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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 481 Documents
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Hubungan obstructive sleep apnea dengan penyakit sistem kardiovaskuler Arie Cahyono; Bambang Hermani; Endang Mangunkusumo; Riski Satria Perdana
Oto Rhino Laryngologica Indonesiana Vol 41, No 1 (2011): Volume 41, No. 1 January - June 2011
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (481.162 KB) | DOI: 10.32637/orli.v41i1.57

Abstract

Background: Obstructive sleep apnea (OSA) is a disease characterized by periodic upper airway collapse during sleep, which could result in either apnea, hypopnea or both. OSA is very often  undetected but it is strongly associated with variety of medical complication, among others cardiovascular diseases.Purpose: To inform ENT specialists about the pathogenesis and pathophysiology of OSA and its complications. Literature review: Recent data from several studies has documented the association between OSA and cardiovascular disorders such as hypertension, heart failure, arrhytmia and atherosclerosis. The undetectable cardiovascular complication that lead by OSA could make the management of cardiovascular  disorders uneffective. Conclusion: A good understanding can help physicians to diagnose, manage and  prevent cardiovascular complication that caused by OSA. Keywords: obstructive sleep apnea, apnea, hipopnea, cardiovascular disease   Abstrak :  Latar belakang: Obstructive sleep apnea (OSA) adalah suatu penyakit yang ditandai dengan peristiwa kolapsnya saluran napas bagian atas secara periodik pada saat tidur yang mengakibatkan apnea, hipopnea atau keduanya. Gejala klinis OSA sering tidak terdeteksi, namun diduga dapat meningkatkan risiko berbagai macam komplikasi medis antara lain kelainan kardiovaskuler. Tujuan: Agar para ahli THT dapat mengerti mengenai patogenesis dan patofisiologi OSA dan komplikasinya. Tinjauan pustaka: Beberapa penelitian telah menyatakan tentang adanya hubungan antara OSA dengan penyakit kardiovaskuler seperti hipertensi, gagal jantung, aritmia dan arteriosklerosis. Patofisiologi OSA pada komplikasi kardiovaskuler yang sulit dideteksi dapat menyebabkan penatalaksanaan penyakit kardiovaskuler menjadi kurang efektif. Kesimpulan:Pemahaman yang baik dapat membantu menegakkan diagnosis dan melakukan tatalaksana yang tepat untuk mencegah komplikasi kardiovaskuler yang berhubungan dengan OSA.Kata kunci: obstructive sleep apnea, apnea, hipopnea, penyakit kardiovaskuler
Evaluasi proses menelan disfagia orofaring dengan Fiberoptic Endoscopic Examination of Swallowing (FEES) Muhammad Iqbal; Amsyar Akil; Riskiana Djamin
Oto Rhino Laryngologica Indonesiana Vol 44, No 2 (2014): Volume 44, No. 2 July - December 2014
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (420.915 KB) | DOI: 10.32637/orli.v44i2.95

Abstract

Latar Belakang: Disfagia adalah kesulitan dalam memulai atau menyelesaikan proses menelan. Disfagia dapat dibedakan menjadi disfagia orofaring dan disfagia esofagus. Sebagian besar pasien dengan keluhan disfagia mengeluhkan atau mengalami kesulitan menelan terutama pada fase orofaring. Disfagia orofaring dapat disebabkan oleh kelainan neurologis dan kelainan struktur yang terlibat dalam proses menelan. Tujuan: Penelitian ini dilakukan untuk  mengetahui perbedaan kejadian temuan FEES pada disfagia neurogenik dan mekanik. Metode: Penelitian observasional pada 10 kasus disfagia neurogenik dan 40 kasus disfagia mekanik kemudian dilakukan pemeriksaan FEES untuk melihat regurgitasi,leakage, residu, penetrasi, dan aspirasi setelah  diberikan 6 jenis bolus makanan yang berbeda mulai dari air, susu, bubur saring, bubur tepung, bubur biasa 5 ml, dan  seperempat biskuit. Hasil: Terdapat perbedaan bermakna antara disfagia neurogenik dengan disfagia mekanik dalam hal kejadian residu air (p=0,001; RP=16,000; IK 95%: 2,830-90,465), penetrasi (p=0,006; RP=9,333; IK 95%: 1,721-50,614). Penetrasi air (p=0,020; RP=6,000; IK 95%: 1,365–26,451), aspirasi (p=0,018; RP=7,000; IK 95%:1,480-33,109), aspirasi air (p=0,018; RP=7,000; IK 95%: 1,480-33,109). Tidak didapat perbedaan yang bermakna dalam hal  regurgitasi; leakage; residu susu, bubur saring, bubur tepung, dan biskuit; penetrasi susu, bubur biasa, bubur tepung, dan biskuit; serta aspirasi  susu, bubur biasa, bubur tepung, dan biskuit. Kesimpulan: Terdapat perbedaan bermakna antara disfagia neurogenik dengan mekanik dalam hal kejadian residu air, penetrasi air, aspirasi, dan aspirasi air. Tidak didapat perbedaan yang bermakna dalam hal  regurgitasi, leakage, residu, penetrasi, dan aspirasi pada konsistensi yang lain.  Kata kunci: Disfagia neurogenik, disfagia mekanik, fiberoptic endoscopic evaluation of swallowing.   ABSTRACTBackground: Dysphagia is difficulty in swallowing or completing ingestion. Dysphagia can be divided as oropharyngeal dysphagia and esophageal dysphagia. The majority of dysphagia cases are in oropharyngeal phase. Oropharyngeal dysphagia in adults can be due to neurological disorders oranatomical abnormalities. Objective: This research aimed to observe the differences of FEES findings in neurogenic dysphagia and mechanical dysphagia. Methods: The study was conducted using the observational method and the cross-sectional approach to 10 neurogenic dysphagia and 40 mechanical dysphagia. FEES examination was conducted to observe regurgitation, leakage, residu, penetration, and aspiration after the administration of 5 ml bolus of food with 6 types of different consistencies: water, milk, liquified sifted rice porridge, flour porridge, rice porridge, and a quarter of biscuit. Results: The research findings revealed that there was a significant difference between the neurogenic with mechanical dysphagia in residual of water (p=0.001; RP=16,000; 95% CI=2.830 to 90.465), penetration (p=0.006; RP=9.333; 95% CI=1.721 to 50.614). Penetration of water (p=0.020; RP=6.000; 95% CI=1.365 to 26.451), aspiration (p=0.018; RP=7.000; 95% CI=1.480 to 33.109), aspiration of water (p=0.018;RP=7.000; 95% CI=1.480 to 33.109. Conclusion: There was a significant difference between the neurogenic with mechanical dysphagia in water residual, penetration, penetration of water, aspiration, and aspiration of water. There were no significant differences for regurgitation, leakage and residual of milk, sifted rice porridge, flour porridge and biscuit; also in penetration of milk, flour porridge and rice porridge; and aspiration of milk, flour porridge, rice porridge and biscuit. Keywords: Neurogenic dysphagia, mechanical dysphagia, fiberoptic endoscopic evaluation of swallowing(FEES).
Peran neutral endopeptidase terhadap inflamasi saluran napas atas pada penderita obstructive sleep apnea Hatmansjah Hatmansjah; Marsetyawan Heparis Nur Ekandaru Soesaty; Bambang Hermani; Indwiani Astuti; Bambang Uji Djoko Rianto
Oto Rhino Laryngologica Indonesiana Vol 46, No 1 (2016): Volume 46, No. 1 January - June 2016
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1186.483 KB) | DOI: 10.32637/orli.v46i1.149

Abstract

Latar belakang: Obstructive sleep apnea (OSA) pada anak yang berhubungan dengan excessivedaytime somnolance (EDS), gagal tumbuh, kelainan kardiovaskular, gagal napas, dan kematian,prevalensinya terus meningkat. Inflamasi berperan pada patogenesis penyakit tersebut.Tujuan:Mengetahui peran neutral endopetidase (NEP) terhadap inflamasi pada penderita OSA dan hubungannyadengan mediator inflamasi subtance P (SP), interleukin-4 (IL-4), dan tumor necrosis factor α (TNF-α).Metode: Penelitian potong lintang dilakukan pada pada 36 pasien hipertrofi tonsil dan adenoid selamaMei 2013-2015. Diagnosis OSA ditegakkan dengan polisomnografi, dan kadar NEP, SP, IL-4 dan TNF-αyang berasal dari tonsil maupun adenoid dengan imunohistokimia.Hasil: Terdapat 21 penderita OSA(58,3%) dan 15 subjek tidak OSA (41,7%), dari total 36 sampel. Dijumpai hubungan yang bermaknaantara SP tonsil dan SP adenoid dengan OSA, serta IL-4 tonsil dengan OSA (p<0,05). Walau kadar NEPtonsil dan NEP adenoid lebih sedikit pada OSA, serta IL-4 adenoid, TNF-α tonsil dan adenoid lebihbesar pada OSA, perbedaan tersebut tidak bermakna (P>0,05). Dijumpai juga hubungan yang bermaknaantara SP tonsil dengan IL-4 tonsil dan SP tonsil dengan TNF-α tonsil (p<0,05).Kesimpulan: Terdapathubungan yang tidak bermakna antara NEP dan OSA, namun ditemukan hubungan yang bermakna antaraSP dan IL-4 dengan OSA. Kata kunci : Obstructive sleep apnea, neutral endopeptidase, substance P, interleukin-4 ABSTRACTBackground: The prevalence of obstructive sleep apnea (OSA) in children, which can lead toexcessive daytime somnolance (EDS), failure to thrive, cardiovascular disorders and respiratory failureand death, continues to rise. Inflammation is associated with OSA. Purpose: To identify the role of neutralendopeptidase (NEP) to inflammation in obstructive sleep apnea (OSA), and its association to inflammatorymediator subtance P (SP), interleukin-4 (IL-4) and tumor necrosis factor-α (TNF-α). Methods: A crosssectionalstudy had been done to 36 adenotonsilar hypertrophy child patients with OSA during the periodof time from May 2013-2015. OSA was diagnosed based on polisomnografi and the level of NEP, SP, IL-4and TNF-α by imunohistochemistry. Results: We found 21 subjects had OSA (58.3%) and 15 subjects didnot have OSA (41.7%), from total sample 36. There were significant associations between SP tonsil, SPadenoid and IL-4 tonsil with OSA (p<0.05). Although the number of NEP level in OSA was smaller thannon OSA and IL-4 adenoid, TNF-α tonsil and TNF-α adenoid OSA were found greater than non OSA,but the difference between them were not significant (p>0.05). Conclusion: This study did not found asignificant correlation between NEP with OSA but there were significant correlations between SP andIL-4 with OSA. Keywords: Obstructive sleep apnea, neutral endopeptidase, substance P, interleukin-4 Alamat Korespondensi: Hatmansjah, SMF THT RSUP Persahabatan, Jl. Persahabatan Raya No. 1,Jakarta, Email: hatmansjah@yahoo.com
Pengaruh vitamin D3 terhadap kadar vitamin D (25(OH)D) dan sel T Regulator pada rinitis alergi Rizki Ekaputra Handoko; Rus Suheryanto; Muhammad Dwijo Murdiyo
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (669.55 KB) | DOI: 10.32637/orli.v47i2.223

Abstract

Latar belakang: Rinitis alergi (RA) adalah peradangan atau inflamasi pada mukosa atau selaput lendir hidung yang didasari oleh reaksi hipersensitivitas tipe 1 dan diperantarai IgE. Rinitis alergi merupakan tipe rinitis kronis yang sering dijumpai. Sebanyak 30-50% penderita rinitis memiliki pemicu alergi dan prevalensinya cenderung meningkat. Vitamin D mempunyai peran memodulasi respon imun alamiah dan adaptif. Banyaknya pengaruh vitamin D dalam sistem imun diharapkan dapat mengatur aktivitas berbagai sel kekebalan, serta fungsi kekebalan tubuh dari epitel sel pada RA, namun konsensus sebagai bagian terapi RA saat ini masih belum ada. Tujuan: Mengetahui pengaruh pemberian vitamin D3 terhadap kadar vitamin D (25(OH)D) dan sel T Regulator (T reg) pada rinitis alergi. Metode: Penelitian eksperimental murni dengan rancangan penelitian randomized clinical trial (RCT) double blind, pre and post test control group dengan perlakuan berupa pemberian terapi sesuai ARIA (Allergic Rhinitis and its Impact on Asthma) dan vitamin D3 oral diberikan selama 4 minggu. Dilakukan penilaian VAS (Visual Analogue Scale), TNSS (Total Nasal Symptom Score), serta kadar vitamin D darah dan persentase sel T reg pada awal dan 4 minggu setelah perlakuan. Hasil: Pada kelompok perlakuan terdapat perbedaan bermakna kadar vitamin D sebelum dan sesudah perlakuan (p=0,01). Terdapat perbedaan yang bermakna dari peningkatan persentase sel T reg pada kelompok perlakuan dibandingkan kelompok kontrol (p=0,02). Terdapat hubungan antara peningkatan persentase sel T reg dengan kadar vitamin D pada kelompok perlakuan (p=0,01). Kesimpulan: Vitamin D3 dapat meningkatkan kadar vitamin D dan persentase sel T reg secara bermakna pada pasien rinitis alergi persisten sedang berat. Kata kunci: Rinitis alergi, vitamin D, sel T regulator ABSTRACT Background: Allergic rhinitis (AR) is an inflammatory disease of nasal mucosa based on type 1 hypersensitivity reaction and mediated by IgE. Allergic rhinitis is the most common type of chronic rhinitis. About 30±50% of patients with allergic rhinitis have trigger factors and its prevalence is increasing. Vitamin D has a function in modulation of innate and adaptive responses. The role of vitamin D in immune system is expected to regulate various immune cells activity, and the immune function of AR epithelial cells, but there were no consensus yet about vitamin D as part of AR therapy. Objective: To identify the effect of vitamin D3 on level of vitamin D (25(OH)D) and T regulator (T reg) cells in allergic rhinitis patients. Methods: This study was purely experimental research with randomized clinical trial, double-blind, pre and post test control group treated with appropriate therapy according to ARIA (Allergic Rhinitis and its Impact on Asthma) and vitamin D3 given orally for 4 weeks. Evaluations of VAS (Visual Analogue Scale) and TNSS (Total Nasal Symptom Score) value, vitamin D levels and the percentage of T reg cells were carried out at baseline and 4 weeks after treatment. Results: In the treatment group there was a significant difference between vitamin D levels before and after treatment (p=0.01). There was a significant difference on increased percentage of T reg cells in the treatment group compared with the control group (p=0.02). There was a correlation between the increasing percentage of T reg cells with vitamin D levels in the treatment group (p=0.01). Conclusion: Vitamin D supplementation could increase the level of vitamin D and the percentage of T reg cells significantly in patients with severe persistent allergic rhinitis. Keywords: Allergic rhinitis, vitamin D, T regulatory cell
Pengaruh pengobatan konservatif terhadap “mucociliar clearance” tuba Eustachius penderita OMSK benigna aktif Chintriany Hadiningsih; Raden Sedjawidada; Linda Kodrat; Abdul Kadir
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.v40i2.5

Abstract

Background: Mucociliary clearance is one of the defense mechanism of Eustachian tube mucosa.Eustachian tube disfunction is an important predisposing factor in the pathogenesis of recurrent otitismedia. Purpose: To find out the change of mucociliary clearence in active benign chronic suppurativeotitis media after conservative therapy. Method:Prospective experimental study in active benign CSOMwith sacharine 5% test, for the evaluation of mucociliary clearance time on day 1 and day 7 conservativetherapy. Result: The mean difference of mucociliary clearance time in the Eustachian tube was 608.94± 626.35 seconds (p<0.05) on day 7 of conservative therapy. Conclusion: The conservative therapy inbenign CSOM has shortened mucociliary clearance time.Key words: mucociliary clearance, mucociliary clearance time, chronic suppurative otitis media. Abstrak : Latar belakang: Mucociliar clearance merupakan salah satu bagian dari pertahanan mukosa tubaEustachius. Gangguan tuba Eustachius dapat merupakan faktor predisposisi penyebab otitis media yangberulang. Tujuan:Mengetahui perubahan waktu transpor mukosilia tuba Eustachius penderita otitismedia supuratif kronik (OMSK) benigna aktif, setelah pengobatan konservatif. Metode:Penelitianeksperimental prospektif pada penderita OMSK benigna aktif. Sampel penelitian mendapatkan perlakuanberupa tes sakarin 5% untuk menilai waktu transpor mukosilia tuba Eustachius pada hari pertama danketujuh pengobatan konservatif. Hasil: Perbedaan rata-rata transpor mukosilia tuba Eustachius sebelumdan sesudah pengobatan adalah 608,94±626,35 detik (p<0,05). Kesimpulan:Pengobatan konservatifdapat memperpendek waktu transpor mukosilia tuba Eustachius pada penderita OMSK benigna aktifyang berbeda secara signifikan.Kata kunci: mucociliar clearance, waktu transpor mukosilia, otitis media supratifkronik.
Pengaruh kemoterapi neoadjuvant terhadap ekspresi NFκB dan c-myc pada karsinoma nasofaring jenis undifferentiated Farida Nurhayati; Muhardjo M; Made Setiamika; Dyah Ratna Budiani
Oto Rhino Laryngologica Indonesiana Vol 42, No 1 (2012): Volume 42, No. 1 January - June 2012
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (445.832 KB) | DOI: 10.32637/orli.v42i1.37

Abstract

Background: Epstein Barr, virus ( EBV ) infection has been frequently related with Nasopharyngeal Carcinoma (NPC), this virus makes the tissue of nasopharyng express Nuclear Factor Kappa Beta  (NFκB). NFκB and c-myc are two transcriptional factor for proliferation. NFκB and c-myc are two sign system for malignancy. The administration of neoadjuvant chemotherapy may prevent the apoptosis and inhibit the proliferation. Purpose: To evaluate the effect of neoadjuvant chemotherapy upon the expression level of NFκB and c-myc in undifferentiated NPC. Method: Quasi Experimental research by one group before and after intervention design. Ten sampels were collected from nasopharyngeal biopsy tissue which had been diagnosed as undifferentiated NPC. Wilcoxon signed Ranks test and Spearman’s were used to analized data, utilizing SPSS 15.0 underwindows program. Result: After neoadjuvant chemotherapy,   there were significant increase (p=0.005) for expression of NFκB (1.11 ± 1.14 / 4.92 ± 2.79) and significant  increase for expression of c-myc (1.15 ± 0,78 / 3.04 ± 1.91). There were significant corelation between  expresion of NFκB and c-myc in undifferentiated NPC (p=0.001). Conclussion: There were significant increase in expression of NFκB and c-myc after neoadjuvant chemotherapy in undifferentiated NPC, and   significant corelation between expresion of NFκB and c-myc in undifferentiated NPC. Keywords: nasopharyngeal carcinoma, neoadjuvant chemotherapy, NFκB and c-myc   Abstrak :  Latar belakang: Patogenesis Karsinoma Nasofaring (KNF) banyak dikaitkan dengan infeksi virus Epstein Barr. Virus ini menyebabkan jaringan mengekspresikan Nuclear Factor Kappa Beta (NFκB). NFκB  dan c-myc merupakan faktor transkripsi, yang menyebabkan proliferasi jaringan. Adanya ekspresi NFκB dan c-myc merupakan dua faktor penting sebagai penanda terjadinya keganasan. Pemberian kemoterapi neoadjuvant diharapkan dapat menghambat proses proliferasi dan menyebabkan terjadinya apoptosis. Tujuan: Mengetahui pengaruh kemoterapi neoadjuvant terhadap ekspresi NFκB dan c-myc pada KNF jenis undifferentiated dan hubungan antara ekspresi NFκB dan c-myc. Metode dan bahan penelitian: Penelitian eksperimen kuasi dengan rancangan one group before and after intervention.  Sebanyak 10 sampel dari jaringan biopsi KNF jenis undifferentiated, masing-masing dilakukan pemeriksaan ekspresi NFκB dan     c-myc sebelum dan sesudah pengobatan. Analisa dengan Uji statistk Wilcoxon signed Ranks test dan Spearman’s menggunakan SPSS 15.0 program underwindow. Hasil penelitian: Setelah kemoterapi neoadjuvant terjadi peningkatan signifikan (p=0,005) ekspresiNFκB (1,11 ± 1,14 dibanding 4,92 ± 2,79) dan terjadi peningkatan signifikan (p=0.025) ekspresi c–myc (1,15 ± 0,78 dibanding 3,04 ± 1,91). Analisis hubungan antara ekspresi NFκB dengan c-myc pada KNF jenis undifferentiated memenuhi garis liniar dan signifikan (p=0,001). Kesimpulan: Terdapat peningkatan ekspresiNFκB dan c-myc sesudah kemoterapi neoadjuvant yang signifikanpada KNF jenis undifferentiated. Terdapat hubungan signifikan antara ekspresi NFκB dengan c-myc pada KNF jenis undifferentiated. Kata kunci: karsinoma nasofaring, kemoterapi neoadjuvant, NFκB dan c-myc
Gangguan pendengaran sensorineural pada gagal ginjal kronis yang dilakukan hemodialisis Muyassaroh Muyassaroh; Loriana Ulfa
Oto Rhino Laryngologica Indonesiana Vol 43, No 2 (2013): Volume 43, No. 2 July - December 2013
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (127.195 KB) | DOI: 10.32637/orli.v43i2.74

Abstract

Latar belakang: Etiologi gangguan pendengaran sensorineural (Sensorineural Hearing Loss/SNHL) yang berhubungan dengan gagal ginjal kronis (GGK) dan hemodialisis masih kontroversi. Mekanisme yang mungkin terjadi adalah perubahan osmotik yang mengakibatkan hilangnya sel-sel rambut, kolaps ruang endolimfatik, edema dan atrofi sel-sel penunjang, serta kemungkinan paparan dari membran selulose asetat dari dializer yang digunakan menyebabkan produk degradasi asetat masuk ke aliran darah. Tujuan: Kasus ini diajukan untuk mengilustrasikan kejadian kurang pendengaran sensorineural dapat diakibatkan oleh GGK dan/ataupenatalaksanaannya (hemodialisis). Kasus: Dilaporkan dua kasus kurang pendengaran terkait dengan GGK yang dilakukan hemodialisis. Satu kasus usia 53 tahun mengalami SNHL bilateral berat setelah 26 sesi dan satu kasus usia 54 tahun mengalami tuli campur (mixed hearing loss = MHL) bilateral setelah 14 sesi. Penatalaksanaan: Pemasangan alat bantu dengar (ABD) dan hemodialisis. Satu kasus pendengaran lebih jelas dengan pemakaianABD satu kasus tidak ada perubahan. Kesimpulan: Kurang pendengaran pada kedua kasus yang dilaporkan ini kemungkinan disebabkan akibat hemodialisis.Kata kunci: Gangguan pendengaran sensorineural, gagal ginjal kronis, hemodialisis.
Tuberkulosis hidung primer Fitri Heryanti; Teti Madiadipoera; Lina Lasminingrum; Sinta Sari Ratunanda
Oto Rhino Laryngologica Indonesiana Vol 45, No 1 (2015): Volume 45, No. 1 January - June 2015
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1713.991 KB) | DOI: 10.32637/orli.v45i1.109

Abstract

Latar belakang: Tuberkulosis (TBC) hidung primer sangat jarang terjadi. Dalam dua dekade terakhir, TBC paru maupun ekstraparu muncul kembali sebagai masalah besar dalam bidang kesehatan di dunia.Penegakkan diagnosis TBC hidung juga tidak mudah baik secara klinis maupun dalam pemeriksaanlaboratorium. Gejala dan tanda klinisnya bervariasi dan tidak spesifik, menyerupai lesi granuloma akibatinfeksi lainnya, non-infeksi, atau keganasan. Tujuan: Kasus ini diajukan untuk  mengingatkan kembalipara dokter umum dan spesialis Telinga Hidung Tenggorok-Bedah Kepala dan Leher mengenai kasusTBC hidung primer yang jarang dijumpai sehingga tidak terjadi keterlambatan penegakan diagnosisdan penanganan kasus tersebut jika ditemukan lesi granuloma di hidung. Kasus: Dilaporkan satu kasusTBC hidung primer pada pasien perempuan usia 28 tahun. Penatalaksanaan: Pada pasien ini, dilakukanprosedur untuk mendiagnosis TBC hidung primer, kemudian diberikan terapi obat anti tuberkulosis kombinasi dosis tetap (KDT)kategori Isesuai panduan nasionaldanWHO,serta larutan pencuci hidung. Kesimpulan:TBC hidung primer harus dipertimbangkan sebagai salah satu diagnosis banding untuk setiap pasien dengan lesi granuloma di daerah kepala dan leher.Diagnosisdinidan penanganan yangtepatdapat menghasilkan kesembuhan total dari penyakit yang jarang ini. Kata kunci: tuberkulosis hidung, lesi granuloma, obat antituberkulosis.ABSTRACT Background: Primary nasal tuberculosis (TB) is an extremely rare case. In the last two decades, tuberculosis both pulmonary and extrapulmonary reemerged as a major health problem worldwide. Thediagnosis of nasal tuberculosis is also not easy, both clinically and in the laboratory. The symptoms andsigns are various and nonspecific, similar to other granulomatous lesions due to infection, non-infectionand malignancy. This condition may cause treatment delays of the desease. Objective: To remind thegeneral practitioner and otorhinolaryngologist about the primary nasal tuberculosis cases which extremelyrare so there is no delay in the diagnosis and treatment of those cases when granulomatous lesionsappeared in the nose. Case: We reported one case of primary nasal tuberculosis in female patients 28years old. Management: We performed diagnostic procedures to this patient and found primary nasaltuberculosis and the patient was given antituberculosis drugs-fixed dose combination (FDC) categoryI based on national guidelines and WHO as well as nasal wash solution. Conclusion: Primary nasaltuberculosis should be considered as one of differential diagnoses for each patient with unusual lesionsappeared in the head and neck region. Early diagnosis and proper treatment could bring about totalcure of this rare disease. Keywords: nasal tuberculosis, granulomatous lesion, antituberculosis drugs
Epistaksis masif pada pseudoaneurisma traumatik arteri karotis interna Anna Mailasari Kusuma Dewi
Oto Rhino Laryngologica Indonesiana Vol 46, No 2 (2016): Volume 46, No. 2 July - December 2016
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1123.471 KB) | DOI: 10.32637/orli.v46i2.166

Abstract

Latar belakang: Pseudoaneurisma arteri karotis interna merupakan kasus yang jarang dijumpai, dengan gejala berupa perdarahan masif yang dapat terjadi secara lambat dan berulang. Pemeriksaan arteriografi merupakan prosedur standar untuk mengetahui sumber perdarahan. Tindakan embolisasi efektif untuk menghentikan perdarahan. Tujuan: Melaporkan kasus epistaksis masif pada pseudoaneurisma traumatik arteri karotis interna. Kasus: Pasien laki-laki berumur 19 tahun dengan trauma sinus sfenoid pasca kecelakaan, mengalami epistaksis masif berulang selama 7 bulan. Hasil nasoendoskopi didapati bekuan darah pada meatus superior, hasil CT scan menunjukkan lesi isodens pada sinus frontalis dan etmoid kanan, serta sinus sfenoid dan maksila bilateral, disertai gambaran arteri karotis komunis interna segmen kavernosus masuk ke sinus sfenoid melalui celah fraktur di sfenoid. Penatalaksaan berupa embolisasi dengan balloon. Pasca embolisasi tidak didapatkan perdarahan aktif. Metode: Penelusuran kepustakaan menghasilkan 33 jurnal, dan terdapat 10 jurnal yang relevan. Hasil: Dari 10 jurnal yang didapatkan, ditemukan 6 laporan kasus dan 4 hasil penelitian pseudoaneurisma traumatik arteri karotis interna yang ditatalaksana dengan embolisasi, mendapat keberhasilan yang tinggi, dan angka komplikasi yang rendah. Kesimpulan: Pseudoaneurisma traumatik karotis interna menimbulkan epistaksis masif berulang, yang membutuhkan ketepatan pemeriksaan penunjang untuk menegakkan diagnosis. Penatalaksanaan dengan embolisasi merupakan pilihan yang efektif untuk mencegah mortalitas.Kata kunci: Pseudoaneurisma karotis interna, trauma sinus sfenoid, epistaksis masifABSTRACT Background: Post injury internal carotid artery pseudoaneurysm is a rare case, mostly caused by head trauma. The symptoms are delayed and recurrent massive epistaxis. Angiography is the gold standard for confirming the diagnosis and visualizing the bleeding point. Endovascular interventions with depleted balloons and coils are effective treatment. Purpose: To report a case of massive epistaxis related to traumatic pseudoaneurysm of internal carotid artery. Case: A nineteen-years old male with sphenoid sinus injury caused by vehicle accident, which subsequently developed recurrent episodes of massive epistaxis for seventh month afterwards. He had undergone blood transfusion and nasal packing to control the bleeding. Nasal endoscopic examination showed blood clot in the superior meatus, while paranasal sinuses CT Scan showed isodense lesion in the right frontal and ethmoid sinuses, and bilateral sphenoid and maxillary sinuses. Cavernous segment of carotid communis artery entered into sphenoid sinus through a fracture line in the superior part of the sinus. Post arteriography and balloon embolization, there was no active anterior and posterior bleeding. Method: Searching for evidence produced 31 journals, and 10 journals were relevant to our clinical question. Result: From the 10 journals, 6 were case reports and 4 were researches of traumatic pseudoaneurysm of internal carotid artery which were treated by embolization. The results were good and complications were minimal. Conclusion: Traumatic pseudoaneurysm of internal carotid artery could cause massive epistaxis that requires a right clinical setting to diagnose, and embolization is the effective treatment to prevent mortality.Keywords: Internal carotid artery pseudoaneurysm, sphenoid sinuses trauma, massive epistaxis
Efektivitas desloratadin terhadap skor gejala hidung total dan kadar interleukin-4 sekret hidung rinitis alergi Luh Putu Dhena Purwaningsih; Dwi Reno Pawarti; Bakti Surarso
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.102 KB) | DOI: 10.32637/orli.v48i1.256

Abstract

Latar belakang: Rinitis alergi (RA) adalah penyakit atopi yang umum terjadi, namun terapi yangtersedia mempunyai keterbatasan baik dalam penggunaan maupun angka keberhasilan. Desloratadinberperan sebagai terapi alternatif RA yang dapat menghilangkan keseluruhan gejala RA dan menurunkankadar interleukin-4 (IL-4) sekret hidung. Tujuan: Menganalisis efektivitas desloratadin dibandingkandengan loratadin dalam menurunkan skor gejala hidung total dan IL-4 sekret hidung pada penderita RA.Metode: Merupakan double blind randomised clinical trial with pre-post test design. Analisis data denganindependent sample t-test. Sebanyak 24 penderita RA dibagi menjadi 2 kelompok terapi yaitu kelompokstudi (desloratadin), dan kelompok kontrol (loratadin). Evaluasi berdasarkan skor gejala hidung total danIL-4 sekret hidung, pra dan pasca 15 hari terapi. Hasil: Penelitian yang dilakukan sejak bulan Juli sampaiOktober 2016 menunjukkan hasil berupa perbedaan bermakna rerata persentase penurunan skor gejalahidung total kelompok desloratadin dibandingkan kelompok loratadin (p=0,000). Perbandingan penurunankadar IL-4 sekret hidung antara kelompok desloratadin dengan loratadin adalah berbeda tidak bermakna(p=0,236). Kesimpulan: Penurunan skor gejala hidung total desloratadin lebih besar dibandingkan denganloratadin, dan tidak didapatkan perbedaan penurunan pada kadar IL-4 sekret hidung. ABSTRACTBackground: Allergic rhinitis (AR) is a common atopic disease but its current treatment is limitedboth in usage, as well as in the success rate. Desloratadine is an alternative choice in the treatment ofAR, and it could reduce the Interleukin (IL-4) nasal secretion level. Purpose: To assess the effectivenessof desloratadine compared to loratadine in decreasing total nasal symptom score (TNSS) and levels ofIL-4 nasal secretions in AR patients. Method: A double blind randomized clinical trial (RCT). Twentyfour AR patients were divided into two treatment groups: study group (desloratadin) and control group(loratadine). Evaluation was based on TNSS and IL-4 nasal secretion level pre and post 15 days oftreatment. Result: Conducted from July to October 2016, this study showed the mean of TNSS reductionpercentage between desloratadine group compared to loratadine group was significant (p=0.000).The comparison of reduction of IL-4 nasal secretion level between desloratadine group and loratadinegroup was not significantly different (p=0.236). Conclusion: The TNSS decreased more in desloratadinecompared to loratadine, but there was no significant difference between both groups in the levels of IL-4nasal secretions

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