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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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Articles 493 Documents
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Pengaruh N–asetilsistein terhadap transpor mukosilia tuba Eustachius penderita otitis media supuratif kronis tanpa kolesteatoma Ajeng Putika Sari; Johanes Bambang Soemantri; Endang Retnoningsih
Oto Rhino Laryngologica Indonesiana Vol 45, No 2 (2015): Volume 45, No. 2 July - December 2015
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (323.684 KB) | DOI: 10.32637/orli.v45i2.113

Abstract

 Latar belakang: Otitis Media Supuratif Kronik (OMSK) adalah radang telinga tengah dengan perforasi membran timpani dan keluarnya sekret lebih dari 2 bulan. Pengobatan OMSK saat ini masih belum memuaskan. Peneliti mengharapkan dengan kelebihan dari N–asetilsistein (NAC) dapat memperbaiki transpor mukosilia tuba Eustachius. Tujuan: Penelitian ini bertujuan membandingkan waktu transpor dan penurunan waktu transpor mukosilia tuba Eustachius penderita OMSK tanpa kolesteatoma sebelum dan setelah diberikan pengobatan, baik pada kelompok pemberian NAC maupun pada kelompok kontrol. Metode: Uji klinis pada 24 subjek penelitian dengan desain penelitian non randomized double blind pre post test control group dengan pendekatan cohort. Hasil: Waktu transpor mukosilia yang dinilai dengan siprofloksasin pada kelompok pemberian NAC sebelum pengobatan sebesar 683,00 detik dan setelah pengobatan sebesar 279,83 detik dengan rerata selisih sebesar 403,17 detik, sedangkan pada kelompok kontrol sebelum pengobatan 538,33 detik dan sesudah pengobatan 225,00 detik dengan rerata selisih sebesar 313,33 detik. Pada penilaian dengan Methylene blue (MB) pada kelompok pemberian NAC sebelum pengobatan sebesar 118,50 detik dan setelah pengobatan sebesar 244,25 detik dengan rerata selisih sebesar 125,75 detik, pada kelompok kontrol sebelum pengobatan 100,67 detik dan sesudah pengobatan 38,33 detik dengan rerata selisih sebesar 62,33 detik. Kesimpulan: Tidak didapatkan perbedaan yang bermakna pada waktu transpor dan penurunan waktu transpor mukosilia tuba Eustachius penderita OMSK tanpa kolesteatoma sebelum dan setelah diberikan pengobatan NAC baik pada kelompok pemberian NAC maupun kelompok kontrol. Kata kunci: OMSK tanpa kolesteatoma, transpor mukosilia, N-asetilsisteinABSTRACT Background: Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of the middle ear with tympanic membrane perforation and discharges, for more than 2 months. Treatment of CSOM is still unsatisfactory. We hoped that N–acetylsistein (NAC) could improve the mucociliary transport of Eustachian tube. Purpose: To compare mucociliary transport time and the decrease of Eustachian tube mucociliary transport time in patients after and before treatment between NAC treated group and control group. Method: This was a randomized double blind pre and post test control group clinical trial with cohort approach involving 24 subjects. Result: Mucociliary transport time subjectively in NAC-treated group before and after NAC therapy were 683,00 seconds and 279,83 seconds respectively, with mean difference -403,17 seconds. Mucociliary transport time in control group before and after therapy were 538,33 seconds and 225,00 seconds respectively, with mean difference -313,33 seconds. Mucociliary transport time objectively in NAC-treated group before and after NAC therapy were 118,50 seconds and 244,25 seconds respectively, with mean difference -125,75 seconds. Mucociliary transport time in control group before and after therapy were 100,67 seconds and 38,33 seconds respectively, with mean difference -62,33 seconds. Conclusion: There was no significant difference of mucociliary transport time and the decrease of mucociliary transport time of Eustachian tube in CSOM without cholesteatoma before and after NAC treatment in both of group Keywords: CSOM without cholesteatoma, mucociliary transport, N-acetylcysteine
Terapi necrobiotic xanthogranuloma dengan siklofosfamid-metilprednisolon Lesmono, Bayu; Dewi, Yussy Afriani; Ratunanda, Sinta Sari; Aroeman, Nur Akbar
Oto Rhino Laryngologica Indonesiana Vol 46, No 2 (2016): Volume 46, No. 2 July - December 2016
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1439.852 KB) | DOI: 10.32637/orli.v46i2.168

Abstract

Latar belakang: Necrobiotic xanthogranuloma (NXG) merupakan suatu penyakit yang langka, kronis, dan progresif. NXG ditandai dengan lesi kulit ulseratif pada daerah indurasi, dan berwarna kuning, atau berupa nodul yang mengenai sel histiosit non Langerhans. Daerah predileksi tersering ialah pada wajah, orbita, dan ekstremitas. Etiologi belum diketahui, tetapi sering dikaitkan dengan monoclonal gammopathy. Gambaran histopatologi NXG yaitu ditemukan makrofag dan terdapat sel busa pada dermis, jaringan subkutan, nekrobiosis luas, sel datia Touton, dan folikel limfoid. Penderita memiliki lesi yang bersifat asimtomatik, parestesi, rasa terbakar, dan terkadang timbul rasa nyeri. Tata laksana NXG sampai saat ini masih sangat bervariasi. Tujuan: Memaparkan hasil penatalaksanaan dua pasien NXG. Laporan kasus: Dilaporkan pasien pertama, laki-laki 44 tahun dengan lesi pada kedua pipi dan dahi sejak 5 bulan sebelumnya. Terapi diberikan metilprednisolon dengan dosis 0,8 mg/kgBB tappering off selama 1 bulan dengan hasil perbaikan. Pasien kedua, wanita 29 tahun dengan lesi pada kedua pipi dan telinga sejak 5 bulan sebelumnya. Terapi diberikan siklofosfamid 750 mg/m2 per 3 minggu dengan hasil membaik. Metode: Pencarian dilakukan melalui PubMed dan Dermatol. Setelah menyaring judul dan abstrak yang sesuai dengan kriteria inklusi dan eksklusi, didapatkan lima artikel utuh. Kemudian, tiga artikel terpilih untuk ditelaah secara konsensus, meliputi kesahihan (validity), kepentingan (importancy), dan aplikabilitas (applicability) pada pasien necrobiotic xanthogranuloma. Hasil: Telaah artikel-artikel tersebut menunjukkan bahwa semua artikel memiliki karakteristik yang serupa dalam hal kesahihan (validity), hasil atau kesimpulannya. Walau demikian, ada beberapa kekuatan dan kelemahan pada masing-masing artikel. Kesimpulan: Penatalaksanaan NXG masih diperlukan penelitian lebih lanjut dengan jumlah sampel yang banyak untuk mengetahui keefektifitasan penatalaksanaan NXG.Kata kunci: Siklofosfamid, metilprednisolon, necrobiotic xanthogranulomaABSTRACT Background: Necrobiotic Xanthogranuloma (NXG) is a rare, chronic, and progressive disease that provokes skin lesions, such as damage of the histiocytes of non-Langerhans cell, skin lesions (yellowish or noduled ulcerative lesions) in the induration skin. The most common predilection areas of this are on the face, orbital, and extremities. The etiology is still unknown, but sometimes associates with monoclonal gammopathy. NXG histopathologic contained macrophages and foam cells in the dermis, subcutaneous tissue, extensive necrobiosis, touton giant cells, and lymphoid follicles. Some patients who had lesions are asymptomatic, sometimes they will feel paresthesias, burning pain. Nowadays, this management is still vary widely. Objective: Sets forth the results of two patients NXG. Case: There were two patients. Patient number one, a 44-years-old man, with some lesions on both cheeks and forehead since 5 months ago. He was treated with methylprednisolon 0.8 mg/kg body weight, and tappered off for a month with improved results. Patient number two, a 29-years-old woman, with some lesions on both cheeks and ears since 5 months ago. She was treated with Cyclosphosphamide 750 mg/m2 with improved results within three weeks. Method: Searching for literature was conducted in PubMed and Dermatol. After screening titles and abstracts with inclusion and exclusion criteria, five articles were available as full texts. Three articles were selected to be reviewed for their validity, importancy and applicability in patient with necrobiotic xanthogranuloma. Results: The review showed that all those articles had a similar characteristic in validity, result, and conclusion. Nevertheless, each articles had its own strong points and weaknesses. Conclusion: NXG treatment still required further research by the number of samples that much to find out the efficiency management NXG.Keywords: Cyclophosphamide, methylprednisolon, necrobiotic xanthogranuloma
Pengaruh ekspresi p53 dan HIF1 terhadap peningkatan laktat jaringan nasofaring pada pasien karsinoma nasofaring Kurniawan, Jemmy; Rahaju, Pudji; Soehartono, Soehartono
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.431 KB) | DOI: 10.32637/orli.v48i1.258

Abstract

Latar Belakang: Karsinoma nasofaring (KNF) merupakan keganasan tersering pada kepala dan leher. Pilihan terapi KNF adalah radioterapi dan kemoterapi yang berhubungan dengan toksisitas, resistensi obat, dan rekurensi. Intervensi metabolik yang didasarkan pada perubahan metabolisme sel kanker merupakan salah satu strategi terapi kanker pada saat ini. Untuk dapat mengetahuinya perlu dipahami pengaruh ekspresi p53 dan hypoxia-inducible factor 1 (HIF1) terhadap peningkatan kadar laktat jaringan nasofaring pada pasien KNF. Tujuan: Mengetahui pengaruh ekspresi p53 dan HIF1 terhadap peningkatan kadar laktat jaringan nasofaring, dan untuk mengetahui kesesuaian antara kadar laktat darah dengan laktat jaringan nasofaring. Metode: Penelitian cross sectional melibatkan 10 subjek, dilakukan biopsi nasofaring dengan tuntunan nasoendoskopi untuk pemeriksaan histopatologi, ekspresi p53 dan HIF1 dengan imunohistokimia, laktat jaringan nasofaring dengan colorimetric, dan laktat darah. Hasil: Seluruh subjek mengalami peningkatan ekspresi p53 dan HIF1 dengan rerata p53 19,53±7,37 dan HIF1 24,30±12,28. Seluruh subjek penelitian memiliki kadar laktat jaringan meningkat, dengan rerata kadar laktat 0,67±0,39. Kadar laktat darah subjek cenderung meningkat dengan rerata 2,93±0,65. Terdapat pengaruh peningkatan ekspresi p53 terhadap peningkatan kadar laktat jaringan (p=0,002). Terdapat pengaruh peningkatan ekspresi HIF1 terhadap peningkatan kadar laktat jaringan (p=0,042). Tidak terdapat kesesuaian antara kadar laktat darah dengan laktat jaringan nasofaring (p=0,000). Kesimpulan: Peningkatan ekspresi p53 dan HIF1 berpengaruh terhadap peningkatan kadar laktat jaringan nasofaring pada pasien KNF, namun kadar laktat darah tidak menggambarkan kadar laktat jaringan nasofaring. ABSTRACTBackground: Nasopharyngeal carcinoma (NPC) is the most frequent malignancy of the head and neck. The options of NPC therapy are radiotherapy and chemotherapy, associated with toxicity, drug resistance, and recurrence. Metabolic intervention based on changes in cancer cell metabolism is currently one of the strategies of cancer therapy. Aim: To determine the impact of p53 and hypoxia-inducible factor 1 (HIF1) expression on elevated lactate levels of nasopharyngeal tissue, and to determine the compatibility between blood lactate and nasopharyngeal tissue lactate levels in patients with NPC. Method: This cross-sectional study involved 10 subjects who underwent nasopharyngeal biopsy for histopathologic examination, p53 and HIF1 expression using immunohistochemistry, lactate of nasopharyngeal tissue using colorimetric, and blood lactate. Results: All subjects had increased expression of p53 and HIF1 with p53 mean of 19.53±7.37 and HIF1 mean of 24.30±12.28. All subjects had elevated tissue lactate levels, with lactate levels mean of 0.67±0.39. The blood lactate level of the subjects increased, with blood lactate level mean of 2.93±0.65. There was a significant increasing impact of p53 expression on tissue lactate elevated level (p=0.002) and a significant increasing impact of HIF1 expression on tissue lactate elevated level (p=0.042). There was no correlation between lactate levels of blood lactate and nasopharyngeal tissue (p=0.000). Conclusion: Increased expression of p53 and HIF1 had an effect on increased levels of lactate nasopharyngeal tissue in NPC patients, but blood lactate levels did not have a correlation with lactate levels of nasopharyngeal tissue.
Hubungan rinitis alergi dan disfungsi tuba Eustachius dengan menggunakan timpanometri Rambe, Andrina Yunita Murni; -, Fadhlia; Munir, Delfitri; Haryuna, Tengku Siti Hajar; Eyanoer, Putri Chairani
Oto Rhino Laryngologica Indonesiana Vol 43, No 1 (2013): Volume 43, No. 1 January - June 2013
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (213.294 KB) | DOI: 10.32637/orli.v43i1.20

Abstract

Latar belakang: Rinitis alergi merupakan masalah kesehatan global dengan prevalensi yang terusmeningkat serta dapat berdampak pada penurunan kualitas hidup penderitanya. Ko-morbiditas rinitis alergi salahsatunya adalah otitis media yang sangat erat hubungannya dengan gangguan fungsi tuba Eustachius yangberkaitan dengan tekanan telinga tengah. Tujuan: Mengetahui hubungan rinitis alergi dengan disfungsi tubaEustachius dengan menggunakan timpanometri. Metode: Satu studi kasus-kontrol. Disfungsi tuba ditentukandengan pemeriksaan timpanometri (MEP negatif/<-25 daPa) dan hasil tes fungsi tuba (ETF) yang tidak baik.Analisis hasil dengan uji Chi-square dan regresi logistik. Hasil: Penelitian ini melibatkan 60 sampel. Tipetimpanogram terbanyak pada kedua kelompok yaitu tipe A, dimana kelompok RA tipe A sebesar 73,3% (rerataMEP -40,8 daPa), tipe As 10%, tipe Ad dan tipe B masing-masing 3,3%, tipe C 10%. Kelompok kontrol tipe Asejumlah 93,3% dan tipe As 6,7%. Pada kelompok kasus 83,3% hasil tes fungsi tuba abnormal dan 16,7%normal, sedangkan kelompok kontrol yaitu 93,3% normal dan 6,7% abnormal. Uji chi-square menunjukkanperbedaan yang signifikan antara klasifikasi RA dan disfungsi tuba Eustachius (p=0,006) dan perbedaan yangsignifikan antara jenis alergen dan disfungsi tuba Eustachius (p=0,041). Hasil uji multivariat terdapat bahwa tiperinitis alergi berpengaruh tiga kali lebih besar terhadap disfungsi tuba Eustachius (OR 2,9; 95% IK: 1,52-241,90dan nilai p=0,022) sedangkan jenis alergen dua kali lebih berpengaruh terhadap disfungsi tuba dengan OR 2,2;95% IK: 0,01-7,31 dan nilai p=0,295. Kesimpulan: Rinitis alergi memiliki kemungkinan 3 kali lebih seringmengalami disfungsi tuba Eustachius dari pada kelompok kontrol OR:2,5 (95% CI 2,36-2,99) P=0,000.Kata kunci: rinitis alergi, disfungsi tuba Eustachius, rerata tekanan telinga.ABSTRACTBackground: Allergic rhinitis is a global health problem with increasing prevalence and can have impacton the quality of life of sufferers. One of co-morbidity of allergic rhinitis is otitis media which is closely relatedto Eustachian tube dysfunction, associated with middle ear pressure. Purpose: To determine the relationshipbetween allergic rhinitis and Eustachian tube dysfunction, using tympanometry. Methods: A case-control study.Tubal dysfunction was determined with tympanometry (MEP negative / <-25 Dapa) and tubal function test resultwas not good (≤15 daPa). Chi-square test and logistic regression analysis used for data analysis. Results: Therewere 60 samples. The most common tympanogram type in both groups were type A, which AR group was 73.3%(mean -40.8 daPa MEP), type As 10%, type ad and type B respectively 3.3%, type C 10.0% and control groupstype A 93.3%, type As 6.7%. In AR group, 83.3% showed abnormal tubal function and 16.7% was normal. As incontrol group, 93.3% was normal and 6.7% was abnormal. Chi-square test showed a significant differencebetween AR classification and Eustachian tube dysfunction (p = 0.006), and also between type of allergens andEustachian tube dysfunction (p= 0.0041). Multivariate test revealed AR classification contributed to Eustachiantube dysfunction OR:2.9 (95% CI 1.52-241.90) p=0.022, not between type of allergens and Eustachian tubedysfunction OR:2.2 (95% CI 0.01-7.31) p=0.295. Conclusion: Allergic rhinitis contributes three times higher toEustachian tube dysfunction than the control group. OR: 2.5 (95% CI 2.36-2.99) p= 0.000.Keywords: allergic rhinitis, Eustachian tube dysfunction, Mean Ear Pressure.
Gambaran ekspresi reseptor estrogen β pada angiofibroma nasofaring belia dengan menggunakan pemeriksaan imunohistokimia Anggreani, Lenny; Adham, Marlinda; Musa, Zanil; Lisnawati, Lisnawati; Bardosono, Saptawati
Oto Rhino Laryngologica Indonesiana Vol 41, No 1 (2011): Volume 41, No. 1 January - June 2011
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.846 KB) | DOI: 10.32637/orli.v41i1.53

Abstract

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign hormonal related fibrovascular tumor which originates from superoposterior area of sphenopalatine foramen. Purpose: To determineER-ß expression of JNA patient at Cipto Mangunkusumo Hospital. Method: Descriptive study to determine ß-estrogen receptor (ER-ß) on 27 JNA patients who had been treated at Oncology Division ENT Departement Cipto Mangunkusumo Hospital between 2001-2008 was conducted. Results: ER-ß expression of JNA in this study is 100%. Based on ER-ß staining intensity, 18.5% gave strong intensity, 29.6% with moderate intensity, and 51.9% with weak intensity. According to positive ER-ß cellular, it consist of three groups: less than 25% positive, 25-50% positive, and more than 50% positive, and the result is 3.7%, 3.7%, and 92.6% respectively. Conclusion: Immunohistochemical examination revealed 100% ER-ß expression. Keywords: Juvenile nasopharyngeal angiofibroma (JNA), ER-ß expression   Abstrak :  Latar belakang: Angiofibroma nasofaring belia (ANB) adalah suatu tumor fibrovaskular jinak, berasal dari area superoposterior foramen sfenopalatina dan diduga berhubungan erat dengan faktor hormonal. Tujuan: Melihat gambaran ekspresi ER-ß pada penderita ANB di RS. Cipto Mangunkusumo. Metode: Penelitian deskriptif untuk melihat gambaran ekspresi reseptor estrogenß (ER-ß) pada 27 kasus angiofibroma nasofaring belia (ANB) yang berobat dari tahun 2001 hingga 2008 di Divisi Onkologi Departemen Telinga Hidung Tenggorok RS. Cipto Mangunkusumo. Hasil:Didapati ekspresi ER-ß pada ANB sebesar 100%. Berdasarkan intensitas pewarnaan terhadap ER-ß didapatkan 18,5% mempunyai intensitas pewarnaan yang kuat, 29,6% intensitas pewarnaannya sedang dan 51,9% memiliki intensitas pewarnaan yang lemah. Tiga koma tujuh persen termasuk kelompok dengan jumlah sel yang positif mengandung ER-ß kurang dari 25%, 3,7% termasuk kelompok dengan jumlah sel 25-50%, dan 92,6% termasuk kelompok dengan jumlah sel yang positif mengandung ER-ß>50%. Kesimpulan: Hasil pemeriksaan imunohistokimia menunjukkan ekspresi ER-ß pada semua kasus (100%). Kata kunci: angiofibroma nasofaring belia (ANB), tumor fibrovaskuler, ekspresi ER-ß
Diagnosis of occupational rhinitis to dust and gasses using peak nasal inspiratory flow Deasi Anggraini; Retno Sulistyo Wardani; Nina Irawati; Muchtarudin Mansyur; Rahajoe Dharmaningsih; De-Yun Wang
Oto Rhino Laryngologica Indonesiana Vol 44, No 2 (2014): Volume 44, No. 2 July - December 2014
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (406.084 KB) | DOI: 10.32637/orli.v44i2.91

Abstract

Background: The recent development in technology and industry has increased the incidence of occupational disorders of which eventually affect the productivity and cost of related industries. Whether the products or the waste-materials are harmful to airway function, it needs to be investigated. Purpose: To study the incidence of occupational \rhinitis (OR) caused by exposure of sodium lauryl sulfate dust and irritant gases in the workplace. Methods: In this prospective study, 115 industrial workers who were exposed daily to multi–irritant material were investigated with questionnaire, anterior rhinoscopy, nasal endoscopy, peak nasal inspiratory flow (PNIF) meter, skin prick test, and nasal mucous scrapping before (V1) and after 8 hours (V2) work. The diagnosis of OR was made when symptoms of rhinitis worsened on workdays and a decrease of PNIF (≥20%) at V2. In addition, hours of daily exposure to irritant, years of working, improper usage of personal protection device (nasal and oral mask), and smoking were assessed by bivariate and multivariate analysis. Result: 32 workers of 115 (27.8%) were diagnosed as OR based on increased rhinitis symptoms during workdays and decreased PNIF after work. Incidence of OR increased in workers who had worked >10 years=2.15 (IC 95%:1.19-3.87, p=0.009) and who did not use personal protective equipment properly (p=0.04, RR:2.3, IC 95%:1.29-4.28). Conclusion: Exposure to occupational reagent such as sodium lauryl sulfate dust and multi-irritant gasses was a causal factor of OR. A proper perusal of personal protection equipment (PPE) is mandatory in workplace to minimize the risk of developing OR. Keywords: Occupational rhinitis, nature exposure of occupational agents, peak nasal inspiratory flow,nasal obstruction, personal protection equipment. ABSTRAKLatar belakang: Kemajuan teknologi dan industri akhir-akhir ini, meningkatkan pemaparan saluran napas terhadap produk atau sisa industri yang merupakan zat iritan. Sebagai akibatnya, insidens kelainan akibat kerja semakin meningkat, yang dapat mempengaruhi produktivitas dan peningkatan beban biaya industri. Seberapa besar pengaruhnya terhadap fungsi saluran napas, hal ini masih perlu diteliti lebih lanjut. Tujuan: Penelitian dilakukan untuk mengetahui insidens Rinitis Akibat Kerja (RAK) yang diakibatkan pajanan debu sodium lauryl sulfate dan gas iritan di tempat kerja. Metode: Pada studi prospektif ini, 115 pekerja yang terpajan setiap hari dengan material multi-iritan diteliti berdasarkan kuesioner, pemeriksan rinoskopi anterior, nasoendoskopi, Peak Nasal Inspiratory Flow (PNIF) meter, uji cukit kulit dan kerokan mukosa hidung sebelum (V1) dan sesudah 8 jam (V2) bekerja. Diagnosis RAK ditegakkan jika didapati perburukan gejala hidung disertai dengan penurunan (>20%) hasil PNIF pada V2. Sebagai tambahan, waktu pajanan iritan (jam), masa kerja (tahun), penggunaan alat perlindungan diri (APD) seperti masker hidung dan mulut secara kurang benar, serta kebiasaan merokok dianalisis dengan analisis bivariat dan multivariat (model regresi logistik). Hasil: 32 dari 115 pekerja (27,8%) didiagnosis sebagai RAK berdasarkan perburukan gejala hidung selama bekerja dan penurunan PNIF sesudah bekerja. Insidens RAK meningkat pada pekerja yang telah bekerja lebih dari 10 tahun=2.15 (95% IK:1,19–3,87, p=0,009) dan para pekerja yang tidak menggunakan APD (masker hidung dan mulut) secara benar, yaitu (p=0,04, RR: 2.4, 95% IK:1,29–2,48). Kesimpulan: Pajanan bahan kimia seperti debu sodium lauryl sulfate dan berbagai gas iritan merupakan faktor penyebab RAK. Penggunaan APD secara benar adalah mutlak untuk menurunkan risiko terjadinya RAK. Kata kunci: Rinitis akibat kerja, pajanan alamiah bahan berbahaya di tempat kerja, peak nasal inspiratory flow, hidung tersumbat, alat pelindung diri
Photodynamic therapy (PDT) pada penderita karsinoma nasofaring: kajian angka harapan hidup Indrasari, Sagung Rai; Hariwiyanto, Bambang; Astuti, Indwiani; Sastrowijoto, Soenarto
Oto Rhino Laryngologica Indonesiana Vol 46, No 1 (2016): Volume 46, No. 1 January - June 2016
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4753.572 KB) | DOI: 10.32637/orli.v46i1.145

Abstract

Latar belakang: Terapi karsinoma nasofaring (KNF) yang adekuat dan efektif tidak selalu tercapaidi negara berkembang. Ketersediaan alat radioterapi yang tidak seimbang dengan jumlah penderita KNFmenyebabkan keterlambatan jadwal terapi, sehingga berakibat pada buruknya hasil terapi. Alternatifterapi lain perlu dikembangkan untuk mengatasi permasalahan tersebut. Photodynamic therapy (PDT)telah digunakan untuk terapi tambahan pada berbagai kanker, termasuk KNF residu maupun rekuren.Tujuan: Mengetahui respon terapi lokal dan angka harapan hidup 5 tahun penderita KNF residu ataurekuren yang mendapatkan PDT.Metode: Kohort retrospektif dengan data rekam medis penderita KNFresidu atau rekuren yang mendapatkan PDT di Departemen THT-KL RSUP Dr. Sardjito Yogyakarta tahun2005–2011.Hasil: Local response rate sebesar 83,9% dan angka harapan hidup 5 tahun penderita sebesar60,7%. Angka harapan hidup 5 tahun penderita laki-laki lebih tinggi (73,5%) dibandingkan penderitaperempuan (42,2%), perbedaan ini bermakna secara statistik (p=0,045). Angka harapan hidup 5 tahunpenderita berusia <40 tahun lebih tinggi (76,2%) dibandingkan penderita berusia > 40 tahun (53,0%),meskipun tidak signifikan (p=0,417). Angka harapan hidup penderita yang masih terdapat tumor padanasofaring lebih baik (80%) dibandingkan penderita dengan hasil biopsi nasofaring negatif (57,8%),namun tidak signifikan (p=0,638). Angka harapan hidup penderita berdasarkan stadium saat ditegakkandiagnosis KNF, penderita stadium awal mempunyai angka harapan hidup lebih kecil (53,3%) dibandingkanpenderita stadium lanjut (62,1%), meskipun tidak signifikan (p=0,521).Kesimpulan: Local responserate PDT 83,9% dan angka harapan hidup 5 tahun sebesar 60,7%. PDT merupakan modalitas terapi yangefektif untuk KNF residu maupun rekuren. Kata kunci: Karsinoma nasofaring, photodynamic therapy, angka harapan hidup ABSTRACTBackground: Adequate and effective nasopharyngeal carcinoma (NPC) treatment cannot bereached in developing countries. The lack of radiotherapy apparatus cause delayed treatment thatbring about bad treatment results. An alternative treatment modality should be created to overcome theproblem. Photodynamic therapy (PDT) has been conducted for many malignancies including recurrentor residual NPC. Purpose: To find out the local response rate and 5-year overall survival amongrecurrent or residual NPC patients who got PDT. Method: Retrospective cohort, data was taken frommedical records of patients with PDT in ENT-H&N Surgery Department Sardjito Hospital since 2005until 2011. Results: Local response rate was 83.9%. Five-year overall survival was 6.7%. The 5-yearoverall survival among men was significantly higher than women (73.5%:42.2%) p=0.045. The 5-yearoverall survival among patients <40 years old was higher than patients > 40 years old (76.2%:53.0%)even though it was not significant (p=0.417). The 5-year overall survival among patients with tumor washigher than patients without tumor (80%:57.8%) although it was not significant (p=0.638). The 5-yearoverall survival among patients with previous early stage NPC was lower than previous advanced stage (53.3%:62.1%) although it was not significant (p=0.521). Conclusion: Local response rate of PDT was83.9% and the 5-year overall survival was 60.7%. PDT was found as an effective treatment modalityfor recurrent or residual NPC. Keywords: Nasopharyngeal carcinoma, photodynamic therapy, 5-year overall survival
Hubungan ototoksisitas dan kemoterapi neoadjuvan pada karsinoma nasofaring berdasarkan ASHA, CTCAE, dan DPOAE Putri, Meyrna Heryaning; Rahaju, Pudji; Indrasworo, Dyah
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (380.65 KB) | DOI: 10.32637/orli.v47i2.219

Abstract

Latar belakang: Kemoterapi neoadjuvan adalah induksi kemoterapi sebelum radioterapi dengan regimen cisplatin dan 5-Fluorouracil. Kemoterapi cisplatin bersifat ototoksik pada pendengaran sensorineural bilateral progresif dan bersifat irreversible. Kriteria dari American Speech-Language Hearing Association (ASHA) dan Common Terminology Criteria for Adverse Events (CTCAE) merupakan kriteria untuk mengidentifikasi ototoksisitas dengan menggunakan audiometri, selain pemeriksaan Distortion Product Otoacoustic Emissions (DPOAE). Tujuan: Mengidentifikasi hubungan ototoksisitas dengan kemoterapi neoadjuvan pada penderita karsinoma nasofaring (KNF) WHO tipe III menggunakan ASHA, CTCAE, serta DPOAE. Metode: Studi ini adalah penelitian observasional dengan desain cohort. Kriteria inklusi penelitian yaitu penderita baru KNF WHO tipe III, yang mendapatkan kemoterapi regimen standar dan berusia <60 tahun. Kriteria pemeriksaan DPOAE adalah penderita dengan ambang dengar ≤40 dB. Percontoh dilakukan pemeriksaan timpanometri, audiometri, dan DPOAE. Hasil: Terdapat 9 sampel percontoh penelitian. Uji repeated-ANOVA menunjukkan tidak ditemukan perbedaan bermakna pada tiga hasil pengukuran audiometri antara pascakemoterapi pertama, kedua, dan ketiga (p>0,05). Deteksi awal ototoksisitas menggunakan kriteria ASHA menunjukkan sensitivitas sebesar 67% dan dan CTCAE 44%, dibandingkan baku emas menggunakan DPOAE. Kesimpulan: Ototoksisitas cisplatin ditemukan sejak kemoterapi pertama dengan menggunakan pemeriksaan DPOAE walaupun tidak bermakna secara statistik. Kemampuan DPOAE untuk mendeteksi awal ototoksisitas lebih baik dibandingkan kriteria ASHA dan CTCAE yang menggunakan audiometri nada murni.Kata kunci: Karsinoma nasofaring, ototoksisitas sisplatin, DPOAE, CTCAE, ASHA ABSTRACT Introduction: Neoadjuvant chemotherapy is induction chemotherapy before radiotherapy with cisplatin and 5-Fluorouracyl regiment. Chemotherapy cisplatin is ototoxic, leads to frequently progresive and irreversible bilateral sensorineural hearing loss. American Speech-Language Hearing Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAE) are the criteria to determine ototoxicity with audiometry, beside Distortion Product Otoacoustic Emissions (DPOAE). Purpose: To identify the relationship between ototoxicity with neoadjuvant chemotherapy in patients NPC WHO type III using ASHA, CTCAE, and DPOAE. Method: This observational study approach with cohort design. Inclusion criteria: new patients NPC WHO type III who consented to undergo standard regiment chemotherapy, and age <60 year-old. For DPOAE examination: hearing level ≤40 dB. Exclucion criteria: NPC WHO type III patients who underwent chemotherapy with unconventional standard regiment. Examinations for hearing function conducted with tympanometry, pure tone audiometry, and Distortion Product Otoacoustic Emissions (DPOAE). Result: There were 9 sample in this study. The result of Repeated-ANOVA test showed no significant difference in three audiometry measurements among three series of chemotherapies. Early detection of ototoxicity using ASHA and CTCAE criterias showed sensitivity of 67% and 44% (compared with DPOAE as a gold standard). Conclusion: Cisplatin ototoxicity had occured since the first chemotherapy and detected with DPOAE, but statistically was not significantly related. Early detection of cisplatin ototoxicity with DPOAE was much better than with criteria American Speech-Language Hearing Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAE), which used pure tone audiometry.Keywords: Nasopharyngeal carcinoma, cisplatin ototoxicity, DPOAE, CTCAE, ASHA
Hubungan antara lama paparan bising terhadap gangguan pendengaran pada instruktur drum Primadewi, Novi; Kandhi, Putu Wijaya; Azizah, Zahroh Zuliana
Oto Rhino Laryngologica Indonesiana Vol 48, No 2 (2018): Volume 48, No. 2 July - December 2018
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (84.992 KB) | DOI: 10.32637/orli.v48i2.275

Abstract

Latar belakang: Alat musik drum merupakan alat musik yang memiliki nilai kebisingan. Instruktur drum dapat terpapar bising yang tinggi, sehingga dapat mengalami gangguan pendengaran. Tujuan: Mengetahui hubungan antara lama paparan bising terhadap gangguan pendengaran pada instruktur drum di Surakarta dan sekitarnya. Metode: Jenis penelitian yang digunakan adalah obervasional non experimental dengan desain cross sectional pada 71 instruktur drum di 14 sekolah musik di Surakarta. Sampel berupa hasil pemeriksaan audiometri nada murni yang dilaksanakan di studio musik kedap suara dengan NAB kurang dari 40 Dba SPL. Data dianalisis menggunakan  uji statistik Chi Square. Hasil analisis statistik bermakna bila didapatkan nilai p=0,001<0,01. Hasil: Pada rerata tingkat kebisingan yang terukur dengan alat Sound Level Meter di 14 sekolah musik di Surakarta. Pada saat memainkan drum adalah sebesar 111,48±3,84 dB. Terdapat responden dengan durasi ≤2 jam tanpa GPAB sebanyak 10 orang (14,1%) dan paling banyak terjadi dengan GPAB pada durasi >4 sampai dengan 6 jam sebanyak 38 orang (51,2%). Nilai p=0,001<0,01 yang berarti ada hubungan yang bermakna antara durasi dengan GPAB pada instruktur drum dengan coefficient of contingency CC sebesar 0,687 (68,70%). Kesimpulan: Terdapat hubungan antara lama paparan bising terhadap gangguan pendengaran pada instruktur drum.  Background: Drum is one of musical instruments producing a high level of noise. Drum instructors are exposed to this loudness, which might give them a high risk of hearing impairment. Objective: To investigate the correlation between loudness exposure time and hearing impairment of drum instructors in Solo area. Methods: This was an observational non experimental research using cross sectional design on 71 drum instructors in 14 music schools in Surakarta. The samples were the result of pure tone audiometry examination conducted in a soundproof music studio with NAB less than 40 Dba SPL. Data were analyzed using Chi Square statistical tests. The results of statistical analysis were significant if  p = 0.001 <0.01. Result: The average noise level measured by a Sound Level Meter tool in 14 music schools in Surakarta, while playing the drum was 111.48 ± 3.84 dB. There were respondents with a duration of ≤ 2 hours without Noise Induce Hearing Loss (NIHL) as many as 10 people (14.1%), and the highest  occurence with NIHL was at a duration of  >4 to 6 hours as many as 38 people (51.2%). The value of p = 0.001 <0.01, revealed that there was a significant correlation between the duration of noise exposure and NIHL in drum instructors with coefficient of contingency (CC) of 0.687 (68.70%). Conclusion: Noise exposure time was correlated with hearing impairment in drum instructors.   
Pengaruh sisplatin dosis tinggi terhadap penurunan fungsi sel rambut luar koklea Asti Kristianti; Teti Madiadipoera; Bogi Soeseno
Oto Rhino Laryngologica Indonesiana Vol 40, No 2 (2010): Volume 40, No. 2 July - December 2010
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v40i2.1

Abstract

Background: Chemotherapy is worldwide used nowadays, and its toxicity still remain a problemespecially toxicity to the ear (ototoxicity). Cisplatin (cis-diamminedichloroplatinum) is one of themost commonly used chemotherapy and highly potent in treating epithelial malignancies. Ototoxicitycaused by cisplatin is irreversible, progressive, bilateral, sensorineural hearing loss especially on highfrequency (4-8 KHz) accompanied by tinnitus. Purpose: To observe the cochlear outer hair cells damagein malignancies patients treated with cisplatin. Methods: This study is an observational analytic studywith prospective design to determine the influence of high dose cisplatin on cochlear outer hair cellsfunction. The research was carried out at the ENT-HNS Department, Hasan Sadikin General HospitalBandung, from November 2007 until June 2008. Audiometry, tympanometry, and distortion productotoacoustic emission (DPOAE) examinations were conducted before chemotherapy and DPOAE, andtimpanometry was again measured three days after first and second cycles of cisplatin administration. McNemar test was performed to calculate the effects of high-dose cisplatin to the cochlear outer haircells function. To compare pre and post-cisplatin on alteration of cochlear hair cells function, Wilcoxontest was used. Results: In this study 60 ears from 30 subjects that meet the inclusion criteria, consistedof 25 man (83.3%) and 5 women (16.7%). The prevalence of damaged cochlear outer hair cells were63% at first cycle and 70% at second cycle of cisplatin administration. The decline of cochlear outerhair cells function was significant (p<0.001). Conclusion: High-dose cisplatin decreases cochlear outerhair cells function in patients with malignant neoplasm. Abstrak : Latar belakang: Kemoterapi sekarang rutin digunakan secara klinis di seluruh dunia. Sejalan denganhal tersebut toksisitas kemoterapi, khususnya terhadap telinga saat ini menjadi perhatian. Sisplatin(cis-diamminedichloroplatinum) adalah salah satu obat kemoterapi yang paling banyak digunakandan paling manjur untuk terapi keganasan epitelial. Efek ototoksik sisplatin yaitu terjadi gangguandengar sensorineural yang irreversible, progresif, bilateral pada frekuensi tinggi (4-8 kHz), dan disertaidengan tinitus. Tujuan: Untuk menilai penurunan fungsi sel rambut luar koklea pada penderita tumorganas sesudah pemberian sisplatin dosis tinggi dengan menggunakan DPOAE. Metode: Studi analitikobservasional dengan rancangan prospektif di Bagian IK. THT-KL RS. Hasan Sadikin Bandung mulaibulan November 2007 sampai dengan Juni 2008. Pada penelitian ini dilakukan pemeriksaan audiometrinada murni, timpanometri, dan distortion product otoacoustic emission (DPOAE) prakemoterapi, kemudianDPOAE dan timpanometri diulang tiga hari sesudah siklus pertama dan kedua kemoterapi sisplatin. Datayang diperoleh diuji dengan uji McNemar dan uji Wilcoxon. Hasil: Dari penelitian didapat 60 telingadari 30 subjek penelitian yang memenuhi kriteria inklusi yang terdiri dari 25 laki-laki (83,3%) dan 5perempuan (16,7%). Insidens penurunan fungsi sel rambut luar koklea sebesar 63% (38 kasus) sesudahsiklus pertama dan 70% (42 kasus) sesudah siklus kedua. Hubungan penurunan fungsi sel rambut luarkoklea memberikan nilai yang sangat bermakna sejak pemberian siklus pertama (p<0,001). Kesimpulan:Pemberian sisplatin dosis tinggi pada penderita tumor ganas menyebabkan penurunan fungsi sel rambutluar koklea.Kata kunci: kemoterapi, sisplatin dosis tinggi, sel rambut luar koklea.

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