequent fungus reported to cause fungus balls. Conclusion: Pattern of histopathologic on HE and GMS is very helpful and sensitive to identify fungi. The most common isolated mould in our study was Aspergillus niger.Keywords: fungus ball, histopathology and culture, Aspergillus nigerABSTRAK Latar Belakang: Infeksi jamur di hidung dan sinus paranasal merupakan kondisi yang jarang terjadi, namun kini lebih sering ditemukan. Gejala klinisnya tidak spesifik dapat berupa obstruksi hidung, sekret dari hidung, nyeri wajah, dan batuk kronis. Bila terjadi unilateral, patut diwaspadai oleh para klinisi. Tujuan: Untuk mengetahui karakteristik morfologi fungus yang didapati pada pasien sinusitis jamur yang kami teliti. Metode: Dilakukan penelitian retrospektif pada 13 pasien sinusitis jamur yang menjalani bedah sinus endoskopi di Departemen Otorinolaringologi-Kepala Leher Rumah Sakit St. Vincentius A Paulo Surabaya dari bulan Maret 2012 sampai dengan Desember 2013. Dilakukan analisis usia, jenis kelamin, histopatologi dan kultur jamur. Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS). Kemudian spesimen diletakkan pada piring agar Sabouraud dextrose, dan dilakukan inkubasi pada suhu 30°C selama satu bulan. Pada akhir masa inkubasi, sampel dievaluasi dengan mikroskop untuk mendeteksi jamur dan spesiesnya. Hasil: Didapati usia 13 penderita berkisar dari 36-63 tahun. Wanita lebih dominan sebanyak 10 penderita (76,92 %) dan 3 penderita laki-laki (23,08%). Hasil pemeriksaan histopatologi menunjukkan spesies Aspergillus sebagai penyebab utama (92,31%) pada 12 penderita (12/13).Tes kultur positif pada 69,23% (9/13). Jamur yang paling sering menyebabkan bola jamur pada sinus adalah Aspergillus niger (61,54%, 8/13). Kesimpulan: Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS) sangat berguna dan sensitif dalam mendeteksi adanya jamur. Jenis jamur yang paling banyak ditemukan pada penelitian kami adalah Aspergillus niger.
Pengaruh pemberian vitamin E terhadap eosinofil mukosa hidung dan kualitas hidup penderita rinitis alergi Nanchy Christy; Rus Suheryanto; Mohammad Dwijo Murdiyo
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.316

Abstract

Latar belakang: Penyakit rinitis alergi (RA) banyak dijumpai dan memberi dampak negatif terhadap produktivitas, kualitas hidup, gangguan tidur, aktivitas di luar rumah, serta gangguan sekolah pada anak. Vitamin E bekerja sebagai antioksidan pada membran sel dan berikatan dengan radikal bebas dengan cara menghambat peroksidasi Poly Unsaturated Fatty Acid (PUFA). Tujuan: Mengetahui pengaruh vitamin E terhadap jumlah eosinofil mukosa hidung dan perbaikan klinis pada penderita rinitis alergi persisten sedang berat. Metode: Menggunakan Randomized Clinical Trial, double blind, pre and post control group dengan perlakuan pemberian terapi semprot hidung triamcinolone acetonide, cetirizine 10 mg, dan vitamin E 400IU selama 4 minggu. Dilakukan penilaian Visual Analogue Scale (VAS) dan Total Nasal Symptom Score (TNSS), serta pemeriksaan eosinofil mukosa hidung pada awal dan 4 minggu setelah perlakuan. Hasil: Didapatkan perbedaan bermakna antara jumlah eosinofil mukosa hidung sebelum dan sesudah pemberian vitamin E pada kelompok perlakuan (p=<0,001). Penurunan jumlah eosinofil mukosa hidung lebih besar dan bermakna pada kelompok perlakuan dibandingkan dengan kelompok kontrol (p=<0,001). Didapat perbaikan kualitas hidup berdasarkan perbaikan nilai VAS dan TNSS yang bermakna setelah perlakuan pada kelompok kontrol maupun perlakuan (p=<0,001), serta didapatkan perbaikan kualitas hidup berdasarkan nilai VAS dan TNSS pada kedua kelompok dengan selisih nilai perbaikan gejala yang lebih besar pada kelompok perlakuan, namun dari perhitungan statistik tidak didapatkan perbedaan yang bermakna. Kesimpulan: Vitamin E 400IU menurunkan jumlah eosinofil mukosa hidung secara bermakna pada pasien rinitis alergi persisten sedang berat. Perbaikan nilai TNSS pada penggunaan vitamin E 400IU lebih baik dibandingkan subjek yang mendapat plasebo, walaupun tidak berbeda secara bermakna.Kata kunci: rinitis alergi, Vitamin E, Total Nasal Symptom Score ABSTRACT Background: Allergic rhinitis (AR) is an allergic disease frequently found and has a negative impact on productivity, quality of life, sleep disorder, outdoors activities, and school disruption in children. Vitamin E works as an antioxidant in cell membranes through binding free radicals by inhibiting peroxidation of Poly Unsaturated Fatty Acids (PUFA). Purpose: To find out the effect of vitamin E administration on nasal mucosa eosinophil counts and the clinical improvement in patients with moderate severe persistent AR. Methods: A double blind randomized clinical trial, pre and post control group, given therapy of triamcinolone acetonide nasal spray, cetirizine 10 mg, and vitamin E 400 IU orally for 4 weeks. Evaluation by Visual Analogue Scale (VAS) and Total Nasal Symptom Score (TNSS), as well as nasal mucosal eosinophils count at baseline and 4 weeks after treatment. Results: There was a significant difference on the number of nasal mucosal eosinophils before and after vitamin E administration in the treatment group (p = <0.001). A greater and more significant decrease in the number of nasal mucosal eosinophils in the treatment group compared to control group (p = <0.001). Significant improvement of VAS and TNSS after treatment in the control and treatment groups (p = <0.001) and quality of life improvement based on VAS and TNSS values in both control and treatment groups, but the statistical calculations showed no significant differences between the two groups. Conclusion: Vitamin E 400IU significantly reduce the number of nasal mucosal eosinophils in patients with moderate severe persistent AR.
Korelasi ekspresi IL-6 dengan STAT3 pada metastasis penderita KNF WHO tipe 3 LMP-1 positif S. Soehartono; Monika Teresa Prasetyo; Hendradi Surjotomo; Hendy Setyo Yudhanto
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.317

Abstract

Latar belakang: Karsinogenesis karsinoma nasofaring sangat kompleks, dan disebabkan oleh interaksi antara infeksi kronis Epstein-Barr Virus (EBV), faktor lingkungan, dan perubahan genetik serta epigenetik. Latent Membrane Protein (LMP)-1 merupakan antigen utama EBV. LMP-1 diyakini menstimulasi ekspresi sitokin yang memengaruhi perilaku sel epitel, salah satunya adalah Interleukin (IL)- 6. IL-6 akan mengaktivasi jalur Signal Transducer and Activator of Transcription (STAT)3. Peningkatan ekspresi IL-6 dan STAT3 memiliki kaitan erat dalam lingkungan mikro tumor KNF, namun peran IL-6 dan STAT3 dalam modulasi migrasi dan invasi sel KNF masih belum jelas diketahui. Tujuan: Mengetahui korelasi antara ekspresi IL-6 dan ekspresi STAT3 di jaringan nasofaring dengan metastasis penderita KNF WHO tipe III LMP-1 positif. Metode: Penelitian observasional analitik dengan pendekatan cross-sectional yang melibatkan 15 penderita KNF WHO tipe III LMP-1 positif. Pemeriksaan ekspresi LMP-1, IL-6, dan STAT3 menggunakan metode pewarnaan imunohistokimia, dan hasilnya dihitung dengan menggunakan software ImmunoRatio. Penentuan stadium klinis metastasis berdasarkan pemeriksaan klinis dan penunjang radiologis, kemudian dievaluasi nilai TNM menggunakan AJCC 2017. Hasil: Analisis statistik ekspresi IL-6 dan STAT3 menunjukkan korelasi yang signifikan (p=0,020) dengan koefisien korelasi r=0,592. Tidak terdapat perbedaan ekspresi IL-6 yang bermakna di antara penderita stadium III, IVa, dan IVb (p=0,116). Terdapat perbedaan ekspresi STAT3 yang signifikan di antara penderita dengan stadium III, IVa, dan IVb (p=0,038). Kesimpulan: Semakin tinggi ekspresi IL-6 maka ekspresi STAT3 pada jaringan nasofaring penderita KNF WHO tipe III LMP-1 positif semakin meningkat. Semakin tinggi stadium klinis, maka ekspresi STAT3 pada jaringan nasofaring penderita KNF WHO tipe III LMP-1 positif akan meningkat. Kata kunci: karsinoma nasofaring, Virus Epstein-Barr, LMP-1, IL-6, STAT3 ABSTRACT Background:Carcinogenesis of NPC is complex interactions among chronic EBV infection, environmental factors, genetic and epigenetic. LMP-1 is EBV’s antigen most expressed in NPC cases. LMP-1 is believed to stimulate expression of cytokines that affect the behavior of epithelial cells, i.e. Interleukin-6 (IL-6) which will activate the STAT3 pathway. Increased expression of IL-6 and STAT3 has a close relationship in tumor microenvironment of NPC patients, but the role of IL-6 and STAT3 themselves in modulation of migration and invasion of NPC cells are not yet fully understood. Purpose: To find out the correlation between IL-6 expression and STAT3 expression in the nasopharyngeal tissue of NPC patients with LMP-1 positive metastatic WHO type III. Method: Observational analytic study with cross-sectional approach involving 15 patients WHO type III LMP-1 positive NPC patients. Examination of LMP-1, IL-6, and STAT3 using immunohistochemical, and the results were calculated using ImmunoRatio. Clinical staging of metastases based on clinical examination and radiological imaging then synchronized with AJCC 2017. Result: Expressions of IL-6 and STAT3 showed significant correlation (p=0.020) with coefficient r=0.592. There were no differences in IL-6 expression among patients with stage III, IVa, and IVb (p=0.116). There were significant differences in STAT3 expression among patients with stage III, IVa, and IVb (p=0.038). Conclusion: There was a significant positive correlation between IL-6 and STAT3 in tissue from WHO type III LMP-1 positive NPC patients. The higher the clinical stage, the expression of STAT3 in the nasopharyngeal tissue of positive WHO type III LMP-1 NPC patients will increase. 
Validitas, reliabilitas dan adaptasi transkultural Dizziness Handicap Inventory dalam Bahasa Indonesia Jenny Bashiruddin; Widayat Alviandi; Brastho Bramantyo; D. Daneswarry
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.318

Abstract

  Latar belakang: Keluhan gangguan keseimbangan berupa dizziness sulit untuk diukur, sementara itu individu dengan keluhan dizziness sering mengalami kesulitan untuk beraktivitas dan terganggu kualitas hidupnya. Salah satu perangkat yang paling sering digunakan untuk menilai kecacatan (handicap) pasien gangguan keseimbangan adalah kuesioner Dizziness Handicap Inventory (DHI). Sampai sekarang, kuesioner ini belum pernah diadaptasi ke bahasa Indonesia. DHI versi adaptasi yang valid dan handal (reliable) dapat digunakan untuk mengukur kualitas hidup, dan sebagai modalitas untuk menilai efektivitas terapi pasien gangguan keseimbangan. Tujuan: Mendapatkan instrumen DHI adaptasi bahasa Indonesia dengan validitas dan reabilitas yang teruji. Metode: Desain potong lintang digunakan pada studi yang dilaksanakan di poliklinik THT Divisi Neurotologi Departemen THT RS Dr. Cipto Mangunkusumo sejak Agustus 2012 sampai Februari 2013, pada pasien gangguan keseimbangan usia dewasa. Kuesioner DHI yang terdiri dari 25 pertanyaan diterjemahkan ke bahasa Indonesia, kemudian dilakukan terjemahan balik dengan proses validasi dan juga adaptasi kultural. Hasil: Uji validitas dilakukan dengan uji korelasi Spearman dan mendapatkan korelasi yang bermakna pada seluruh butir pertanyaan pada tingkat signifikansi p < 0,1 dengan nilai r sebesar 0,409- 0,783. Uji reliabilitas mendapatkan hasil nilai Cronbach-α total 0,9265 yang sangat baik untuk semua skala. Kesimpulan: Instrumen DHI adaptasi bahasa Indonesia valid dan handal berdasarkan kaidah validasi transkultural WHO sehingga dapat digunakan sebagai instrumen psikometrik untuk menilai kualitas hidup pasien gangguan keseimbangan.Kata kunci: Dizziness Handicap Inventory, gangguan keseimbangan, kecacatanABSTRACT Background: Balance disorder symptoms, such as dizziness is difficult to be assessed, it could caused difficulties in doing daily activities, and declining the quality of life. The most frequent tools used to measure handicap in patients with balance disorder is Dizziness Handicap Inventory (DHI). This questionnaire has never been adapted to Indonesian language. A valid and reliable version of the DHI adaptation can be used to measure the quality of life and also as a modality for assessing the effectiveness of therapeutic outcomes in balance disorders patients. Purpose: To obtain an Indonesian adaptation of DHI instrument which is valid and reliable. Methods: A cross-sectional research design in Outpatient Clinic of Neurotology Division, Department of Otorhinolaryngology, Cipto Mangunkusumo General Hospital, from August 2012 to February 2013. Respondents were all adult patients with balance disorders. DHI questionnaire contained 25 questions was translated into Indonesian language and re-translated with validation process and cultural adaptation. Results: The validity test was carried out with Spearman correlation test and obtained a significant correlation on all questions at a significance level of p<0.1 with r value of 0.409-0.783. The reliability test obtained a Cronbach-α value of 0.9265 which was very good for all scales. Conclusion: The Indonesian adaptation of DHI instrument was valid and reliable based on WHO transcultural validation rules, therefore it can be used as a psychometric instrument to assess the quality of life of patients with balance disorders.
Communication ability and related factors in children with hearing aids W. Wijana; Rico Doloksaribu
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.319

Abstract

Background:Hearing function is very significant in the development of speech and language. Hearing disorders in children can lead to communication skill disturbance. Hearing aids can help to support the development of hearing, talking, and communication abilities. Several factors such as age, duration of using hearing aids, and parental participation in encouraging children to communicate and undergo auditory verbal therapy, are recognized to have impacts on communication skills. Aim:To find out communication capabilities and related factors after using hearing aids in children. Method:A cross sectional study was performed at a private hearing center in Bandung. Inclusion criteria was children using hearing aids who were doing follow-up in the period January-May 2018. Result: From 60 research subjects, there were 35 (58.33%) who used mixed communication, and 23 (38.33%) were in special school. There were 37 (61.67%) who had more than 6 hours communication, 45 (75%) underwent routine therapy, and 23 (38.33%) underwent Auditory Verbal Therapy (AVT) and Speech Therapy. The assessment was using PEACH (Parents’ Evaluation of Aural/oral performance of Children) score. A total of 66.67% subjects had a low (<60) PEACH score, 16.67% had a moderate (>60 - ≤75) PEACH score, and 16.66% had a normal (>75) PEACH score. The PEACH score in this study showed an average value of 52.63% with 16.66% had a normal (>75) PEACH score. Conclusion:Specific characters that had significant correlation with normal PEACH score were communication method, educational method, communication duration, frequency of therapy, and type of therapy (p <0.05). Keywords: PEACH score, hearing aid, communication, children ABSTRACT Latar Belakang: Fungsi pendengaran sangat berpengaruh pada perkembangan bicara dan bahasa. Gangguan pendengaran pada anak dapat menyebabkan gangguan komunikasi. Alat bantu dengar menunjang mengembangkan kemampuan mendengar, berbicara, dan berkomunikasi. Beberapa faktor seperti usia, lamanya penggunaan alat bantu dengar, dan keaktifan orang tua dalam mendorong anak untuk berkomunikasi dan melakukan terapi verbal pendengaran diketahui memiliki dampak pada keterampilan komunikasi. Tujuan: Mengetahui kemampuan komunikasi dan faktor yang memengaruhi setelah menggunakan alat bantu dengar pada anak-anak. Metode: Telah dilakukan penelitian cross sectional di sebuah Klinik Pusat pendengaran di Bandung pada periode Januari-Mei 2018 . Kriteria inklusi untuk penelitian ini adalah anak yang menggunakan alat bantu dengar, yang melakukan kontrol pada periode Januari-Mei 2018. Hasil: Dari 60 subjek yang sesuai dengan kriteria penelitian, terdapat 35 anak (58,33%) yang menggunakan komunikasi campuran, dan 23 anak (38,33%) mengikuti pendidikan di sekolah khusus. Ada 37 anak (61,67%) yang memiliki durasi komunikasi lebih dari 6 jam, 45 anak (75%) rutin dalam terapi, dan 23 anak (38,33%) yang menggunakan terapi Auditory Verbal Therapy (AVT) dan terapi wicara. Penilaiannya menggunakan skor PEACH (Parents’ Evaluation of Aural/ oral performance of Children). Sebanyak 66,67% subjek memiliki skor PEACH rendah (<60), 16,67% memiliki skor PEACH sedang (> 60 - ≤ 75), dan 16,66% memiliki skor PEACH normal (> 75). Skor PEACH dalam penelitian ini menunjukkan nilai rata-rata 52,63% dengan 16,66% memiliki skor PEACH normal (>75). Kesimpulan: Karakteristik yang memiliki hubungan yang signifikan dengan skor PEACH normal adalah metode komunikasi, metode pendidikan, durasi komunikasi, frekuensi terapi, dan jenis terapi yang digunakan (p<0,05). 

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