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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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Peran β-glucan dalam diagnosis rinosinusitis kronik jamur Dhaniel Abdi Wicaksana; Rus Suheryanto; Iriana Maharani
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Latar Belakang: Rinosinusitis kronik jamur merupakan permasalahan kesehatan terutama dinegara berkembang karena prevalensinya yang semakin meningkat, sulitnya penanganan medis, sertaberdampak besar terhadap penurunan kualitas hidup. Saat ini tengah dikembangkan teknologi untukmembantu penegakan diagnosis tanpa tindakan invasif, yaitu dengan memanfaatkan β-glucan sebagaikomponen terbesar penyusun dinding sel beberapa spesies jamur. Tujuan: Mengetahui hubungan antarakadar β-glucan jaringan sinus dan serum darah untuk diagnosis rinosinusitis kronik jamur. Metode:Penelitian cross sectional ini melibatkan 20 subjek penelitian. Dilakukan pengambilan sampel darah, danpembedahan sinus maksila untuk mengambil jaringan mukosa, yang kemudian dilanjutkan pemeriksaanpolymerase chain reaction (PCR) untuk identifikasi jamur pada mukosa sinus. Bila didapatkan spesiesjamur yang memiliki β-glucan, dilakukan pemeriksaan enzyme-linked immunosorbent assay (ELISA) untukpengukuran kadar β-glucan. Hasil: Aspergillus flavus merupakan jamur yang paling banyak ditemukan.Seluruh subjek melampaui batasan positif β-glucan (≥80 pg/mL) dari spesimen mukosa, dan hanya 1subjek memberikan hasil intermediate (60-79 pg/mL) dari darah. Uji t berpasangan mendapatkan kadarβ-glucan darah tidak berbeda bermakna dengan mukosa sinus (p=0,886), sehingga pemeriksaan β-glucanpada darah dapat menggambarkan kadar β-glucan pada sinus paranasal. Kesimpulan: β-glucan dapatdimanfaatkan untuk membantu memperoleh diagnosis rinosinusitis kronik jamur, sehingga diharapkandiagnosis dapat ditegakkan dengan cepat dan tepat tanpa memerlukan tindakan invasif, namun hasil inimembutuhkan penelitian lebih lanjut, khususnya terkait uji diagnostik. ABSTRACTBackground: Chronic fungal rhinosinusitis is a major health problem particularly in developingcountries due to its increasing prevalence, difficult medical treatment, and also could make a large impacton the quality of life. The current technology to establish diagnosis without invasive procedure is byutilizing β-glucan, the largest component of fungal cell wall in some fungal species. Purpose: To discoverthe correlation of β-glucan level in paranasal sinus tissue and blood serum as a potential diagnosismarker for chronic fungal rhinosinusitis. Methods: A cross sectional study involving 20 subjects. Bloodsampling and maxillary sinus surgery were performed, then fungi identification in the sinus mucosawas done by Polymerase Chain Reaction (PCR). If a fungal species with β-glucan was found, then theexamination was continued with the measurement of β-glucan by Enzyme-Linked Immuno Sorbent Assay(ELISA) technique in sinus and blood. Results: Aspergillus flavus is the most commonly found fungus. Allsubjects passed the positive β-glucan limit (≥80 pg/mL) of the mucosal sample, and only 1 subject hadintermediate results (60-79 pg/mL) from the blood. Paired t-test result showed no significant differencebetween the level of β-glucan in blood and mucosal sinus (p=0.886), so that β-glucan blood examinationcould illustrate β-glucan levels in paranasal sinuses. Conclusion: β-glucan may be used to establishthe diagnosis of fungal chronic rhinosinusitis with one hope that the diagnosis process can be obtainedquickly and accurately without invasive procedure, although it still requires more studies, particularlyrelated to diagnostic test.

Jabir deltopektoral pada rekonstruksi diseksi leher radikal: seri kasus berbasis bukti Dini Widiarni; Marlinda Adham; Rossa Martiastini
Oto Rhino Laryngologica Indonesiana Vol 43, No 1 (2013): Volume 43, No. 1 January - June 2013
Publisher : PERHATI-KL

Latar belakang: Jabir deltopektoral merupakan salah satu pilihan untuk rekonstruksi defek yang luasakibat tindakan ekstirpasi tumor dan pemberian radioterapi pada keganasan kepala leher. Jabir deltopektoralbukan merupakan pilihan utama dalam rekonstruksi defek kepala leher, namun pada kondisi tertentu, jabirtersebut memiliki tingkat keberhasilan yang lebih baik dibandingkan dengan metode jabir yang lain. Tujuan:Mengingatkan kembali para ahli THT tentang indikasi dan teknik penggunaan jabir deltopektoral pada kasusrekonstruksi defek akibat reseksi tumor dengan telaah sistematis kepustakaan. Kasus: Dilaporkan tiga kasuspenggunaan jabir deltopektoral sebagai penutup defek, satu kasus laki-laki 73 tahun dengan unknown primarytumor dengan penyulit diabetes melitus yang dilakukan tindakan diseksi leher radikal. Dua kasus lain dengandefek akibat stoma rekuren pascalaringektomi total. Penatalaksanaan: Pada ketiga kasus ini dilakukanpenutupan defek menggunakan jabir deltopektoral. Kesimpulan: Pada kondisi pemakaian jabir bebasmerupakan kontraindikasi, adanya keterbatasan fasilitas atau dokter ahli serta kondisi sistemik pasien maka jabirdeltopektoral merupakan salah satu alternatif untuk rekonstruksi defek luas pada daerah kepala leher, sebelumatau sesudah radioterapi.Kata kunci : jabir deltopektoral, rekonstruksi, defek kepala leher.ABSTRACTBackground: Deltopectoral flap is one of the options for execessive defect caused by tumor ablation andradioterapy in head and neck cancer. Deltopectoral flap is not the main option in head and neck reconstruction,but in some certain condition, it has a better success rate than other flap techniques. Purpose: To presentevidence based case report in order to broaden otolaryngologists’ knowledge about indications and techniquesof deltopectoral flap in reconstruction of defect caused by tumor resection. Cases: We reported 3 cases ofdeltopectoral flap used as a defect closure, one of them was a man 73 years old who had an unknown primarytumor with diabetic status and had undergone radical neck dissection. Two other cases were patients withdefect caused by postlaryngectomy reccurent stoma. Management: We used deltofectoral flap for closing thedefect our patients. Conclusion: In conditions in which the use of free flaps are contraindicated, limitedinstrumentations or experienced surgeons, and poor systemic condition of the patient, deltopectoral flap can beconsidered as an alternative for reconstruction of wide defect of the neck, either pre or post radiotherapy.Keywords: deltopectoral flap, reconstruction, head neck defect.

Validitas metode rinohigrometri sebagai indikator sumbatan hidung Rachmawati Djalal; Abdul Qadar Punagi; Andi Baso Sulaiman; Fadjar Perkasa
Oto Rhino Laryngologica Indonesiana Vol 41, No 2 (2011): Volume 41, No. 2 July - December 2011
Publisher : PERHATI-KL

Background: The narrowing of nasal cavity due to nasal mucosa changes or other factors may leadsto nasal obstruction. Symptoms of nasal obstruction can be classified from mild to severe and in somecases total obstruction may occur. Purpose: The objective of the research was to determine the validity of rhinohygrometric method as nasal obstruction indicator. The complaint of nasal obstruction depicted theexistence of abnormalities either anatomically, physiologically or pathologically. The evaluation of thenasal obstruction was based on anamnesis, physical examination and also supporting examination forthe measurement of the nasal patency. Method: An analytic study had been carried out on the diagnostic test for determining sensitivity and specificity values of rhinohygrometeric method as nasal obstruction indicator compared with peak nasal inspiratory flow (PNIF) as the basic standard on subjects who hadnasal obstruction and subjects who did not have nasal obstruction. Results: In the research, the valuesof cutting off point rhinohygrometeric method are 3 cm and 4 cm on the length and width, while thevalue of basic standard of PNIF cutting off point is 80 liter/minute. Sensitivity and specificity methodof rhinohygrometeric on the length were 87.8% and 100% while on the width were 95.1% and 89.8%.Conclusion: Rhinohigrometeric method has validity as indicator of nasal obstruction. Keywords: rhinohygrometeric method, nasal obstruction, cutting off point, sensitivity and specificity Abstrak : Latar belakang: Setiap penyempitan rongga hidung baik akibat proses perubahan pada mukosahidung ataupun penyebab yang lain akan mengakibatkan timbulnya gejala sumbatan hidung. Gejalasumbatan hidung dapat bersifat ringan sampai berat bahkan dapat terjadi sumbatan total. Tujuan: Untukmenentukan validitas metode rinohigrometri sebagai indikator sumbatan hidung. Metode: Penelitian inimenggunakan studi analitik terhadap uji diagnostik untuk menentukan nilai sensitivitas dan spesifisitasmetode rinohigrometri sebagai indikator sumbatan hidung dibandingkan dengan peak nasal inspiratoryflow (PNIF) sebagai standar baku pada subjek yang mengalami sumbatan hidung dan subjek yang tidakmengalami sumbatan hidung. Hasil: Penelitian menunjukkan bahwa telah ditetapkan nilai titik potongmetode rinohigrometri adalah 3 cm dan 4 cm pada sisi panjang dan lebar, sedangkan nilai titik potongstandar baku PNIF adalah 80 liter/menit. Sensitivitas dan spesifisitas metode rinohigrometri padasisi panjang adalah 87,8% dan 100%, sedangkan pada sisi lebar adalah 95,1% dan 89,8%. Kesimpulan:Metode rinohigrometri memiliki validitas sebagai indikator sumbatan hidung. Kata kunci: metode rinohigrometri, sumbatan hidung, titik potong, sensitivitas, spesifisitas

Tuberkulosis tonsil dan nasofaring disertai limfadenopati servikal dan tuberkulosis milier Rina Hayati; Abdul Rachman Saragih
Oto Rhino Laryngologica Indonesiana Vol 44, No 1 (2014): Volume 44, No. 1 January - June 2014
Publisher : PERHATI-KL

Latar belakang: tuberkulosis pada saluran nafas atas sangat jarang dijumpai dan biasanya disertai dengan penyakit paru primer. Dengan kemajuan pengobatan tuberkulosis saat ini, infeksi mycobacterium pada tonsil dan nasofaring jarang dijumpai. Limfadenopati servikal merupakan simptom yang sering terjadi, dan seharusnya didiagnosis banding dengan suatu massa di kepala dan leher. Tujuan: untuk menambah pengetahuan dalam mendiagnosis dan menangani tuberkulosis tonsil dan nasofaring yang jarang dijumpai. Kasus: Seorang anak laki-laki 14 tahun dikonsulkan dengan masa dileher bilateral disertai disfagia, demam dan malaise selama satu bulan. Penatalaksanaan: Pasien awalnya kami diagnosis banding sebagai suatu massa di kepala leher. Setelah ditegakkan diagnosis sebagai tuberkulosistonsil dan nasofaring disertai limfadenopati servikal dan tuberkulosis milier, diberikan terapi dengan anti tuberkulosis dan diperoleh hasil yang baik. Kesimpulan: Tuberkulosis sebaiknya dimasukkan sebagai diagnosis banding suatu massa di kepala dan leher terutama jika gambaran klinis dan pencitraan yang dijumpai tidak khas, sementara itu biopsi dan gambaran mikrobiologi selalu harus dipertimbangkan. Kata kunci: tuberkulosis nasofaring, tonsil, millier, limfadenopati. ABSTRACTBackground: Tuberculosis (TB) of the upper aerodigestive tract is rare and is usually associated with primary pulmonary disease. With recent advances in medical treatment of tuberculosis, mycobacterial infection of the nasopharynx and tonsil becomes very rare. The most common presenting symptom is cervical lymphadenopathy, so TB should be considered in the differential diagnosis of soft tissue masses of the head and neck. Purpose: To remind Otolaryngologists about the diagnosis and management of nasopharyngeal and tonsillar tuberculosis, which become rare case nowadays. Case: A 14-year-old boy was consulted with bilateral neck masses, disphagia, fever and malaise for one month. Case Management: At first we made a differential diagnosis of soft tissue masses of the head and neck. After he was diagnosed as nasopharyngeal and tonsilar tuberculosis with cervical lymphadenopathy and millier tuberculosis, the patient was treated with anti tuberculosis medication and the result was good. Conclusion: TB should be considered in the differential diagnosis of soft tissue masses of the head and neck, particularly when the imaging findings and clinical presentation are atypical, at which point appropriate biopsies and microbiologic studies should be conducted. Keyword : Nasopharyngeal tuberculosis, tonsilar tuberculosis, cervical lymphadenopathy, milliertuberculosis

Hubungan paparan bising dan profil lipid dengan gangguan pendengaran pada pekerja pabrik minyak goreng Adlin Adnan; Renold Yurensa
Oto Rhino Laryngologica Indonesiana Vol 46, No 1 (2016): Volume 46, No. 1 January - June 2016
Publisher : PERHATI-KL

Latar belakang: Gangguan pendengaran akibat bising (GPAB) adalah komplikasi yang palingumum disebabkan oleh paparan terhadap bising, meskipun ada beberapa komplikasi lain yang bisadisebabkan oleh paparan bising. Komplikasi metabolik dari paparan terhadap bising telah dievaluasi olehberbagai penelitian.Tujuan: Meneliti hubungan antara GPAB dengan kadar profil lipid pada pekerja yangterpapar bising di lingkungan kerja.Metode: Penelitian ini bersifat deskriptif analitik dengan desain crosssectional study. Data diperoleh melalui proses wawancara, pemeriksaan audiometri, dan pemeriksaankadar profil lipid.Hasil: Rerata intensitas kebisingan bagian proses 98 dB, dan non-proses berkisar 46-98 dB. Berdasarkan hasil pemeriksaan audiometri terhadap 50 pekerja yang memenuhi kriteria inklusidan eksklusi, didapatkan 26 orang (52%) dengan GPAB tuli sensorineural dan 24 orang (48%) tidakmengalami GPAB. Kami menemukan hubungan signifikan antara paparan bising pada pekerja denganpeningkatan kadar trigliserida (TG), total kolesterol (TC), low-density lipoprotein (LDL), dan penurunankadar high-density lipoprotein (HDL) (p<0,05). Terdapat hubungan antara kadar TG yang tinggi terhadapterjadinya GPAB pada pekerja yang terpapar bising dengan intensitas >85 dB (p<0,05) dan tidak dijumpaihubungan peningkatan kadar TC, LDL, dan penurunan kadar HDL terhadap terjadinya GPAB (p>0,05).Kesimpulan: Pada penelitian ini, ada hubungan antara hiperlipidemia dengan GPAB. Pekerja denganhipertrigliseridemia yang tepapar bising >85 dB berisiko lebih besar menderita GPAB. Kata kunci: Kebisingan, GPAB, profil lipid ABSTRACTBackground: Noise induced hearing loss (NIHL) is the most common complication that causedby noise exposure, although there are other complications as a result of noise exposure. Metaboliccomplications from noise exposure have been evaluated in various studies. Purpose: To examine therelationship between NIHL with lipid profile in workers who are exposed to noise in workplace. Methods:The study design was analytic descriptive with cross-sectional study. Data collection was done throughinterviews, audiometry screening, and lipid profile examinations. Results: The average intensity in processsection was 98 dB, and in non-process section ranged between 46-98 dB. The results of audiometricexamination of the 50 workers who met the inclusion criteria, were 26 persons (52%) with sensorineuralNIHL and 24 persons (48%) did not experience NIHL. We found a significant association between noiseexposure among workers with elevated levels of triglyceride (TG), total cholesterol (TC), low-densitylipoprotein (LDL), and decreased high-density lipoprotein (HDL) levels (p<0,05). There was highcorrelation beween TG levels with the NIHL among workers who are exposed to noise >85 dB (p<0,05),and no correlation between elevated levels of TC, LDL and decreased HDL levels with NIHL (p>0,05).Conclusion: We found a significant relationship between hyperlipidemia and NIHL. Workers withhypertriglyceridemia had greater risk of suffering NIHL when exposed to noise >85 dB in the workplace. Keywords: Noise, NIHL, lipid profile

Schwannoma aurikula dekstra yang meluas ke kanalis auditorius eksternus Astin Prima Sari; Dian Ayu Ruspita
Oto Rhino Laryngologica Indonesiana Vol 47, No 1 (2017): Volume 47, No. 1 January - June 2017
Publisher : PERHATI-KL

Latar belakang: Schwannoma merupakan tumor jinak yang berasal dari sel Schwann. InsidenSchwannoma aurikula sangat jarang. Sebagian besar yang terjadi adalah Schwannoma vestibular.Penatalaksanaaan dengan ekstirpasi secara in toto dapat mencegah kekambuhan.Tujuan: Melaporkansatu kasus jarang, yaitu Schwannoma aurikula yang meluas ke kanalis auditorius eksternus (KAE).Kasus: Anak laki-laki usia 3 tahun datang dengan keluhan muncul benjolan pada daun telinga kiri sejak 6bulan terakhir, yang membesar perlahan hingga menutupi liang telinga. Dilakukan ekstirpasi biopsi padamassa tumor, dengan pendekatan retroaurikula. Massa dapat dilepas secara in toto. Hasil histopatologikesan Schwannoma. Enam bulan pasca operasi tidak didapatkan kekambuhan.Metode: Penelusurankepustakaan didapatkan 5 jurnal laporan kasus yang relevan.Hasil: Dari 5 kasus, seluruhnya melakukanekstirpasi massa Schwannoma secara in toto. Terdapat 2 kasus mengunakan pendekatan transmeatal, 2kasus dengan pendekatan retroaurikula, dan 1 kasus ekstirpasi langsung pada aurikula.Kesimpulan:Schwannoma aurikula merupakan kasus yang sangat jarang. Tidak ada kecenderungan usia maupun jeniskelamin tertentu. Penanganan dengan ekstirpasi yang komplit dapat mencegah kekambuhan.Kata kunci: Schwannoma aurikula, ekstirpasi, insisi retroaurikula ABSTRACTBackground: Schwannoma is a Schwann cells benign tumors. The incidence of auricularSchwannoma is rare. The most common is vestibular Schwannoma. Treatment of choice is completesurgical excision, and recurrence is rare. Purpose: Reporting a rase case of an auricular Schwannomathat spread to external auditory canals. Case: A three years old boy presented with a swelling in the leftauricular for 6 months, which was progressively increasing and spread into external auditory canals.An excisional biopsy via postauricular was performed under general anesthesia. The mass was totallyremoved. Diagnosis was reported to be Schwannoma by histopathologic examination. There was no signsof local recurrence during a 6 months of follow-up period. Method: Search literatures for evidence found5 case report journals were relevant to our clinical question. Result: From the 5 journals, all of themopted to do total excisional removal, 2 cases by transmeatal incision, 2 cases by postauricular incision,and 1 case by direct incision of the auricular mass. Conclusion: Auricular schwannoma is a rare case.Previous case reports showed no sufficient relevance on the age and sex tendency to the occurence ofauricular Schwannoma. A complete extirpation can prevent recurrence.Key words: Auricular schwannoma, extirpation, postroauricular incision

Prognostic Factors for Refractory Chronic Rhinosinusitis in Patients Chronic Rhinosinusitis Concomitant Asthma : An Evidence Based Case Report Kartika Dwiyani; Eka Dian Safitri; Yupitri Pitoyo
Oto Rhino Laryngologica Indonesiana Vol 48, No 2 (2018): Volume 48, No. 2 July - December 2018
Publisher : PERHATI-KL

Background: In chronic rhinosinusitis (CRS) patients concomitant with asthma, more severe sinus disease has been reported and recurrence rate remains significant after optimal management. In this review, patients with CRS concomitant with asthma which had optimal management will be analyzed. Did several factors e.g. mucosal eosinophilia, high eosinophil count, high Lund MacKay score, severity of asthma, peripheral blood count and type of surgery, affect the recurrence of rhinosinusitis? Purpose: To investigate prognostic factors for the recurrence or refractory in CRS patients concomitant with asthma. Case Report: Female, 31 years old, suffered CRS with nasal polyp concomitant with asthma. She had recurrence of her sinus disease although she had already received optimal management. Methods: Using Medline, Cochrane database and Hand searching to search for the evidence. The evidence selected was appraised by at least two members of our group using Oxford Centre for Evidence-based Medicine (CEBM) worksheet. Result: Two valid prognostic articles were appraised for the validity, importance and applicability in our clinical scenario. Conclusion: In this evidence-based case report, the type of surgery could affect the olfactory function and endoscopic postoperative score in CRS patients concomitant with asthma. It was found that Extensive Endoscopic Sinus Surgery (EESS) contributed as a prognostic factor to improve olfactory Visual Analog Scale (VAS) score and endoscopic postoperative score. Latar belakang: Pada pasien rinosinusitis kronis (RSK) yang disertai dengan asma telah banyak dilaporkan gejala sinus yang lebih berat dan angka kekambuhan yang signifikan walaupun pasien telah mendapatkan tatalaksana optimal. Dalam laporan ini, akan dianalisis pasien RSK yang disertai asma, yang telah mendapat terapi optimal. Apakah faktor-faktor eosinofilia pada mukosa, tingginya hitung jumlah eosinofil, tingginya skor Lund-MacKay, derajat keparahan asma, hitung jenis darah perifer dan jenis operasi, berperan terhadap kekambuhan rinosinusitis? Tujuan: Mengetahui faktor prognostik yang mempengaruhi kekambuhan pada pasien RSK yang disertai asma. Laporan kasus: Pasien wanita 31 tahun, dengan diagnosis RSK dengan polip yang disertai asma. Pasien mengalami kekambuhan rinosinusitis walaupun telah mendapatkan terapi optimal. Metode: Pencarian bukti dilakukan melalui Medline, Cochrane, Hand searching. Artikel yang didapat ditelaah oleh setidaknya dua anggota kelompok dengan menggunakan lembar kerja yang diperoleh dari Oxford Centre for Evidence-based Medicine (CEBM). Hasil: Dua artikel prognosis yang didapat, ditelaah kritis untuk dinilai validitas, pentingnya, dan kemampuan untuk dapat diaplikasikan dalam skenario klinis. Kesimpulan: Pada laporan kasus berbasis bukti ini, jenis operasi dapat merupakan faktor prognostik dalam memperbaiki skor Visual Analog Scale (VAS) olfaktori dan skor endoskopi pasca operasi. Extensive endoscopic sinus surgery (EESS) memiliki kontribusi sebagai faktor prognostik dalam memperbaiki skor VAS olfaktori dan skor endoskopi pasca operasi.

Pengaruh tonsilektomi terhadap ukuran dan ekspresi IL-6 tonsil lingualis pada pasien OSA Sally Mahdiani; Teti Madiadipoera; Iwin Sumarman; Bambang Purwanto
Oto Rhino Laryngologica Indonesiana Vol 42, No 2 (2012): Volume 42, No. 2 July - December 2012
Publisher : PERHATI-KL

Background: Obstructive sleep apnea (OSA) is a sleep breathing disorder caused by upper airway obstruction. It occurs on 51% adult and could cause systemic side effects. Hypertrophy of the palatine and lingual tonsils cause upper airway obstruction and increasing cytokine IL-6 production. Obstruction and inflammation products have an important role in causing OSA. Inflammation of the palatine tonsil causes lingual tonsil to be inflamed. Purpose: To find out the impact of tonsillectomy on size and IL-6 expression of lingual tonsil. Method:The quasiexperimental open label pre and post test design was done on August 2010 – October 2011. There were 20 adult subjects with snoring, palatine and lingual tonsil hypertrophy. All subjects filled the Epworth Sleepiness Scale (ESS) questionnaire, underwent ENT examination and biopsy using fiber optic rhinolaryngoscope. Immunohistochemistry examination for IL-6 were performed on all biopsy specimens. Results: There is highly significant improvement on lingual tonsil size score from 3 to 1 after tonsillectomy. IL-6 expression was significantly decreased from 12 to 2 after tonsillectomy. ESS score was also significantly decreased from 16 to 5. The reducing size of lingual tonsil correlates with decreasing of IL-6 expressions. Conclusion:Tonsillectomy on OSA patients reduced the IL-6 expression of the lingual tonsil and that cause the reducing of its size. Decreasing of obstruction and inflammation could lead to the decrease of the ESS score. Keywords: OSA, tonsillectomy, Epworth Sleepiness Scale, lingual tonsil size, IL-6 expression Abstrak : Latar belakang: Henti napas obstruktif saat tidur (OSA) merupakan gangguan napas saat tidur yang terjadi karena obstruksi saluran napas atas. Keluhan ini terjadi pada 51% orang dewasa dan menimbulkan efek samping sistemik berat. Pembesaran ukuran tonsil palatina dan tonsil lingualis akan menyebabkan obstruksi saluran napas atas dan mengakibatkan peningkatan produksi IL-6, sehingga akan menyebabkan OSA. Inflamasi yang terjadi pada tonsil palatina membuat tonsil lingualis mengalami inflamasi. Tujuan: Untuk melihat pengaruh tonsilektomi terhadap ukuran dan ekspresi IL-6 tonsil lingulis. Metode: Penelitian quasiexperimental open label pre and post test design di Poliklinik IK. THT-KL RSHS Bandung sejak Agustus 2010 – Oktober 2011. Subjek 20 orang dewasa dengan keluhan mendengkur, pembesaran tonsil palatina dan tonsil lingualis. Seluruh subjek mengisi kuesioner skala kekantukan Epworth (Epworth Sleepiness Scale/ESS), biopsi tonsil lingualis dengan rinolaringoskopi serat optik lentur dan imunohistokimia IL-6 jaringan biopsi. Hasil: Didapatkan perbaikan yang sangat bermakna skor ukuran tonsil lingualis sebelum tonsilektomi (3) dibandingkan setelah tonsilektomi (1). Nilai ekspresi IL-6 menurun sangat bermakna dari 12 menjadi 2. Skor ESS menurun secara bermakna dari 16 menjadi 5. Pengecilan ukuran tonsil lingualis berhubungan dengan penurunan ekspresi IL-6. Kesimpulan: Tonsilektomi pada pasien OSA dapat menurunkan ekspresi IL-6 pada tonsil lingualis, sehingga ukuran tonsil lingualis mengecil. Hilangnya obstruksi dan inflamasi mengakibatkan skor ESS menurun. Kata kunci: henti napas obstruktif saat tidur, tonsilektomi, Epworth Sleepiness Scale, ukuran tonsil lingualis, ekspresi IL-6

Penilaian kualitas hidup penderita karsinoma nasofaring berdasarkan Karnofsky Scale, EORTC QLQ-C30 dan EORTC QLQ-H & N35 Dewi Kurniawati; Frederik George Kuhuwael; Abdul Qadar Punagi
Oto Rhino Laryngologica Indonesiana Vol 43, No 2 (2013): Volume 43, No. 2 July - December 2013
Publisher : PERHATI-KL

Latar belakang: Karsinoma nasofaring (KNF) berpengaruh terhadap kualitas hidup penderita, baik dari kankernya sendiri, maupun pengobatan serta efek sampingnya. Penilaian kualitas hidup penderita KNF dapat secara unidimensional menggunakan parameter status tampilan Karnofsky Performance Scale (Karnofsky PS) atau multidimensional memakai parameter European Organization For Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) dan European Organization For Research And Treatment Of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35).Tujuan: Menilai kesesuaian hasil skor Karnofsky PS, EORTC QLQ-C30 dan EORTC QLQ-H&N35 dalam menilai kualitas hidup penderita KNF dengan menentukan korelasi antar parameter dan menentukan estimasi skor Karnofsky PS menggunakan skor EORTC QLQ-C30 dan skor EORTC QLQ-H&N35. Menganalisis hubungan antar parameter menurut stadium.Metode: Penelitian adalah observasional analitik dengan pedekatan cross sectional. Populasinya semua kasus KNF yang berobat ke Bagian THT-KL, Rumah Sakit Wahidin Sudirohusodo, Makassar. Sampel sebanyak 48 orang dipilih secara purposive. Penilaian kualitas hidup menggunakan parameter Karnofsky PS, EORTC QLQ-C30 dan EORTC QLQ-H&N35. Hasil: Didapati kesesuaian hasil skor dari ketiga parameter, ditandai adanya korelasi bermakna antara skor Karnofsky PS, skor EORTC QLQ-C30 dan skor EORTC QLQ-H&N35. Semakin tinggi skor Karnofsky PS, akan semakin rendah skor EORTC QLQ-C30 dan skor EORTC QLQ-H&N35 maka kualitas hidup penderita KNF semakin baik. Skor EORTC QLQ-C30 dan skor EORTC QLQ-H&N35 dapat mengestimasi skor Karnofsky PS. Terdapat hubungan bermakna antara Karnofsky PS, EORTC QLQ-C30 dan EORTC QLQ-H&N35 menurut stadium (p<0,05). Kesimpulan: DEORTC QLQ-C30 dan EORTC QLQ-H&N35 dapat melengkapi Karnofsky PS dalam penilaian kualitas hidup penderita kanker kepala leher terutama KNF. Kata kunci: Kualitas hidup, KNF, Karnofsky PS, EORTC QLQ-C30, EORTC QLQ-H&N3.

Fibrin glue and demineralized bone matrix effect on autologus cartilage graft in microtia reconstruction Dini Widiarni Widodo; Jenny Bashiruddin; Helmi Helmi; Alida Harahap; Nurjati Chairani Siregar
Oto Rhino Laryngologica Indonesiana Vol 45, No 1 (2015): Volume 45, No. 1 January - June 2015
Publisher : PERHATI-KL

Background: Microtia reconstruction is a challenge for ENT Head and Neck surgeons. Varioussurgical techniques using autograft cartilage have been done to perform auricular reconstruction.Knowledge of cartilage graft concerning resorption process that affected the size, form, and aestheticsubunit of the ear is mandatory. Purpose: To evaluate the success of cartilage autograft by identifyingchondrocyte apoptosis, tissue degradation based on cell character, matrix homogeneity, fibrosis,proteoglycans, collagen and Transforming Growth Factor β (TGF β) expression in application of FibrinGlue (FG) and or Demineralized Bone Matrix (DBM) after 12 weeks in microtia reconstruction by Nagatatechnique. Methods: Quasi-experiments. FG and/or DBM were applied on the rest of the 12 ear cartilageframework which was implanted on mastoid area. Apoptosis was examined by TUNEL. Safranin Ostaining and modified Mankin’s score was used to evaluate cartilage degradation and TGF β expressionby ELISA. Results: FG or DBM on cartilage graft showed significant increase in chondrocyte viabilitycompare with control group (p=0.00). Minimal fibrosis, more homogeneous extracellular matrix, decreasedproteoglycan and minimal thickening of collagen, had significant differences compared with control orFG-DBM group. Structure differences occurred among cartilage graft after 12 week implantation whereasFG showed minimal fibrous tissue, normal cell character, proteoglycan, collagen, and tissue homogeneity(p< 0.05). Conclusion: FG is highly recommended to reduce degradation of cartilage graft in microtiareconstruction. DBM can be still used to maintain chondrocyte viability, proteoglycans, and collagen. Keywords: cartilage graft, fibrin glue, demineralized bone matrix, transforming growth factor β, Mankinscore.ABSTRAK Latar belakang: Rekonstruksi mikrotia merupakan tantangan bagi ahli bedah THT-KL. Berbagaiteknik operasi menggunakan rangka telinga dengan tandur kartilago autologus telah dilakukan untukrekonstruksi mikrotia. Pengetahuan mengenai tandur kartilago sangat diperlukan, mengingat tandurdapat mengalami resorpsi dengan berjalannya waktu, sehingga mempengaruhi ukuran, bentuk, dan detilestetik subunit daun telinga. Tujuan: Mengetahui viabilitas kondrosit, degradasi jaringan berdasarkanperubahan karakter kondrosit, fibrosis, homogenitas matriks, ekspresi proteoglikan dan kolagenserta ekspresi transforming growth factor β (TGF β ) dengan atau tanpa fibrin glue (FG) dan/ataudemineralized bone matrix (DBM) pada rekonstruksi mikrotia setelah 12 minggu penanduran. Metode:Quasi-eksperimen. FG dan/atau DBM digunakan pada sisa tandur autologus kartilago rangka telinga,dilanjutkan pemeriksaan apoptosis dengan TUNEL. Pewarnaan Safranin O untuk menilai degradasijaringan dengan skor modifikasi Mankin dan ekspresi TGF β dengan ELISA. Hasil: penambahan FGatau DBM pada tandur kartilago, viabilitas sel meningkat berbeda bermakna dengan tanpa perlakuanatau FG-DBM.(p=0.00), fibrosis minimal, matriks lebih homogen, penurunan proteoglikan dan penebalankolagen minimal berbeda bermakna dengan kelompok tanpa perlakuan dan campuran FG-DBM. Terjadiperbedaan struktur jaringan setelah 12 minggu, FG mempunyai nilai fibrosis yang terendah, karaktersel normal, proteoglikan, kolagen, dan homogenitas jaringan (p<0,05). Kesimpulan: Penggunaan FGsangat dianjurkan untuk mengurangi degradasi tandur kartilago autologus pada rekonstruksi mikrotia. Dalam keadaan tidak memungkinkan dapat digunakan DBM karena masih baik dalam mempertahankanviabilitas kondrosit, proteoglikan dan kolagen. Kata kunci: tandur kartilago, fibrin glue, demineralized bone matrix (DBM), transforming growth factorβ (TGF β), Mankin score.

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