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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.
Arjuna Subject : -
Articles 493 Documents
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The depression level effect on the QOL of patients with obstructive sleep apnea syndrome Vicky Eko Nurcahyo; Donny Hendriyanto
Oto Rhino Laryngologica Indonesiana Vol. 50 No. 2 (2020): Volume 50, No. 2 July - December 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i2.377

Abstract

ABSTRACTBackground: Obstructive sleep apnea syndrome is one of the obstructive sleep disorders, which has a high prevalence. The neuropsychological impact will affect daily life activities, social life, and reduce the quality of life in patients with obstructive sleep apnea syndrome. Purpose: To find out the effect of depression level against the quality of life (QOL) on patients with obstructive sleep apnea syndrome. Method: Analytical observational study with cross sectional approach. The study sample was 30 patients with high risk of obstructive sleep apnea syndrome who came to Otorhinolaryngology Head and Neck Surgery Department of Dr. Moewardi Hospital, from February to April 2019. The samples were determined using the Modified Berlin Questionnaire, and had fulfilled the inclusion and exclusion criteria. The variables studied were measured using questionnaires, including the level of depression (Beck’s Depression Inventory-II) and quality of life (Sleep Apnea Quality of Life Index). Result: From 30 samples, there were 20 patients (66.7%) with moderate depression and 10 patients (33.3%) with severe depression. The mean QOL of patients with obstructive sleep apnea syndrome with moderate depression was 4.085±0.369, while with severe depression was 3.040±0.241. The Independent Samples t-test showed a statistically and clinically significant correlation between the level of depression and QOL patients with obstructive sleep apnea syndrome (95% CI=0.78-1.31; p=0.000; t=8.097). Conclusion: There was a significant effect of depression level on the quality of life of patients with obstructive sleep apnea syndrome. ABSTRAKLatar belakang: Obstructive sleep apnea syndrome merupakan salah satu gangguan bernapas saat tidur tipe obstruktif, yang memiliki prevalensi cukup tinggi. Gangguan neuropsikologis yang ditimbulkannya dapat mempengaruhi aktivitas kehidupan sehari-hari, kehidupan sosial, dan akan menurunkan kualitas hidup pada pasien obstructive sleep apnea syndrome. Tujuan: Mengetahui pengaruh tingkat depresi terhadap kualitas hidup pasien dengan obstructive sleep apnea syndrome. Metode: Penelitian observasional analitik dengan pendekatan potong lintang, yang dilaksanakan pada 30 pasien dengan risiko tinggi obstructive sleep apnea syndrome di Bagian Telinga Hidung Tenggorok Bedah Kepala dan Leher RSUD dr. Moewardi Surakarta. Subjek penelitian diambil berdasarkan Modified Berlin Questionnaire, dan memenuhi kriteria inklusi dan eksklusi. Variabel yang diteliti diukur menggunakan kuesioner, meliputi tingkat depresi (Beck’s Depression Inventory-II) dan kualitas hidup (Sleep Apnea Quality of Life Index). Analisis data dilakukan uji normalitas dengan uji Saphiro- Wilk. Jika data terdistribusi normal, uji hipotesis yang digunakan adalah Independent Samples t-test. Apabila data tidak terdistribusi normal maka dilakukan uji Mann Whitney. Nilai p<0,05 menunjukkan hasil yang signifikan. Hasil: Dari 30 sampel didapatkan 20 pasien (66,7%) dengan depresi sedang dan 10 pasien (33,3%) dengan depresi berat. Nilai rerata kualitas hidup pasien obstructive sleep apnea syndrome dengan depresi sedang didapatkan 4,085±0,369, sedangkan dengan depresi berat 3,040±0,241. Uji Independent Samples t-test menunjukkan adanya hubungan yang signifikan antara tingkat depresi dengan kualitas hidup pasien obstructive sleep apnea syndrome (IK 95%=0,78-1,31; p=0,000; t=8,097). Kesimpulan: Terdapat pengaruh tingkat depresi terhadap kualitas hidup pasien obstructive sleep apnea syndrome.
Diagnostic of lingual tonsil hypertrophy with lateral soft tissue cervical X-ray on laryngopharyngeal reflux Ade Asyari; Novialdi -; Bonny Murizky; Wahyu Julianda; Esmaralda Nurul Amany; Tuti Handayani; Hafni Bachtiar
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 1 (2021): Volume 51, No. 1 January - June 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i1.381

Abstract

Background: Lingual tonsil hypertrophy (LTH) evaluation could be performed by flexible fiberoptic laryngoscopy, lateral soft tissue cervical X-ray, CT scan, and magnetic resonance imaging (MRI). Lateral soft tissue cervical X-ray examination is considered as a procedure-of-choice for diagnostic testing of LTH, which, aside from being low cost, the examination could also be conducted in all hospitals and easy to be performed on children. Objective: To compare the lingual tonsil enlargement with examination procedure using lateral soft tissue cervical X-ray as an LTH diagnostic measure compared to the flexible fiberoptic laryngoscopy examination as the gold standard examination. Methods: A retrospective analytic study with cross-sectional design on 30 respondents of laryngopharyngeal reflux (LPR) patients who came for routine ENT physical examination, followed by flexible fiberoptic laryngoscopy examination along with lateral soft tissue cervical X-ray. Results: The sensitivity level of 65.38% was acquired from the statistical tests, along with specificity level of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 30.37%. Conclusion: Based on sensitivity and specificity, lateral soft tissue cervical X-ray examination could be used as a diagnostic measure and have an accurate capability to diagnose LTH.ABSTRAK Latar belakang: Evaluasi hipertrofi tonsil lingual (HTL) dapat dilakukan menggunakan laringoskopi serat optik fleksibel, foto Rontgen cervical soft tissue lateral, CT scan, dan magnetic resonance imaging (MRI). Foto Rontgen cervical soft tissue lateral dapat dipertimbangkan sebagai pilihan pemeriksaan diagnostik HTL, karena selain biayanya terjangkau, pemeriksaan ini dapat dilakukan di semua rumah sakit serta mudah dilakukan pada pasien anak. Tujuan: Membandingkan hasil pemeriksaan pembesaran tonsil lingual menggunakan foto Rontgen cervical soft tissue lateral dengan pemeriksaan laringoskopi serat optik fleksibel sebagai pemeriksaan baku emas. Metode: Penelitian analitik retrospektif dengan desain potong lintang pada 30 pasien laryngopharyngeal reflux (LPR) yang dilakukan pemeriksaan fisik THT rutin, diikuti dengan pemeriksaan laringoskopi serat optik fleksibel serta foto Rontgen cervical soft tissue lateral. Hasil: Didapatkan tingkat sensitivitas dari uji statistik sebesar 65,38%, dengan tingkat spesitivitas sebesar 100%, dan didapatkan nilai prediksi positif (NPP) sebesar 100% serta nilai prediksi negatif (NPN) sebesar 30,37%. Kesimpulan: Berdasarkan sensitivitas dan spesifisitas, foto Rontgen cervical soft tissue lateral dapat digunakan sebagai alat diagnostik dan memiliki kemampuan yang akurat dalam diagnosis HTL. Kata kunci: hipertrofi tonsil lingual, laryngopharyngeal reflux, laringoskopi serat optik fleksibel, foto Rontgen cervical soft tissue lateral 
Bilateral choanal atresia Luh Putu Lusy Indrawati; Muhammad Syafiq Riski; Ranita Parjaman
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.394

Abstract

ABSTRACTBackground: Choanal atresia is an uncommon anomaly that causes upper airway obstruction in newborns, with a frequency of 1 in 5000 to 7000 births. The definitive treatment is surgery. Purpose: To inform the diagnosis and management of a bilateral choanal atresia. Case report: A 2-months-old girl with a diagnosis of bilateral choanal atresia. The patient underwent transnasal endoscopic repair of choanal atresia under general anesthesia. Clinical question: Could transnasal endoscopic repair of choanal atresia followed by stenting, provide better result than other approaches? Review method: Literature search using keywords ’choanal atresia’ AND ’bilateral’ AND ’membranous’ AND ’endoscopic’ AND ’surgery’ AND ’stent’ was conducted through PubMed, Science Direct, and The Cochrane Library. Result: The search obtained 34 articles concerning choanal atresia. Selection based on inclusion and exclusion criteria, found 15 articles were relevant with the topic. Conclusion: A baby girl came with bilateral choanal atresia. The diagnosis was established by nasoendoscopy, supported by CT imaging. She underwent transnasal endoscopic repair of the stenotic choanae under general anesthesia.Keywords: bilateral choanal atresia, transnasal endoscopic surgery, congenital nasal airway anomalyABSTRAKLatar belakang: Atresia koana merupakan kelainan pada neonatus yang jarang terjadi, yang dapat menyebabkan obstruksi jalan napas atas. Frekuensi kasus sebanyak 1 dari 5000 sampai 7000 kelahiran. Tatalaksana definitif pada kasus atresia koana adalah tindakan operatif. Tujuan: Memberikan informasi mengenai diagnosis dan tatalaksana atresia koana bilateral. Laporan kasus: Bayi berusia 2 bulan dengan diagnosis atresia koana bilateral. Tatalaksana pada kasus ini adalah operasi membuka koana dengan pendekatan endoskopi transnasal. Pertanyaan klinis: Apakah tatalaksana operasi perbaikan atresia koana dengan pendekatan transnasal endoskopi yang diikuti dengan pemasangan stent lebih baik dibandingkan dengan pendekatan lain? Telaah literatur: Dilakukan penelusuran menggunakan kata kunci ’choanal atresia’ DAN ’bilateral’ DAN ’membranous’ DAN ’endoscopic’ DAN ’surgery’ DAN ’stent’ pada beberapa sumber data seperti PubMed, Science Direct, dan The Cochrane Library. Hasil: Didapatkan 34 artikel yang membahas atresia koana. Melalui kriteria inklusi dan eksklusi diperoleh 15 artikel yang relevan dengan topik. Kesimpulan: Telah dilaporkan pasien dengan diagnosis atresia koana bilateral. Diagnosis ditegakkan melalui endoskopi transnasal dan CT scan. Dilakukan perbaikan koana menggunakan pendekatan endoskopi transnasal, dengan anestesi umum.Kata kunci: atresia koana bilateral, endoskopi transnasal, kelainan kongenital hidung
Hearing impairment in hemodyalisis patients with hypertension and diabetes mellitus type-2 Nyilo Purnami; Nunuk Mardiana; Sabrina Izzattisselim; Alfarika Rosmalia; Makhmudyah Indri Cahyani
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 1 (2021): Volume 51, No. 1 January - June 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i1.396

Abstract

Background: Sensorineural hearing loss could occur in chronic kidney disease (CKD) patients undergoing hemodyalisis. In general, the frequency of hearing impairment in CKD is connected with age and gender, and with associated disorders such as hypertension and diabetes mellitus. Purpose: To find out the incidence of hearing loss (HL) in CKD patients with hypertension and diabetes mellitus who were undergoing hemodialysis, in Dr. Soetomo General Hospital. Method: This was an observational descriptive study. Subjects were all CKD patients who were undergoing hemodialysis from June until December 2019 in Dr. Soetomo General Hospital. Subjects were categorized demographically and the hearing impairment was examined with audiometric examination and otoacoutic emission test. Result: From 52 samples, there were 31 female and 21 male, with the ratio 1.5:1. The highest age group was in 31-40 years old, and the average was 47 years old. Hemodialysis CKD patients with hypertension were 46 subjects, 14 patients with normal hearing and 32 patients had hearing impairment: mild HL 25 patients, moderate HL 5 patients and moderate-severe 2 patients. Hemodialysis CKD patients with DM type-2 were 12 subjects, 3 patients with normal hearing, and 9 patients had hearing impairment: mild HL 4 patients, moderate HL 4 patients, and moderate-severe HL 1 patient. Conclusion: In this study, female hemodyalisis patients were more than male, and the highest age group was between 31-40 years old. Hearing impairment in CKD subjects with hypertension were mostly mild HL, while in CKD subjects with DM type-2 were mostly mild and moderate HL.ABSTRAK Latar belakang: Tindakan hemodialysis yang dilakukan pada penderita penyakit ginjal kronis (PGK) dapat menyebabkan gangguan pendengaran tipe sensorineural. Perlu dikembangkan penatalaksanaan gangguan pendengaran terkait hemodialisis. PGK dan gangguan pendengaran secara umum berhubungan dengan usia dan jenis kelamin, serta penyakit yang sering menyertai PGK seperti hipertensi dan diabetes mellitus. Tujuan: Mendapatkan angka kejadian gangguan pendengaran pada penderita PGK yang menjalani hemodialisis, dengan disertai hipertensi dan diabetes mellitus (DM) di RSUD. Dr. Soetomo. Metode: Disain penelitian ini adalah deskriptif observasional dengan sampel semua penderita PGK yang dilakukan hemodialisis di RSUD Dr Soetomo yang memenuhi kriteria inklusi. Sampel yang diambil berdasarkan data demografi kemudian dilakukan pemeriksaan audiometri dan otoacoustic emission. Hasil: Didapati penderita PGK perempuan sebanyak 31 orang dan laki-laki 21 orang, dengan rasio 1,5:1. Kelompok usia terbanyak adalah 31-40 tahun, dan rerata usia penderita 47 tahun. Pasien PGK yang dihemodialsis dengan disertai hipertensi ada 46 subjek, 14 orang tanpa gangguan pendengaran dan 32 orang mengalami gangguan pendengaran: derajat ringan 25 penderita, derajat sedang 5 penderita, dan derajat sedang-berat 2 penderita. Pasien PGK yang dihemodialisis dengan DM type-2 ada 12 orang: tanpa ganguan pendengaran 3 orang, gangguan pendengaran derajat ringan 4 penderita, derajat sedang 4 penderita,dan derajat sedang-berat 1 penderita. Kesimpulan: Penderita PGK jenis kelamin perempuan lebih banyak daripada laki-laki. Kelompok usia terbanyak adalah 31-40 tahun. Sebagian besar pasien PGK dengan HD mengalami gangguan pendengaran derajat ringan. PGK yang disertai hipertensi terbanyak mengalami gangguan pendengaran derajat ringan, sedangkan yang disertai DM yaitu derajat ringan dan derajat sedang.Kata kunci: gangguan pendengaran, hipertensi, diabetes mellitus tipe 2, penyakit ginjal kronis,hemodialisis
Non-Powder gunshot injury of the parapharynx space Raden Ayu Hardianti Saputri; Annika Famiasti; Nur Akbar Aroeman; Agung Dinasti Permana; Sinta Sari Ratunanda
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.402

Abstract

ABSTRACTBackground: Non-powder firearm is a weapon which used compressed air or CO2 gas to propel lead or steel ball pellets. Trauma caused by non-powder firearm has the potential for significant morbidity and mortality. Head and neck wounds account for 13.8%-30% of all non-powder firearm injuries. Bullets from gunshots often nest in the parapharyngeal space. Purpose: To present a case of non-powder firearm trauma in parapharyngeal space and its management. Case Report: A 13 years-old boy came with non-powder firearm trauma on the left cheek and bleeding from the left nostril. Upon physical examination there was a vulnus sclopetorum sized 0.5x0.5 cm without active bleeding in the left zygoma area. Three dimensional CTscan showed a hyperdense metal lesion in the left parapharyngeal space with 42.6 cm distance from penetrating site to the bullet location. The bullet was then extracted with transparotid approach surgery guided by C-arm imaging. Clinical Question: How is the management of trauma from a non-powder gunshot in the parapharyngeal space? Review method: Literature search through Pubmed, Cochrane Library, and Wiley using non-powder firearm injury in parapharyngeal space and its management as keywords. Result: The search obtained 11 articles. Based on inclusion and exclusion criteria, one article was found relevant with the topic i.e. one case report of non-powder firearm injury in parapharyngeal space and its surgical management. Conclusion: The safe procedure for retrieving bullets from the parapharyngeal space is in the form of surgery with the help of C-arm imaging to pinpoint the bullet’s location and to prevent further complication.Keywords: non-powder firearm, gunshot injury, parapharynx space, C-armABSTRAKLatar belakang: Senapan angin merupakan senjata yang menggunakan tenaga penggerak berjenis gas CO2 untuk melontarkan peluru. Trauma akibat senapan angin dapat berpotensi fatal. Sebanyak 13,8-30% luka tembak senapan angin terjadi pada daerah kepala dan leher. Salah satu ruang leher yang kerap menjadi tempat bersarangnya peluru adalah ruang parafaring. Tujuan: Melaporkan kasus dan penanganan trauma tembak senapan angin pada parafaring. Laporan kasus: Anak laki-laki berusia 13 tahun dengan riwayat tertembak senapan angin di pipi kiri dan perdarahan dari hidung kiri. Pada pemeriksaan fisis didapatkan vulnus sklopetorum berukuran 0,5 x 0,5 cm tanpa perdarahan aktif di area zigoma kiri. Hasil CT scan 3D didapatkan lesi hiperdens dengan densitas metal pada parafaring kiri, berjarak 42,6 mm dari luka. Benda asing peluru kemudian diekstraksi melalui tindakan operatif menggunakan pendekatan transparotid dengan bantuan C-Arm. Pertanyaan klinis: Bagaimana penatalaksanaan trauma tembak senapan angin pada ruang parafaring? Telaah literatur: Penelusuran literatur melalui Pubmed, Cochrane Library, dan Wiley menggunakan kata kunci luka tembak senapan angin pada ruang parafaring dan penatalaksanaannya. Ditemukan 11 artikel, dan pemilihan artikel berdasarkan kriteria inklusi dan eksklusi, terdapat satu penelitian yang relevan. Hasil: Didapat satu laporan kasus tentang luka tembak senapan angin di ruang parafaring dengan tindakan bedah sebagai penanganannya. Kesimpulan: Tatalaksana pengambilan peluru yang aman adalah dengan pendekatan pembedahan dengan bantuan C-Arm untuk mencegah komplikasi lebih lanjut.Kata kunci: senapan angin, luka tembak, trauma, ruang parapfaring, C-arm
Pathophysiology and management of gustatory rhinitis Shally Adhina Putri; Nina Irawati
Oto Rhino Laryngologica Indonesiana Vol. 50 No. 2 (2020): Volume 50, No. 2 July - December 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i2.404

Abstract

ABSTRACTBackground: Gustatory rhinitis is a syndrome that causes symptoms of annoying rhinorrhea, occurring immediately after consuming solid or liquid foods which are hot and /or spicy. Usually starts within a few minutes after the ingestion of the foods involved, and is not associated with itching, sneezing, nasal congestion or facial pain. Purpose: To discuss the pathophysiology and proper management of gustatory rhinitis. Literature Review: Recent studies suggest that gustatory rhinitis is likely associated with phenomenon of neurogenic inflammation. The ingestion of spicy foods  caused  the  stimulation of trigeminal sensory nerve endings located in the upper part of the aerodigestive track. Sensory   nerve stimulation seems to be correlated with an activation of post ganglionic cholinergic muscarinic parasympathetic fibers and sensitive to atropine. Conclusion: The initial management of gustatory rhinitis is avoiding the trigger foods. Using combination of topical steroid and anticholinergic intranasal had been proven more effective to treat the rhinorrhea caused by gustatory rhinitis than administration of single drug. ABSTRAKLatar belakang: Rinitis gustatori adalah sindroma yang menimbulkan gejala rinore yang mengganggu, sesaat setelah mengonsumsi makanan padat atau cair, yang bersifat pedas dan/atau berempah. Biasanya dimulai dalam beberapa menit setelah menelan makanan tersebut, dan tidak disertai dengan gatal, bersin, hidung tersumbat atau nyeri wajah. Tujuan: Untuk membahas patofisiologi dan tatalaksana yang tepat pada rinitis gustatori. Tinjauan Pustaka: Sejumlah studi terbaru mendapatkan rinitis gustatori berkaitan dengan fenomena inflamasi neurogenik. Proses menelan makanan pedas dapat menyebabkan stimulasi ujung saraf sensorik trigeminal yang terletak di jalur aerodigestif bagian atas. Stimulasi saraf sensorik tersebut berkaitan dengan pengaktifan serabut saraf parasimpatik muskarinik kolinergik post ganglion yang sensitif terhadap atropin. Kesimpulan: Tatalaksana awal yang dapat dilakukan untuk mengatasi rinitis gustatori adalah menghindari makanan pemicu. Kombinasi penggunaan antikolinergik intranasal dan steroid topikal, secara profilaksis atau sebagai terapi telah terbukti lebih efektif untuk mengatasi rinore akibat rinitis gustatori dibandingkan pemberian masing- masing obat tersendiri.
Laryngomalacia: diagnosis and management at Otorhinolaryngology Head and Neck Surgery Department Dr.Soetomo Hospital, Surabaya Muhtarum Yusuf; Puji Utami
Oto Rhino Laryngologica Indonesiana Vol. 50 No. 2 (2020): Volume 50, No. 2 July - December 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i2.405

Abstract

ABSTRACTBackground: Laryngomalacia is an abnormality of the larynx that leads to the inward collapse of the supraglottic structure during inspiration. The condition is primarily characterized by congenital stridor in infants and children. Diagnosis is often made based on the larynx visualization during inspiration. Laryngomalacia is generally recovers spontaneously at the age 2-5 years old, surgery is reserved for severe cases. Purpose: To obtain data of the clinical appearance, diagnosis, and therapy of laryngomalacia. Method: An observational study on medical records of all laryngomalacia patients at the Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine Universitas Airlangga /Dr. Soetomo General Hospital, Surabaya from January 1st, 2017 to December 31st, 2018. Data evaluation included clinical symptoms, type of laryngomalacia, comorbid factors, the age range of clinical improvement, and the management. Result: The main complaint of laryngomalacia was inspiratory stridor in 63 patients (82.89%), followed by dyspnea, snoring, hoarseness, and choking. Endoscopy finding mostly was type 1 in 69 patients (90.79%), the others were type 2 and 3. Comorbid factor mostly was neurological disease in 16 patients (21.03%), followed by congenital heart disease, congenital abnormality, prematurity, and laryngopharyngeal reflux. The age group of clinical improvement majority were <12 months, followed by >12-24 months, and no improvement in 56 patients (73.69%). Conservative therapy was conducted in 73 patients (96.05%) and 3 patients were tracheotomized. Conclusion: The main complaint of laryngomalacia was inspiratory noises, mostly found was laryngomalacia type 1.The highest comorbid factor was neurological disease. The most common management was conservative therapy. ABSTRAKLatar belakang: Laringomalasia adalah kolapsnya struktur supraglotik laring saat inspirasi. Laringomalasia umumnya sembuh spontan pada umur 2-5 tahun, pembedahan hanya dilakukan pada kasus yang berat.Tujuan: Memperoleh gambaran klinis penderita laringomalasia, diagnosis dan terapi. Metode: Penelitian observasional pada semua rekam medik yang lengkap penderita laringomalasia  di Departemen THT-KL RSUD Dr. Soetomo, Surabaya, periode 1 Januari 2017 - 31 Desember 2018. Data yang dievaluasi meliputi gejala klinik, tipe, faktor komorbid, usia perbaikan gejala, dan terapi. Hasil: Keluhan utama adalah napas berbunyi pada 63 penderita (82,89%), disusul sesak napas, mengorok saat tidur, suara parau, dan mudah tersedak. Temuan  endoskopik mayoritas tipe 1 pada  69 penderita (90,79%), sisanya tipe 2 dan 3. Faktor komorbid terbanyak penyakit neurologis pada   16 penderita (21,03%), disusul kelainan jantung bawaan, anomali kongenital, prematur, dan refluks laring faring. Usia perbaikan klinis mayoritas <12 bulan, diiikuti >12-24 bulan dan belum membaik 56 penderita (73,69%). Terapi konservatif dilakukan pada 73 penderita (96,05%) dan 3 penderita menjalani trakeotomi. Kesimpulan: Keluhan utama napas berbunyi, mayoritas laringomalasia tipe 1. Faktor komorbid terbanyak penyakit neurologis. Laringomalasia mayoritas diterapi secara konservatif.
The correlation of MMP-9 and VEGF expressions towards nasopharyngeal angiofibroma clinical stage Yuli Tetriana Sari; Rizalina Asnir; Ashri Yudhistira; Izry Naomi Lumbantobing
Oto Rhino Laryngologica Indonesiana Vol. 50 No. 2 (2020): Volume 50, No. 2 July - December 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i2.406

Abstract

ABSTRACTBackground: Nasopharyngeal angiofibroma (NA) is a benign tumor with a destructive tendency, commonly affecting male adolescents. The management of NA could become quite a challenge because it is highly vascularized, and localized in an intricate area. Recently, the role of molecular biology in the development of NA is the research target for a better prognosis. Purpose: To analyze the correlation between expressions of matrix metalloproteinase (MMP-9) and vascular endothelial growth factor (VEGF) with clinical stage, and the correlation between these two markers and nasopharyngeal angiofibroma. Method: This was a descriptive analytic study using cross sectional method. Twenty-four postoperative NA cases were categorized into early and advance stages according to Chandler classification. Evaluation of MMP-9 and VEGF expressions were examined by immunohistochemistry. The correlation of VEGF and MMP-9 towards clinical stage, was analyzed using chi-square or Fisher’s exact test (α = 0.05). Result: No significant correlation between MMP-9 expression and clinical stage (p = 0.204), whereas VEGF expressions and clinical-stage showed a significant correlation (p<0.001). Statistical analysis on correlation between MMP-9 and VEGF expressions showed no significant result (p = 0.099). Discussion: MMP-9 produces pro-angiogenic and anti-angiogenic factors. MMP-9 expression does not affect the growth of NA. VEGF is a pro-angiogenic growth factor that has the most important role in tumor pathophysiology and induces vasculogenesis and angiogenesis. VEGF secretion is affected by pro-angiogenic and anti- angiogenic activities of MMP-9. Conclusion: VEGF expression is related to the clinical stage of NA. Anti-VEGF could be further investigated as an alternative treatment for NA. ABSTRAKLatar belakang: Angiofibroma nasofaring (AN) merupakan suatu tumor jinak dengan kecenderungan destruktif. Penatalaksanaan AN merupakan tantangan karena banyaknya vaskularisasi, anatomi yang kompleks dan terjadi pada usia muda. Peranan biologi molekular pada pertumbuhan AN menjadi sasaran penelitian untuk mencari prognosis yang lebih baik. Tujuan: Mengetahui hubungan ekspresi matrix metalloproteinase-9 (MMP-9) dan vascular endothelial growth factor (VEGF) dengan stadium klinis, dan hubungan kedua marker tersebut pada AN. Metode: Studi analitik deskriptif menggunakan metode potong lintang. Dua puluh empat kasus AN pasca operasi, ditentukan stadiumnya berdasarkan klasifikasi Chandler, dan dikelompokkan menjadi kategori awal dan lanjut. Evaluasi ekspresi VEGF dan MMP-9 diperiksa secara immunohistokimia. Korelasi VEGF dan MMP-9 terhadap stadium klinis dianalisis menggunakan Chi-square atau Fisher’s exact test (α =0.05). Hasil: Tidak terdapat hubungan yang bermakna antara ekspresi MMP-9 terhadap stadium klinis (p = 0,204), sebaliknya ekspresi VEGF terhadap stadium klinis menunjukkan hubungan yang bermakna (p < 0,001). Analisis statistik antara hubungan MMP-9 dan VEGF menunjukkan hasil tidak bermakna (p = 0,099). Diskusi: MMP-9 memiliki kemampuan menghasilkan faktor-faktor pro-angiogenik, dan anti-angiogenik, sehingga ekspresi MMP-9 tidak mempengaruhi pertumbuhan angiofibroma nasofaring. VEGF merupakan pro-angiogenic growth factor yang memiliki peranan paling penting dalam patofisiologi tumor dan menginduksi vaskulogenesis dan angiogenesis. Sekresi VEGF dipengaruhi oleh kemampuan pro-angiogenik dan anti-angiogenik dari MMP-9. Kesimpulan: Ekspresi VEGF berhubungan dengan stadium klinis AN. Anti-VEGF dapat diteliti lebih lanjut sebagai alternatif pengobatan pada AN.
How I manage patient with tinnitus? Asma Abdullah; Yii Hern E; Norsyamimi AR; Kirubananthini J; Roslenda AR; Tuti Iryani MD; Noor Dina Hashim; Rosa Falerina; Zara Farina N; Khai Yng H
Oto Rhino Laryngologica Indonesiana Vol. 50 No. 2 (2020): Volume 50, No. 2 July - December 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i2.407

Abstract

ABSTRACTBackground: Tinnitus is believed to cause significant psychological distress leading to impairment in quality of life (QOL). Purpose: To assess the negative impact of tinnitus on patient’s QOL and discuss the management approach of tinnitus patient. Method: A cross-sectional study was conducted within one year duration on 88 patients who experienced tinnitus. Patients from Otorhinolaryngology clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were evaluated based on socio-demographic data, clinical data and QOL. QOL was assessed using Tinnitus Handicap Inventory (THI), a self-report questionnaire measuring 3 domains of QOL: functional, emotional and catastrophic scales. Result: Respondents consisted of 35 males (39.8%) and 53 females (60.2%), with mean age of 57.9±13.9 years old. Pure tone audiometry should be done at least once during the follow up period. Patients with persistent tinnitus had significantly higher mean THI total scores (p=0.042) and emotional subscale score (p=0.037) compared to patients with intermittent tinnitus. However, there were no significant associations between gender, duration of tinnitus and laterality of tinnitus with patient’s THI score. Discussion: All patients should have good history taking, proper physical examination and investigation. Those without the primary cause of tinnitus would be given tinnitus activity treatment by good counselling on tinnitus. Patient with vascular disorder would be given conservative treatment. Conclusion: Magnetic resonance imaging was indicated in asymmetrical hearing loss with tinnitus. Computed tomography scan with contrast was indicated when there is pulsatile tinnitus with/without abnormal ear finding. Patients with high grades THI questionnaire would be referred to psychiatrist for further assessment. ABSTRAKLatar belakang: Tinitus diyakini dapat menyebabkan stress psikologi yang signifikan sehingga mengakibatkan penurunan kualitas hidup seseorang (Quality of Life / QOL). Tujuan: Menilai dampak negatif tinitus pada kualitas hidup penderita dan merencanakan penatalaksanaannya. Metode: Penelitian ini merupakan studi potong lintang pada 88 penderita tinitus selama satu tahun. Penderita yang datang ke unit rawat jalan Telinga Hidung Tenggorok Bedah Kepala dan Leher (THT-KL), Universiti Kebangsaan Malaysia Medical Centre (UKMMC) dilakukan evaluasi berdasarkan data demografi, data klinis dan QOL. Quality of life dinilai menggunakan Tinnitus Handicap Inventory (THI), kuesioner tentang penderita yang mengukur 3 domain QOL: skala fungsional, emosional dan katastropik. Hasil: Responden terdiri dari 35 laki-laki (39,8%) dan 53 perempuan (60,2%), dengan rerata usia 57.9±13.9 tahun. Audiometri nada murni perlu dilakukan minimal satu kali selama periode penelitian. Penderita dengan tinitus persisten secara signifikan memiliki nilai rata-rata THI yang lebih tinggi (p=0.042) dan nilai emotional subscale (p=0.037) dibandingkan dengan penderita tinitus intermiten. Tidak ada hubungan yang signifikan antara jenis kelamin, durasi tinitus dan lateralisasi tinitus dengan nilai THI penderita. Diskusi: Semua penderita diperlukan anamnesis yang baik dan pemeriksaan fisik yang menyeluruh. Penderita tanpa penyebab primer dari tinitusnya akan diberikan terapi konseling tinitus yang baik. Penderita dengan gangguan pembuluh darah akan diberikan pengobatan konservatif. Kesimpulan: Magnetic resonance imaging perlu dilakukan pada gangguan pendengaran satu sisi dengan tinitus. Computed tomography scan dengan kontras dilakukan pada tinitus pulsatil dengan atau tanpa kelainan pada telinga. Pada pendertita dengan nilai kuesioner THI yang tinggi akan dirujuk ke psikiater untuk penilaian lebih lanjut.
Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis Bobby Pardomuan Sitompul; Rus Suheryanto; Hendradi Surjotomo
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 1 (2021): Volume 51, No. 1 January - June 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i1.409

Abstract

Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration compared to fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was an experimental research with double blind randomized clinical trial (RCT) design, and pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg in the morning and oral cetirizine 10 mg in the evening, and group-2 received intranasal fluticasone furoate 110 μg and montelukast 10mg. The treatment efficacy was assessed from nasal eosinophil count and total five symptoms score (T5SS) based on visual analogue scale (VAS) before and 4 weeks after treatment. Result: Both groups showed a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). Group-2 showed a statistically significant improvement in nasal obstruction and rhinorrhea compared to group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS was higher in group-2 than group-1, however it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast was found to be more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizineABSTRAK Latar belakang: Rinitis alergi masih merupakan masalah besar secara global dengan tatalaksana yang kompleks. Terapi medikamentosa rinitis alergi persisten sedang berat (RAPSB) berdasarkan guideline yaitu pemberian kortikosteroid intranasal (INCS) dikombinasikan dengan antihistamin oral atau leukotriene receptor antagonist (LTRA). Saat ini, terapi menggunakan kombinasi LTRA masih berdasarkan ada atau tidaknya komorbiditas asma pada pasien RAPSB. Tujuan: Mengetahui pengaruh pemberian fluticasone furoate bersama cetirizine dibandingkan dengan fluticasone furoate bersama montelukast terhadap eosinofil mukosa hidung dan perbaikan klinis pada penderita RAPSB. Metode: Penelitian eksperimental murni dengan rancangan uji klinik secara acak, tersamar ganda, serta kontrol pra dan pasca perlakuan. Penderita dibagi menjadi 2 kelompok. Kelompok 1 mendapat terapi fluticasone furoate intranasal 110 μg/hari dengan cetirizine 10mg/hari dan kelompok 2 fluticasone furoate intranasal 110 μg/hari dengan montelukast 10mg/hari. Penilaian efektivitas terapi dengan menilai jumlah eosinofil mukosa hidung dan total five symptoms score (T5SS) berdasarkan visual analogue scale (VAS) pada awal penelitian dan 4 minggu setelah perlakuan. Hasil: Kedua kelompok memperlihatkan penurunan jumlah eosinofil mukosa hidung dan penurunan T5SS berdasarkan VAS antara sebelum dan setelah perlakuan (p< 0.05). Kelompok 2 lebih baik secara bermakna menurunkan keluhan hidung tersumbat dan pilek encer dibandingkan kelompok 1 (p <0.05). Jumlah eosinofil dan T5SS berdasarkan VAS kelompok 2 lebih menurun dibandingkan kelompok 1, akan tetapi secara statistik tidak terdapat perbedaan yang bermakna. Kesimpulan: Pemberian fluticasone furoate serta montelukast lebih baik secara bermakna menurunkan keluhan hidung tersumbat dan pilek encer dibandingkan pemberian fluticasone furoate serta cetirizine. Kata kunci: rinitis alergi, cetirizine, kortikosteroid intranasal, montelukast

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