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Oto Rhino Laryngologica Indonesiana

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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.

Arjuna Subject : -

Articles 493 Documents

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Refluks Helicobacter pylori di mukosa hidung penderita rinosinusitis kronik disertai refluks laringofaring Sinta Sari Ratunanda; Billy Talakua; Teti Madiadipoera; Thaufiq Boesoirie; Ratna Anggraeni; Rovina Ruslami
Oto Rhino Laryngologica Indonesiana Vol 48, No 2 (2018): Volume 48, No. 2 July - December 2018
Publisher : PERHATI-KL

Latar belakang: Rinosinusitis kronik masih menjadi problema di seluruh dunia. Faktor yang berasosiasi dengan Rinosinusitis Kronik (RSK) diduga multifaktorial, salah satunya adalah refluks laringofaring (RLF). Isi refluks cairan lambung antara lain adalah bakteri Helicobacter pylori (H. pylori) yang dengan patomekanisme refluks, diduga dapat mencapai mukosa laringofaring bahkan sampai mukosa sinonasal, dan menyebabkan RSK. Tujuan: Mendeteksi H. pylori di mukosa hidung akibat refluks pada penderita RSK disertai RLF. Bila terdeteksi H. pylori, tata laksana harus lebih komprehensif, sehingga diharapkan RSK menjadi terkontrol. Metode: Penelitian deskriptif untuk mengetahui ada tidaknya H. pylori di mukosa sinonasal penderita RSK dengan RLF. Deteksi H. pylori menggunakan teknik quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) dari bahan penyikatan mukosa hidung. Hasil: Didapatkan 86 orang penderita RSK disertai RLF, terdiri dari 30 (35%) pasien laki-laki dan 56 (65,0%) pasien wanita, dengan rerata usia 43,25±6,30 tahun. Keluhan RSK terbanyak adalah hidung tersumbat dengan skor VAS > 7 sebesar 76,8%. Skor nasoendoskopi RSK terbesar pada skor 2 untuk edema mukosa sebesar 65,3% dan skor 2 untuk sekret hidung sebesar 58,2%. Rata-rata skor gejala refluks (SGR) adalah 26,43±4,03 dan rata-rata total skor temuan refluks (STR) adalah 11,28±1,21. Hasil pemeriksaan deteksi H. pylori dengan qRT-PCR, 100% tidak menemukan H. pylori dari penyikatan mukosa hidung. Kesimpulan: Refluks berupa H. pylori tidak ditemukan pada mukosa hidung penderita RSK disertai RLF. Penelitian lebih lanjut diperlukan dengan menggunakan gabungan beberapa metode pemeriksaan bersamaan untuk deteksi H. pylori akibat refluks di mukosa sinonasal penderita RSK disertai RLF. Background: Chronic rhinosinusitis is presently still a worldwide problem. Assosiating factors to chronic rhinosinusitis (CRS) are multifactorial, one of them is laryngopharyngeal reflux (LPR). The gastric juice contains Helicobacter pylori (H. pylori), which by pathologic reflux could reach laryngopharyngeal and sinonasal area causing CRS. Purpose: To detect H. pylori in nasal mucosa caused by reflux, which suspected of causing CRS with LPR disease. Should H. pylori be found in nasal mucosa, the management of the disease must be comprehensive to enable controlling CRS. Methods: A descriptive study to detect H. pylori in nasal mucosa CRS with LPR patients, using Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) through nasal brushing. Results: Eighty-six CRS with LPR patients as study objects consisted of 30 (35%) male, and 56 (65%) female, the age mean was 43.25±6.3 years old. Visual Analoque Scale (VAS) score for nasal obstruction more than 7 was the highest complaint (76.8%). Nasal endoscopic score of mucosal edema (65.3%) and nasal discharge (58,2%) had score 2. The average total score reflux symptom index (RSI) was 26.43±4.03 and the total score reflux finding score (RFS) was 11.28±1.21. H. pylori detection found negative 100% in CRS with LPR specimens. Conclusion: This study did not find reflux containing H. pylori in nasal mucosa of CRS with LPR patients. Suggesting further study using simultaneously several methods to detect H. pylori in nasal mucosa CRS with LPR patients.

Gambaran fungsi penghidu dengan Sniffin’ sticks pada pasien rinitis alergi Nurul Endah Ardianti; Nina Irawati; Niken Lestari Poerbonegoro; Saptawati Bardosono
Oto Rhino Laryngologica Indonesiana Vol 42, No 2 (2012): Volume 42, No. 2 July - December 2012
Publisher : PERHATI-KL

Background: Allergic rhinitis (AR) is defined as an inflammation of the lining mucosa of the nose induced by allergen exposure. The olfactory disturbance could affect around 21%-23% of AR patients.Purpose: To determine the olfactory performance of AR patients at the Allergy-Immunology outpatientclinic, ENT Department, Cipto Mangunkusumo Hospital. To find out the mean difference of olfactorythreshold, discrimination, and identification (TDI) score between intermittent AR group and persistent ARgroup, and also to determine the percentage of the AR patient who had olfactory disturbance. Method:Observational descriptive study with cross sectional method to assess the TDI in AR patients using theSniffin’ sticks extended test. Results: The olfactory performance characteristics of AR patients were:threshold score 0,25; discrimination score 7,00; identification score 10,10; TDI score 23,50. There wasno statistical difference of the TDI mean score between intermittent AR group and persistent AR group.In our study, 45% of all AR subjects were reported to have olfactory disturbance. Conclusion: The TDIresults which represent olfactory function of AR patients were lower compared to the healthy subjects. Key words: allergic rhinitis, olfactory function, Sniffin’ sticks Abstrak : Latar belakang: Rinitis alergi (RA) adalah penyakit inflamasi mukosa hidung akibat pajanan terhadap suatu alergen. Sekitar 21% sampai 23% pasien RA dapat mengalami gangguan penghidu. Tujuan: Mengetahui gambaran fungsi penghidu pada pasien rinitis alergi (RA). Menentukan perbedaan rerata nilai ambang, diskriminasi dan identifikasi (ADI) pada pasien RA intermiten dan persisten, dan mengetahui persentase pasien RA dengan gangguan fungsi penghidu di poliklinik Divisi Alergi-Imunologi, Departemen THT RSCM. Metode: Penelitian observasional dengan metode potong lintang untuk menilai ADI penghidu pada percontoh RA menggunakan pemeriksaan Sniffin’ sticks extended test. Hasil: Didapati karakteristik fungsi penghidu percontoh RA ambang 0,25; diskriminasi 7,00; identifikasi 10,10; nilai ADI 23,50. Tidak didapatkan perbedaan bermakna rerata nilai ADI antara kelompok rinitis alergi persisten dan intermiten. Diperoleh 45% dari seluruh percontoh RA mengalami gangguan fungsi penghidu. Kesimpulan: Nilai ADI yang merupakan fungsi penghidu pasien RA lebih rendah dibandingkan dengan subjek sehat. Kata kunci: rinitis alergi, fungsi penghidu, Sniffin’ sticks

Pengaruh suplementasi probiotik Lactobacillus casei L shirota strain terhadap kadar IgE penderita rinitis alergi Asti Widuri; Lilis Suryani
Oto Rhino Laryngologica Indonesiana Vol 41, No 1 (2011): Volume 41, No. 1 January - June 2011
Publisher : PERHATI-KL

Background: Allergic rhinitis is a nasal mucosal inflammatory reactions mediated by immunoglobulin E (IgE), after allergen exposure. Probiotics is considered has strong influence on the regulation of primary immunophysiology in intestinal mucosal barrier and might be useful to prevent allergy attacks.Purpose: To study the benefits of Lactobacillus casei Shirota strain L in preventing allergy attacks through the mechanism of immunomodulatory systems that inhibit the production of IgE. Methods:The study was quasi-experimental with pretest-posttest design. The subjects were 45 students with history of allergic rhinitis. Serum IgE levels were measured before and after given milk containing probiotics for one month. Results: With a paired t test, there was significant difference of the average IgE levels between before (291.88 IU/L) and after one month. Probiotic supplementation (141.43 IU/L),p<0.05. Conclusion: Supplementation of probiotic Lactobacillus casei Shirota strain L is useful in preventing allergy attacks. Keywords: allergic rhinitis, probiotics, immunoglobulin E (IgE) Abstrak : Latar belakang: Rinitis alergi adalah reaksi peradangan mukosa hidung yang diperantarai oleh imunoglobulin E (IgE) setelah terjadi pajanan alergen. Pemberian probiotik dianggap mempunyai pengaruh yang kuat terhadap regulasi imunofisiologi primer dalam barier mukosa usus. Tujuan:Mengkaji manfaat suplemen probiotik Lactobacillus casei L shirota strain dalam mencegah serangan alergi melalui mekanisme sistem imunomodulator yang menghambat produksi IgE. Metode: Desain penelitian adalah eksperimental kuasi case control dengan rancangan pretest-postest design. Subjek penelitian adalah 45 orang yang mempunyai riwayat rinitis alergi, diambil darah sampel untuk diperiksa kadar IgE sebelum dan setelah diberi susu yang mengandung probiotik selama satu bulan. Hasil: Dengan paired t test, terdapat perbedaan bermakna antara rata-rata kadar IgE sebelum suplementasi (291,88 IU/L) dan setelah diberi suplementasi probiotik Lactobacillus casei Lshirota strain selama satu bulan (141,43 IU/L), p<0,05. Kesimpulan: Suplementasi probiotikLactobacillus casei L shirota strain bermanfaat dalam mencegah serangan alergi melalui mekanisme imunomodulator yang menghambat produksi IgE. Kata kunci: rinitis alergi, probiotik, imunogobulin E (IgE)

Epithelial papillary angioepithelioma pada rongga sinus maksila wanita dewasa muda Bima Mandraguna; Yussy Afriani; Agung Dinasti; Nur Akbar; Tonny Basriyadi
Oto Rhino Laryngologica Indonesiana Vol 44, No 2 (2014): Volume 44, No. 2 July - December 2014
Publisher : PERHATI-KL

Latar belakang: Epithelial Papillary Angioepithelioma (EPA) yang dikenal juga sebagai tumor Dabska adalah suatu tumor vaskular yang jarang terjadi pada rongga hidung dan sinus paranasalis. Tindakan bedah, radioterapi dan kemoterapi serta kombinasi ketiganya adalah pengobatan utama untuk tumor ganas sinonasal. Tujuan: Memberikan informasi mengenai diagnosis dan penatalaksanaan tumor Dabska. Kasus: Kasus langka ini ditemukan pada wanita usia 16 tahun dengan massa tumor pada rongga hidung dan sinus paranasal yang berekstensi hingga rongga mulut. Pemeriksaan histopatologi didapatkan sel tumor endothelial yang menunjukkan pola pertumbuhan papiler. Pemeriksaan imunohistokimiaCD34 positif. Penatalaksanaan: Radioterapi preoperasi 10 kali untuk mengurangi massa tumor yang progresif kemudian dilakukan maksilektomi infrastruktur dilanjutkan radioterapi postoperasi. Dilakukan juga pemasangan protesa palatum bars postoperasi dan protesa palatomaksilaris 3 bulan pasca operasi. Evaluasi pasca operasi tampak perbaikan, tidak didapatkan infeksi maupun tanda-tanda kekambuhan,dan secara anatomi fungsi kembali seperti semula. Kesimpulan: Diagnosis dan penatalaksanaan yang cepat dan tepat dapat meningkatkan prognosis pada tumor DabskaKata kunci: Tumor Dabska, maksilektomi infrastruktur, radioterapi, tumor sinonasal, protesa ABSTRACTBackground: Epithelial papillary angioepithelioma (EPA), also known as Dabska tumor, is a very rare vascular neoplasm in the sinonasal. Surgery, radiotherapy and chemotherapy, and the combination of those three are the primary treatment for malignant sinonasal tumors. Purpose: To inform about the diagnostic and treatment of Dabska tumor. Case: We present an exceptionally rare case of EPA of the sinonasal in a 16 year old female. A well defined, reddish tumor existed at the sinonasal that extended to oral cavity. Microscopic examination revealed the endothelioid tumor cells showing a papillary growth pattern with positive imunohistchemistry of CD34. Management: Ten consecutive radiotherapies was performed preoperatively and then continued with progressive infrastructure maxillectomy andreconstructions of the maxilla, followed by postoperative radiotherapies. Postoperative management also include the mounting bars palate prosthesis and palatomaxillary prosthesis 3-month after the operation. Postoperative evaluation showed improvement, there was no sign of any infection or recurrence, and the anatomical function returned to normal. Conclusion: Prompt diagnosis and the rightmanagement could improve the prognosis in Dabska tumors.Keywords: Dabska tumor, infrastructure maxillectomy, radiotherapy, sinonasal neoplasm, prosthesis

Patofisiologi kasus skleroderma pada disfagia esofagus Nancy Liwikasari; Muyassaroh Muyassaroh
Oto Rhino Laryngologica Indonesiana Vol 46, No 1 (2016): Volume 46, No. 1 January - June 2016
Publisher : PERHATI-KL

Latar belakang: Disgafia adalah kesulitan menelan yang dapat disebabkan oleh kelainan kongenitalatau kelainan sistemik seperti skleroderma. Skleroderma merupakan penyakit autoimun kronis denganinsidens yang jarang yaitu 20:1.000.000. Skleroderma akan menyebabkan atrofi otot polos dan fibrosis padaesofagus sehingga menyebabkan Barrett’s esophagus, striktur, bahkan keganasan.Tujuan: Mengetahuidan memahami patofisiologi disfagia fase esofagus yang disebabkan oleh skleroderma sehingga dapatmemberi tata laksana yang optimal.Kasus: Perempuan berusia 31 tahun dengan disfagia fase esofaguse.c. skleroderma. Skleroderma menyebabkan atrofi dan fibrosis otot polos yang menimbulkan dismotilitasesofagus sehingga gerakan peristaltik hilang secara progresif, sfingter esofagus inferior melemah,pengosongan esofagus tertunda, dan terjadi refluks gastroesofagus.Penatalaksanaan: Terapi suportif:Ringer Laktat (RL) 20 tpm, metil-prednisolon 125 mg 1/3-0-0, ranitidin 50 mg 1-0-1, omeprazole 20mg/12 jam, chlorpheniramin maleat (CTM) 4 mg/8 jam, soft U derm lotion topical setiap 12 jam. Terapikonservatif: pengaturan diet, berbaring dengan kepala ditinggikan, obat antasida, agen prokinetik,dan antisekretorik.Kesimpulan: Disfagia fase esofagus dapat disebabkan oleh skleroderma, denganmemahami patofisiologinya maka akan dapat memberikan tatalaksana yang tepat. Kata kunci: Skleroderma, disfagia esofagus, patofisiologi ABSTRACTBackground: Disphagia is difficulty of swallowing which could be caused by congenitalabnormalities or systemic disorders such as scleroderma. Scleroderma is a rare chronic autoimmunedisease with incidence of 20:1.000,000. Scleroderma causes atrophy of smooth muscles and fibrosis ofthe esophagus, that leading to Barrett’s esophagus, strictures, or even malignancy. Purpose: Knowingand understanding the pathophysiology of the esophageal phase dysphagia caused by scleroderma,as to provide optimal management. Case: We reported a 31 years old female, with esophageal phasedysphagia that caused by scleroderma. Scleroderma causes smooth muscles atrophy and fibrosis thatcaused esophageal dysmotility and decrease peristaltic progressively, weakening of inferior esophagealsphincter, delayed emptying of the esophagus, and gastroesophageal reflux. Management: Supportivetherapy: Ringer Lactate (RL) 20 drops/minute, methylprednisolone 125 mg 1/3-0-0, ranitidin 50 mg 1-0-1,omeprazole 20 mg/12 hrs, chlorpheniramine maleat (CTM) 4 mg/8 hrs, soft U-derm topical lotion every12 hrs. Conservative therapy: Diet regulation, laying down with elevated head, antacid, prokinetic, andantisecretory. Conclusion: Esophageal phase dysphagia can be caused by scleroderma. Understandingthe pathophysiology will lead to a proper management. Keywords: Scleroderma, dysphagia esophageal, pathophysiology Alamat korespondensi : Nancy Liwikasari. Email: cy_nancy16@yahoo.com

Mengenali gangguan pendengaran pada sindrom Waardenburg Semiramis Zizlavsky; Safira Trifani Putri; Ronny Suwento
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Latar belakang: Sindrom Waardenburg adalah suatu kelainan yang bersifat autosomal dominan yang ditandai oleh gangguan pendengaran sensorineural dan kelainan pigmen pada mata, rambut, dan kulit. Sindrom auditori-pigmen ini terjadi karena tidak adanya melanosit dari kulit, rambut, mata, serta stria vaskularis pada koklea. Tujuan: Memberikan informasi mengenai manifestasi klinis Sindrom Waardenburg sehingga dapat melakukan deteksi dan penanganan sedini mungkin, terutama untuk gangguan pendengaran. Kasus: Seorang anak laki-laki berusia 7 tahun dengan keterlambatan deteksi gangguan pendengaran. Orang tua anak tidak mengetahui bahwa gangguan pendengaran tersebut merupakan salah satu manifestasi sindrom Waardenburg, sehingga pada anak ini terdapat gangguan perkembangan wicara. Metode: Penelusuran literatur menghasilkan 14 jurnal, dan terdapat 2 jurnal yang relevan. Hasil: Dari 2 jurnal yang didapat, ditemukan 1 artikel penelitian dan 1 laporan kasus sindrom Waardenburg yang memaparkan berbagai manifestasi klinis yang menyertai pasien. Kesimpulan: Deteksi dini dan penatalaksanaan untuk gangguan pendengaran yang merupakan manifestasi klinis tersering dari sindrom Waardenburg, penting dilakukan karena mempengaruhi perkembangan individu dan perkembangan sosial pasien. Kata kunci: Sindrom auditori-pigmentasi, kelainan pigmen, gangguan pendengaran sensorineural, sindrom Waardenburg ABSTRACT Background: Waardenburg Syndrome (WS) is an autosomal-dominant disorder, characterized by sensorineural hearing loss and pigmentary abnormalities of the eyes, hair, and skin. Auditory-pigmentary syndromes are caused by physical absence of melanocytes from the skin, hair, eyes, and the stria vascularis of the cochlea. Purpose: To provide information regarding clinical manifestation of Waardenburg Syndrome for early detection and prompt treatment particularly for hearing impairments. Case: A 7-year-old boy with late detection of hearing impairment. Previously, his parents didn’t recognize that this condition was one manifestation of Waardenburg syndrome, so that this patient developed speech delay. Method: Searching for evidence produced 14 journals and only 2 journals were relevant. Result: Of the 2 relevant journals, there were 1 research article and 1 case report that explained several clinical manifestations of Waardenberg Syndrome. Conclusion: Early detection and management of hearing impairment as one of frequent clinical manifestation of Waardenberg Syndrome is significantly important since this condition could influence patient’s individual and social developments. Keywords: Auditory pigmentary syndrome, pigmentary abnormality, sensorineural hearing loss, Waardenburg syndrome

Parotidektomi radikal pada karsinoma sel asinus parotis Marlinda Adham; Meila Sutanti
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.v40i2.8

Background: Acinic cell carcinoma is an uncommon type of parotid malignant tumour. One commonsymptom of this low grade malignancy is slowly growing parotid mass. Pain in parotid area and facialnerve paresis are important symptoms that indicate malignancy. From clinical manifestations, it is difficultto differentiate between this kind of malignancy with benign parotid tumour. Fine needle aspiration biopsyand CT scan are important in diagnosing acinic cell parotid carcinoma, and surgery is the main therapy.Purpose: We present this case to enlighten general practitioners and also otorhinolaryngologists aboutthis kind of parotid malignancy that has similar presentation with benign parotid tumour. Case: Onecase of acinic cell carcinoma of the parotis was reported. A 53 years old man was diagnosed as stage IVacinic cell carcinoma. Case management: The patient underwent radical parotidectomy. He was plannedfor chemotherapy and radiotherapy but untill now, he still refused further treatment. Conclusion: Aciniccell carcinoma is one of malignant tumour that has a good prognosis, especially if diagnosed early andadequately treated.Key words: malignant parotid tumour, acinic cell carcinoma, fine needle aspiration biopsy,parotidectomy.Abstrak : Latar belakang: Karsinoma sel asinus adalah salah satu tipe keganasan kelenjar liur yang jarang sekaliterjadi. Karsinoma ini bersifat low grade yang ditandai oleh benjolan pada daerah parotis yang tumbuhsecara lambat. Dari pemeriksaan klinis, keganasan ini sulit dibedakan dengan tumor jinak. Salah satugejala yang membedakan dari tumor jinak adalah rasa nyeri dan paresis nervus fasialis. Pemeriksaan biopsiaspirasi jarum halus dan tomografi komputer dapat menegakkan diagnosis karsinoma parotis jenis ini.Terapi utamanya adalah parotidektomi. Tujuan: Kasus ini diajukan agar para dokter umum dan dokterspesialis Telinga, Hidung, Tenggorok dapat mengenali adanya karsinoma parotis yang bermanifestasiklinis seperti tumor jinak ini. Kasus: Dilaporkan satu pasien, laki-laki berusia 53 tahun yang didiagnosiskarsinoma sel asinus kelenjar parotis stadium IV. Penatalaksanaan: Pada pasien ini dilakukan operasiparotidektomi radikal dan direncanakan untuk radiasi dan kemoterapi. Sampai saat ini, pasien masihmenolak untuk tatalaksana lebih lanjut pascabedah.Kesimpulan: Karsinoma sel asinus merupakan kasuskeganasan yang memiliki prognosis baik, terutama jika didiagnosis dini dan diterapi secara adekuat.Kata kunci: tumor ganas parotis, sel asinus, biopsi aspirasi jarum halus, parotidektomi.

Hubungan status nutrisi penderita karsinoma nasofaring stadium lanjut dengan kejadian mukositis sesudah radioterapi Fransiska Tricia; Pudji Rahaju; Rus Suheryanto
Oto Rhino Laryngologica Indonesiana Vol 42, No 1 (2012): Volume 42, No. 1 January - June 2012
Publisher : PERHATI-KL

Background: Normal nutritional status is a balanced condition of nutritional intake and requirement in a person. Lack of nutrition in cancer patients promotes undesirable effects on various organs and systems of the body. Purpose: To determine the nutritional status differences in patients with advanced stage NPC type III WHO before and after radiotherapy, and the relationship between nutritional status with mucositis occurance after radiotherapy. Method: Observational analytic study. Sampling was conducted by non-random purposive sampling technique with 10 subjects with NPC. The statistical analysis used paired sample Wilcoxon test and Spearman correlation test. Result: The study found significant differences between nutritional state regarding BMI, LOLA and transferrin before and after radiotherapy with p<0.05. Paired sample t test of BMI, LOLA, transferrin before and after radiotherapy demonstrated BMI p=0.000, LOLA p=0.001 and transferrin p=0.005. The paired sample t test for albumin before and after radiotherapy showed that radiotherapy did not cause significant decrease in albumin. Correlation test to determine the relationship among BMI, LOLA, albumin, and transferrin before radiotherapy with mucositis occurance showed BMI p=0.062, LOLA p=0.209, p=0.904 albumin, transferrin p=0.631 which meant that nutritional state has no corelation with mucositis occurance. While after radiotherapy it showed BMI p=0.122, p=0.209 LOLA, albumin, p=0.902 and transferrin p=1.000 which meant that nutritional state after radiotherapy has no corelation to the occurance of mucositis. Conclusion: Radiotherapy in patients with advanced-stage of NPC caused a significant difference in nutritional state before and after radiotherapy, but had no significant association with mucositis occurance. Keywords: nasopharyngeal carcinoma, radiotherapy, nutritional state, malnutrition, mucositis Abstrak : Latar belakang: Status nutrisi normal menggambarkan keseimbangan yang baik antara asupan nutrisi dengan kebutuhan nutrisi. Kekurangan nutrisi pada penderita kanker memberikan efek yang tidak diinginkan terhadap struktur dan fungsi hampir semua organ dan sistem tubuh. Tujuan: Penelitian ini untuk mengetahui perbedaan status nutrisi penderita karsioma nasofaring (KNF) WHO tipe III stadium lanjut sebelum dan sesudah radioterapi, hubungan status nutrisinya dengan kejadian mukositis sesudah radioterapi. Metode: Penelitian ini adalah observasional analitik, dengan jumlah sampel 10 penderita KNF. Analisis statistik menggunakan paired sample t test dan uji korelasi Spearman. Hasil: Terdapat perbedaan yang bermakna antara status nutrisi dengan parameter Body Mass Index (BMI), lingkar otot lengan atas (LOLA) dan transferin sebelum dan sesudah radioterapi (BMI p=0,000, LOLA p=0,001 dan transferin p=0,005 dengan p<0,05). Pada paired sample t test albumin sebelum dan sesudah radioterapi menunjukkan nilai p=0,205 yang berarti bahwa radioterapi tidak menyebabkan penurunan albumin yang bermakna. Uji korelasi hubungan antara BMI, LOLA, albumin, dan transferin sebelum radioterapi dengan kejadian mukositis menunjukkan bahwa status nutrisi tidak berhubungan dengan kejadian mukositis (BMI p=0,062, LOLA p=0,209, albumin p=0,904, transferin p=0,631 dengan p>0,05). Uji korelasi hubungan antara BMI, LOLA, albumin, dan transferinsesudah radioterapi menunjukkan bahwa status nutrisi tidak berhubungan secara signifikan dengan kejadian mukositis sesudah radioterapi (BMI p=0,122, LOLA p=0,209, albumin p=0,902 dan transferin p=1,000 dengan p>0,05) Kesimpulan: Pemberian radioterapi pada penderita KNF stadium lanjut menyebabkan penurunan bermakna pada status nutrisi sebelum dan sesudah radioterapi, tetapi tidak berhubungan secara bermakna dengan kejadian mukositis sesudah radioterapi. Kata kunci: karsinoma nasofaring, radioterapi, status nutrisi, malnutrisi, mukositis.

Posisi elektroda intrakoklea dan ECAP sebagai pedoman pemetaan pada tuli sensorineural dengan implan koklea Semiramis Zizlavsky; Ratna Dwi Restuti; Jacub Pandelaki; Muchtaruddin Mansyur; Bambang Hermani; Teguh Ranakusuma; Edrial Eddin; Sarwono Waspadji
Oto Rhino Laryngologica Indonesiana Vol 44, No 1 (2014): Volume 44, No. 1 January - June 2014
Publisher : PERHATI-KL

Latar belakang: Implan koklea merupakan pilihan utama untuk habilitasi pendengaran dan berbicara pada anak tuli sensorineural berat bilateral. Pengaturan comfortable dan threshold level berdasarkan nilai evoked compound action potential (ECAP) direkam dengan neural responses imaging (NRI) saat pemetaan. Tujuan: Memperoleh nilai ECAP sebagai acuan pemetaan berdasarkan jarak elektroda intrakoklea ke modiolus, jarak terpanjang elektroda nomor satu dengan elektroda berhadapan, jarak marker dengan lubang kokleostomi dan faktor lainnya. Metode: Anak tuli sensorineural usia 2-10 tahun, menggunakan implan koklea dengan desain contour atau straight terdiri dari 16 elektroda, 120 channel sebagai subjek penelitian. Subjek penelitian sebanyak 46 telinga (39 anak), terpasang implankoklea diperoleh secara konsekutif dengan desain potong lintang. Perekaman ECAP elektroda 3-5, 8-10, 13-15 mewakili daerah apeks, medial dan basal. Hasil tomografi komputer resolusi tinggi koklea dengan program OsiriX dilakukan rekonstruksi 3D untuk menilai posisi dan jarak elektroda. Analisis data diawali dengan univariat dan uji korelasi Spearman ‘s pada bivariat. Kandidat faktor yang berperan disertakan pada regresi ganda untuk mendapatkan faktor determinan ECAP. Comfortable zone untuk populasi diperoleh dari analisis area pada distribusi normal menggunakan comfortable level. Hasil: Diperoleh persamaan yaitu: (rerata ECAP)=-21,19+5,87 rerata jarak elektroda ke modiolus (mm)+1.31, rerata threshold level (cu)+0.48 lama penggunaan implan koklea (bulan). (R square=0.60). Comfortable zone diperoleh dengan ECAP yang berada pada variasi 84-87,5% comfortable level. Kesimpulan: Jarak elektroda ke modiolus, lama penggunaan implan koklea dan t level merupakan faktor determinan ECAP. Nilai ECAP dapat digunakan untuk mengidentifikasi penyimpangan jarak elektroda dan memperoleh comfortable zone.Kata kunci : ECAP, implan koklea, lokasi elektroda, tuli sensorineuralABSTRACT Background: Currently cochlear implant remains a preferred choice in hearing and speechhabilitation in children with bilateral profound SNHL. Comfortable and threshold level setting based on ECAP value is recorded by NRI during mapping. Purpose: To obtain ECAP value as mapping guidance based on the distance between electrode to modiolus, the longest distance between electrode number one with the ones it faces, the distance between marker and cochleostomy and other factors. Methods: Research subject were children with SNHL, between 2-10 years old using CI with 16 electrodes, 120 channels. There were 46 ears (39 children) with CI chosen consecutively by cross sectional design. Using NRI, ECAP was recorded on electrode 3-5, 8-10, 13-15 that represent the apex, medial and basal area. Their cochlears were examined with HRCT then 3D reconstruction with OsiriX programto determine the electrode position and calculate the distance. Data analysis started with univariat 1 and bivariat with Spearman’ correlation. Candidates’ factor were analysed with multiregression test to gain ECAP determinant factor. Comfortable zone for population was gained from area analysis in normal distribution using comfortable level. Results: The equation found were: y (average ECAP)=21.19+5.87 the average electrodes to modiolus distance (mm)+1.31, threshold level (cu)+0.48 CI length use (months). (R square=0.60).Comfortable zone was acquired with ECAP between 84-87,5% comfortable level variation. Conclusion: The electrode to modiolus distance, duration of CI use and t level are ECAP determinant factor. The value of ECAP can be used as guidance to identify electrode distance deviation and to gain comfortable zone.Keywords: cochlear implant, ECAP, electrode location, sensoryneural hearing loss

Korelasi otitis media dengan temuan nasoendoskopi pada penderita rinosinusitis akut Ariel Anugrahani; Teti Madiadipoera; Arif Dermawan
Oto Rhino Laryngologica Indonesiana Vol 45, No 2 (2015): Volume 45, No. 2 July - December 2015
Publisher : PERHATI-KL

Latar belakang: Rinosinusitis akut adalah inflamasi pada hidung dan sinus paranasal yang berlangsung kurang dari 12 minggu. Adanya sumbatan pada hidung dapat menyebabkan sumbatan pada tuba Eustachius sehingga dapat terjadi gangguan ventilasi dan inflamasi yang dapat menimbulkan otitis media. Tujuan: Melihat adanya hubungan hidung tersumbat, nasal edema, dan rinore pada pasien rinosinusitis akut dengan otitis media. Metode: Penelitian dengan desain cross sectional study dan data diambil secara deskriptif retrospektif dari rekam medis, di Poliklinik Rinologi Alergi Ilmu Kesehatan THT-KL RSHS Bandung, dalam periode Januari 2013 - Juni 2014. Didapatkan jumlah sampel sebanyak 93 pasien yang terdiri dari 38 pasien dengan OMA, 27 pasien dengan OME, dan 28 pasien dengan OMSK, dengan usia 1 sampai 79 tahun, berdasarkan derajat berat penyakit menurut Visual Analogue Scale (VAS), gejala hidung berdasarkan Weeke, Davis dan Okuda, pemeriksaan nasoendoskopi berdasarkan Lund-Kennedy. Analisis data menggunakan uji Kruskal-Wallis, chi square (p<0,05), dan analisis korelasi Spearman. Hasil: Terdapat korelasi yang bermakna antara otitis media dengan temuan nasoendoskopi yaitu edema mukosa dan rinore. Kesimpulan: Terdapat hubungan antara peningkatan gejala obstruksi hidung dan edema mukosa serta rinore pada temuan nasoendoskopi pada penderita rinosinusitis akut dengan otitis media. Kata kunci: rinosinusitis akut, nasoendoskopi, otitis mediaABSTRACT Background: Acute rhinosinusitis is an inflammation of the nose and paranasal sinuses, which going on less than 12 weeks. If the Eustachian tube obstruction occurs, there will be ventilation and inflammatory disorders that can cause otitis media.rPurpose: This study aimed to find out the correlation of nasal obstruction, nasal edema, and rhinorrhea in acute rhinosinusitis patients with otitis media. Methods: The study was a cross sectional study which data were collected from retrospective descriptive study based on medical record at Rhinology-Allergy Clinic of ORL-HNS Department, Dr. Hasan Sadikin General Hospital, Bandung, from January 2013 to June 2014, involved 93 patients from 1 to 79 years old. Data were analyzed by using the Kruskal-Wallis, chi square, and Spearman statistical test based on anamnesis, severity of the disease using Visual Analogue Scale, nasal symptoms from Weeke, Davis and Okuda, nasoendoscopy findings from Lund-Kennedy. Results: There was a significant correlation between otitis media with mucosal edema and rhinorrhea from nasoendoscopy. Conclusion: There was a correlation between the increased symptoms of nasal obstruction,mucosal edema, and rhinorrhea in nasoendoscopy findings in patients with acute rhinosinusitis with the occurrence of otitis media. Key words: acute rhinosinusitis, nasoendoscopy, otitis media

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