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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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Gambaran persepsi auditori CAP-II pada anak tuli prelingual bilateral 6–12 bulan pasca implantasi koklea Arief, Wresty; Zizlavsky, Semiramis; Priyono, Harim; Wahyuni, Luh Kurnia; Medise, Bernie Endyarni; Prihartono, Joedo
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Latar belakang: Anak tuli prelingual akan kehilangan fungsi mendengar dan bicara, sehingga akan berpengaruh pada komunikasi, psikologis, dan kualitas hidupnya. Implan koklea hadir sebagai alat habilitasi terutama pada anak dengan tuli derajat berat dan sangat berat. Tujuan: Membahas karakteristik anak 6-12 bulan pasca implantasi koklea, evaluasi perkembangan auditori anak, serta faktor-faktor yang memengaruhi hasil keluaran. Metode: Bersifat deskriptif potong lintang, pada 36 subjek yang dievaluasi dengan metode penilaian berupa pengamatan yang bersifat global yaitu Categories Auditory Performance (CAP)-II. Hasil: Median waktu saat evaluasi 8,9 bulan, median CAP-II pada subjek ialah 3 (minimal 2-maksimal 7), dengan pencapaian 33,3% subjek dalam kategori CAP tinggi (skor 5 atau lebih). Kesimpulan: anak pasca implantasi koklea memiliki peningkatan persepsi auditori CAP-II dibandingkan sebelum penggunaan implan koklea yang dapat mulai dievaluasi sejak 6 bulan pasca implan. ABSTRACT Background: Prelingual deaf in children will cause the sufferers to loose their function of hearing and speaking, thus, are unable to hear and speak, and impacting on their ability to communicate, to grow psychologically, and on their overall life quality. Cochlear implant comes as a habilitating device especially mainly for children with severe and profound deafness. Purpose: This study described the children’s characteristics at 6-12 months after cochlear implantation, by evaluating their auditory development, and other factors influencing the output. Method: A descriptive cross sectional study, conducted on 36 subjects, evaluating the subjects by using the global observation method of Categories Auditory Performance (CAP)-II. Results: The median hearing age was 8.9 months, the median score of CAP-II was 3 (minimum 2-maximum 7), and 33.3% of subjects reached high CAP scores (CAP score of ≥ 5). Conclusion: CAP-II score would increase in children

Metode biakan jaringan kolesteatoma pasien otitis media supuratif kronik tipe bahaya Restuti, Ratna Dwi
Oto Rhino Laryngologica Indonesiana Vol 43, No 1 (2013): Volume 43, No. 1 January - June 2013
Publisher : PERHATI-KL

Background: Tissue culture is a technique to multiply cells or tissue in vitro. With tissue culture cells can be studied as well as the nature of the application. Similarly, tissue culture methods can be applied also to cholesteatoma of chronic suppurative otitis media patients that can be used to study the nature of cholesteatomas to the cellular level. Purpose: The purpose of this study was to get tissue culture methods for cholesteatomas, so that the steps, techniques and specific tools for culturing cholesteatoma can be determined, also the number of cells that were planted, good environment in order to obtain cell viability and good culture results. Methods: This study consists of three phases: 1) Preliminary research phase aimed to determine the method of cell culture techniquesof cholesteatomas keratinocytes. 2) The stage of planting keratinocyte cells. 3) Phase keratinocytes cell harvest (harvest). Results: After this study, to get the optimal growth and viability, it would require the following methods: 1) Petri dish used for growing cholesteatomas keratinocyte cell is 1 cmdiameter petri dish; 2) The number of cells that were grown per cm2 of surface area of planting was 1-2 x 104cells per cm2; 3) The tripsinization time while harvesting cell was 30 seconds. Conclusion: Culture of cells was taken from the dispersion of certain organ which was done by enzymatic, mechanical and chemical disaggregation. Cultured keratinocytes had a short span of time and could be mixed with fibroblasts. Keratinocytes had a very limited replication half-life and there was a relationship between age and decline in the number of generations. This was associated with age, changes in the cell membrane and matrix components.Keywords: tissue culture, cholesteatoma, CSOM. ABSTRAKLatar belakang: Biakan jaringan merupakan suatu teknik memperbanyak sel atau jaringan secara in vitro. Dengan biakan jaringan dapat dipelajari berbagai sifat sel serta aplikasinya. Demikian juga jaringan kolesteatoma pasien otitis media supuratif kronik dapat digunakan metode biakan jaringan untuk mempelajari sifat jaringan kolesteatoma hingga tingkat sel. Tujuan: Tujuan penelitian ini adalah untuk mencari metode biakan jaringan kolesteatoma, sehingga didapatkan tahap-tahap biakan beserta teknik operasional baik alat spesifik yang digunakan, jumlah sel yang ditanam, lingkungan yang baik sehingga diperoleh viabilitas sel dan hasil biakan yang baik. Metode: Penelitian ini terdiri atas tiga tahap yaitu: 1) tahap penelitian pendahuluan yang bertujuan untuk menentukan metode teknik biakan sel keratosit kolesteatoma, 2) tahap menanam sel keratosit, 3) tahap memanen sel keratosit (harvest). Hasil: Setelah penelitian ini, untuk mendapatkan hasil pertumbuhan dan viabilitas yang optimal, maka diperlukan metode sebagai berikut: 1) petri yang digunakan untuk menanam sel keratinosit kolesteatoma adalah petri dengan diameter 1 cm, 2) jumlah sel yang ditanam per-cm2 luas permukaan bidang tanam adalah 1-2 x 104 sel per-cm2, 3) waktu tripsinisasi saat pengangkatan sel adalah 30 detik. Kesimpulan: Biakan sel adalah biakan yang diambil dari dispersi sel organ tertentu yang dilakukan dengan cara enzimatik, mekanik dan disagregasi secara kimiawi. Biakan keratinosit memiliki rentang waktu yang pendek dan hendaknya diwaspadai tercampur dengan fibroblas. Keratinosit memiliki waktu paruh replikasi yang sangat terbatas dan terdapat hubungan antara usia dengan penurunan jumlah generasi. Hal ini dikaitkan dengan usia, perubahan membran sel dan komponen matriks.Kata kunci: kultur jaringan, kolesteatoma, otitis media supuratif kronik.

Penyakit kelenjar saliva dan peran sialoendoskopi untuk diagnostik dan terapi Susyana Tamin; Duhita Yassi
Oto Rhino Laryngologica Indonesiana Vol 41, No 2 (2011): Volume 41, No. 2 July - December 2011
Publisher : PERHATI-KL

Background: Human salivary glands could be prone to diseases. Special tools have been createdto diagnose the disease of the glands and with the advancement of technology, better instruments weredeveloped. Purpose: We present this literature review to share the knowledge of diagnostic and therapyin today’s management of salivary gland disease. Literature Review: Human salivary glands consistedof major and minor salivary glands which produce saliva. Salivary gland secretion is a process that involves cell synthesis and active transport. Salivary gland diseases are also associated with secretion process. Sialoendosopy can be use as diagnostic and therapeutics tool in salivary glands disease. As atherapeutic tool, sialoendoscopy has a role in stone fragmentation and extraction and also dilatation ofstenosis and stricture. Conclusion: Sialoendscopy has many advantages in diagnosis and treatment ofsalivary gland disease, but its employment is still limited because of the high price and required skilledand experienced operator. Key words: salivary gland, salivary gland disease, sialoendoscopy Abstrak : Latar belakang: Kelenjar saliva manusia tidak lepas dari gangguan penyakit. Beberapa alat telahditemukan untuk diagnosis penyakit ini dan dengan semakin berkembangnya teknologi, sangat diharapkanberkembang pula alat diagnosis yang lebih baik. Tujuan: dengan tulisan ini diharapkan dapat memperluaswawasan terhadap perangkat diagnostik dan terapi pada penyakit kelenjar saliva. Tinjauan Pustaka:Kelenjar saliva manusia terdiri dari kelenjar saliva mayor dan minor yang berperan untuk memroduksisaliva. Sekresi kelenjar saliva merupakan suatu proses yang melibatkan sintesis sel dan transpor aktif.Penyakit kelenjar saliva juga berhubungan dengan proses sekresi. Sialoendoskopi dapat digunakansebagai alat diagnostik maupun terapi pada penyakit kelenjar saliva. Sebagai alat terapi, sialoendoskopidapat berperan pada fragmentasi dan ekstraksi batu serta dilatasi stenosis dan striktur. Kesimpulan:Sialoendoskopi memiliki keunggulan dalam diagnosis dan terapi penyakit kelenjar saliva, namunpenggunaannya masih terbatas karena harganya yang mahal dan diperlukan operator yang trampil danberpengalaman. Kata kunci: kelenjar saliva, penyakit kelenjar saliva, sialoendoskopi

Validitas dan reliabilitas EORTC QLQ-H&N35 sebagai alat ukur kualitas hidup penderita kanker kepala leher Rahmaeni, Rahmaeni; Kuhuwael, Freddy; Rahardjo, Sutji Pratiwi
Oto Rhino Laryngologica Indonesiana Vol 45, No 2 (2015): Volume 45, No. 2 July - December 2015
Publisher : PERHATI-KL

Latar Belakang: Saat ini belum ada alat yang valid dan reliabel untuk mengukur kualitas hidup penderita kanker kepala leher di Indonesia. Tujuan: Menilai validitas dan reliabilitas dari EORTCQLQ-H&N35 sebagai alat ukur kualitas hidup penderita kanker kepala leher di Makassar. Metode: Jenispenelitian ini adalah observasional analitik dengan pendekatan cross-sectional. Penelitian ini dilakukan pada bulan September–November 2013. Populasi penelitian adalah semua kasus kanker kepala leher yang datang berobat ke Bagian Ilmu Kesehatan THT-KL, Rumah Sakit Dr. Wahidin Sudirohusodo Makassar.Sampel sebanyak 60 orang dipilih secara purposive, yakni penderita kanker kepala leher yang belummenjalani terapi, sementara terapi, dan telah selesai terapi. Pengukuran kualitas hidup menggunakanEuropean Organization for Research and Treatment of Cancer - Head and Neck Cancer Quality of LifeQuestionnaire (EORTC QLQ-H&N35) yang sebelumnya sudah dilakukan uji validitas dan reliabilitasterlebih dahulu melalui validasi transcultural menurut WHO (World Health Organzation). Hasil: Padauji validitas didapatkan korelasi bermakna pada hampir semua skala gejala, sedangkan pada uji reliabilitashasil penilaian EORTC QLQ-H&N35 dengan adaptasi bahasa Indonesia ini mempunyai nilai reliabilitasyang sangat baik dengan nilai Cronbach-a >0,7. Kesimpulan: Instrumen EORTC QLQ-H&N35 denganadaptasi bahasa Indonesia adalah valid dan reliabel untuk mengukur kualitas hidup penderita kankerkepala leher di Bagian THT-KL RS Dr. Wahidin Sudirohusodo Makassar. Kata kunci: validitas, reliabilitas, EORTC QLQ-H&N35 ABSTRACTBackground: The lack of measurement tools which is valid and reliable for evaluating the quality of life of patients with head neck cancer in Indonesia. Purpose: To assess the validity and reliability ofthe EORTC QLQ-H&N35 as a tool to measure the quality of life of patients with head and neck cancerin Makassar. Methods: This study was an observational analytic cross-sectional approach. This researchwas conducted during September - November 2013. The population was all head and neck cancer caseswho came for treatment to the ENT Department Dr. Wahidin Sudirohusodo hospital. Sample of 60 peoplewere selected purposively. Assessment of quality of life used the European Organization for Research andTreatment of Cancer - Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35) afterthe validity and reliability tests was conducted transcultural validation in Indonesian language adaptationaccording to the WHO. Results: On the validity of the test, it showed significant correlation in almostall scales of symptoms, while on reliability test results of the EORTC QLQ–H&N35 assessment, it was excellent with values of Cronbach-a >0,7. Conclusion: The Indonesian adaptation EORTC QLQ–H&N35was found as valid and reliable instrument for assessing the quality of life of patients with head and neckcancer in ENT Department, Dr. Wahidin Sudirohusodo Hospital in Makassar. Keywords : validity, reliability, EORTC QLQ-H7N35

Pengaruh imunoterapi spesifik terhadap adenoid pada pasien rinitis alergi Pratita, Nindya; Madiadipoera, Teti; Ratunanda, Sinta Sari; Dermawan, Arif; Boesoirie, Shinta Fitri
Oto Rhino Laryngologica Indonesiana Vol 47, No 1 (2017): Volume 47, No. 1 January - June 2017
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah suatu reaksi inflamasi hidung yang diperantarai oleh IgE, dengan gejala hidung tersumbat, rinore, bersin, dan rasa gatal, akibat mukosa hidung terpapar alergen.Hipertrofi adenoid (HA) dianggap sebagai salah satu komorbid dari RA, sehingga mungkin terdapathubungan antara RA dengan HA.Tujuan: Mengetahui pengaruh imunoterapi spesifik terhadap penurunanukuran adenoid pada pasien RA.Metode: Penelitian dilakukan dengan desain quasi-eksperimental,menggunakan anamnesis, nasoendoskopi, dan skin prick test (SPT). Pengukuran derajat adenoid dilakukanpada 32 sampel di Poliklinik Rinologi-Alergi Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala- Leher Rumah Sakit Dr. Hasan Sadikin Bandung selama Februari – Juni 2015. Penelitian ini dibagimenjadi dua kelompok yaitu kelompok pasien RA dengan HA sebagai komorbid yang mendapatkanpengobatan imunoterapi spesifik, dan kelompok yang mendapatkan terapi medikamentosa kombinasiberupa fluticasone furoate dengan cetirizine.Hasil: Pada kelompok yang diberikan imunoterapi spesifik,terjadi penurunan ukuran adenoid yang bermakna, dibandingkan dengan kelompok yang diberikan terapimedikamentosa kombinasi. Persentase penurunan untuk kelompok imunoterapi spesifik sebesar 80,4%,sedangkan pada kelompok pembanding sebesar 60,5%.Kesimpulan: Terdapat penurunan ukuran adenoidsecara signifikan pada kelompok yang mendapatkan pengobatan imunoterapi spesifik, yang lebih baikjika dibandingkan terapi medikamentosa kombinasi.Kata kunci: Rinitis alergi, hipertrofi adenoid, imunoterapi spesifik ABSTRACTBackground: Allergic rhinitis (AR) is an IgE-mediated inflammation reaction of the nosecharacterized by specific symptoms of nasal obstruction, rhinorrhea, sneezing, and nasal itching, whenthe nasal mucous membrane was exposed to allergen. Adenoid hyperthrophy (AH) is considered to beone of AR comorbid factor, and there might be a relationship between AR and AH. Purpose: To evaluatethe effect of specific immunotherapy in decreasing the size of AH in AR’s patients. Methods: This studydesign was a quasi-experimental. We used anamnesis, nasoendoscopic finding, and skin prick test.Measurement of adenoid had been conducted on 32 subjects in the Rhinology-Allergy Clinic of ORL-HNSDepartement of Dr. Hasan Sadikin General Hospital during February – June 2015. This study was dividedinto a group which was given specific immunotherapy, and a group which was given medical treatmentin the form of combination fluticasone furoate and cetirizine. Results: The group which was treated withspecific immunotherapy showed a significant decrease of the adenoid size compared to the group withcombination medication of fluticasone furoate and cetirizine. Specific immunotherapy decreased adenoidsize up to 80.4%, while in the other group was 60.5%.Conclusion: The study showed that the decreaseof adenoid size in the group treated with specific immunotherapy treatment was better than the grouptreated with combined medication treatment.Keywords: Allergic rhinitis, adenoid hyperthrophy, specific immunotherapy

Association between dust particulate and occupational rhinitis among basement parking lot workers in Jakarta Niken Lestari Poerbonegoro; Setyawati Budiningsih; Rina Metalapa
Oto Rhino Laryngologica Indonesiana Vol 48, No 2 (2018): Volume 48, No. 2 July - December 2018
Publisher : PERHATI-KL

Background: Jakarta municipal government estimates that at least 70% of Jakarta air pollution comes from traffic and vehicles. The prevalence of occupational rhinitis increases in such polluted environment. History of atopic disease and smoking habit might aggravate this condition. Purpose: To determine the association between dust particulate matter exposure and occupational rhinitis among basement parking lot workers in Jakarta. Methods: A cross-sectional study was performed on 57 workers from December 2014 until March 2015. Questionnaires on nasal symptoms and eosinophil counts by nasal mucosal scrapings were collected before and after working-hours to evaluate occupational rhinitis. Level of dust particulate matter was measured using high volume air sampler, and calculated by gravimetric method. Results: Three workers were diagnosed with occupational rhinitis (5.2%). Level of dust particulate matter was below permitted level in studied basement parking lots. There was no significant association between occupational rhinitis and working period (OR 0.5 [95% CI 0.43 to 5.85], p=1.000) and workplace (OR 435 [95%CI =0.37-51.37], p=0.255). Increased eosinophil level was associated with the history of atopic disease (OR 23.33 [95%CI=2.40-224.62], p=0.001but not associated with smoking habit (OR 0.13 [95%CI=0.22-7.71], p=0.575). Conclusion: There was no significant association between dust particulate matter exposure and occupational rhinitis among basement parking lot workers. Despite the low level of dust particulate matter exposure, occupational rhinitis did occur. Latar Belakang: Pemerintah DKI Jakarta memperkirakan sekitar 70% polusi udara di Jakarta berasal dari lalu lintas dan kendaraan bermotor. Prevalensi Rinitis Akibat Kerja (RAK) cenderung meningkat pada lingkungan berpolusi. Riwayat atopi dan kebiasaan merokok dapat memperberat penyakit tersebut. Tujuan: mengetahui hubungan pajanan partikulat debu terhadap RAK pada pekerja area parkir basement di Jakarta. Metode: Studi potong lintang dilakukan terhadap 57 pekerja dari Desember 2014 sampai Maret 2015. Pengisian kuesioner gejala hidung dan hitung jumlah eosinofil kerokan mukosa hidung dilakukan sebelum dan sesudah jam kerja untuk evaluasi RAK. Kadar partikulat debu diukur dengan High Volume Air Sampler lalu dikalkulasi dengan metode gravimetrik. Hasil: Didapatkan 3 orang pekerja dengan diagnosis RAK (5,2%). Kadar pajanan partikulat debu di lokasi studi dibawah nilai ambang batas yang diizinkan. Tidak terdapat hubungan bermakna antara RAK dengan lama bekerja (OR 0,5 [95% CI 0,43- 5,85], p=1,000) dan tempat kerja (OR 435 [95%CI=0,37-51,37], p=0,255). Terdapat hubungan yang bermakna antara peningkatan kadar eosinofil dan riwayat atopi (OR 23,33 [95%CI=2,40-224,62], p=0,001), tetapi hubungan tidak bermakna ditemukan antara peningkatan kadar eosinophil dan kebiasaan merokok (OR 0,13 [95% CI=0,22-7,71], p=0.575). Kesimpulan: Tidak terdapat hubungan bermakna antara pajanan partikulat debu dan RAK pada pekerja area parkir basement. Pada kadar partikulat debu rendah, ternyata ditemukan pekerja dengan RAK.

Ekspresi cyclooxygenase-2 (COX-2) pada penderita rinosinusitis kronis Agus Multazar; Siti Nursiah; Andrina Rambe; Ida Sjailandrawati Harahap
Oto Rhino Laryngologica Indonesiana Vol 42, No 2 (2012): Volume 42, No. 2 July - December 2012
Publisher : PERHATI-KL

Background: Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinus mucosa, which are closely related to the involvement of ostiomeatal complex as the drainage pathway of of maxillary and frontal sinuses. Inflammation or edema at the ostiomeatal complex could cause drainage problems leading to rhinosinusitis. Increased expression of COX-2 regulation was considered to play an important role in the development of CRS and increased airway inflammation in the nasal mucosa and paranasal sinuses. Purpose: To find out the expression of Cyclooxygenase-2 in our CRS patients. Methods: This descriptive research was conducted on July 2011 - December 2011 at ENT Department and Pathology Anatomy Department of Medical Faculty of Sumatera Utara University/H. Adam Malik General Hospital, Medan, to all patients diagnosed with CRS and underwent sinus surgery on July 2011 - December 2011. Results: The highest proportion of pain in patients with CRS is facial pain/pressure and headache with nasal congestion which was 78.6%. Multisinusitis on paranasal sinus CT scan was 88.0%. There was a significant correlation between the proportion of pain with the expression of COX-2 (p = 0.033). There was a significant correlation in proportion between the number of sinuses involved with the expression of COX-2 (p = 0.002). Conclusion: This study found positive expression of COX-2 was 84,0%, while negative expression was 16,0% in our rhinosinusitis patients. This lead to conclusion that upregulation of COX-2 expression is thought to play a role as a mediator in the development of CRS. Keywords: chronic rhinosinusitis, ostiomeatal complex, cyclooxygenase-2, immunohistochemical. Abstrak : Latar belakang: Rinosinusitis kronis merupakan peradangan mukosa hidung dan sinus paranasal yang erat hubungannya dengan keterlibatan kompleks ostiomeatal atau celah sempit di etmoid anterior, yang merupakan serambi muka bagi sinus maksila dan frontal. Bila terdapat gangguan di daerah kompleks ostiomeatal seperti inflamasi atau edema maka hal itu akan menyebabkan gangguan drainase sehingga terjadi rinosinusitis. Peningkatan regulasi ekspresi COX-2 diperkirakan memegang peran penting sebagai mediator dalam terjadinya rinosinusitis kronis dan peningkatan inflamasi saluran napas di mukosa hidung dan sinus paranasal. Tujuan: Mengetahui ekspresi cyclooxygenase-2 pada penderita rinosinusitis kronis di RSUP H. Adam Malik, Medan. Metode: Penelitian ini bersifat deskriptif dilakukan di Departemen THT-KL FK USU/RSUP H. Adam Malik, Medan dan Departemen Patologi Anatomi FK USU. Penelitian dilakukan bulan Juli - Desember 2011 pada seluruh penderita yang didiagnosis rinosinusitis kronis, yang menjalani operasi sinus di Divisi Rinologi Departemen THT-KL FK USU/RSUP H. Adam Malik, Medan bulan Juli 2011 - Desember 2011. Hasil: Proporsi rasa nyeri terbanyak pada penderita rinosinusitis kronis adalah rasa nyeri/ nyeri tekan wajah, sakit kepala disertai dengan hidung tersumbat 78,6%. Multi sinusitis pada pemeriksaan CT-Scan sinus paranasal sebanyak 88,0%. Ada hubungan yang bermakna antara jumlah sinus yang terlibat dengan ekspresi COX-2 (p = 0,002). Ada hubungan yang bermakna antara proporsi rasa nyeri dengan ekspresi COX-2 (p=0,033). Kesimpulan: Pada penelitian ini didapati pada penderita rinosinusitis kronis, ekspresi COX-2 yang positif yaitu sebanyak 84,0%, sedangkan yang negatif sebanyak 16,0%. Diperkirakan peningkatan regulasi ekspresi COX-2 berperan sebagai mediator dalam terjadinya rinosinusitis kronis. Kata Kunci: rinosinusitis kronis, kompleks ostiomeatal, cyclooxygenase-2, imunohistokimia.

Pengaruh bising lingkungan sekolah terhadap kelelahan bersuara pada guru sekolah dasar Hellena Miranda; Abdul Rachman Saragih; Adlin Adnan; Tengku Siti Hajar Haryuna
Oto Rhino Laryngologica Indonesiana Vol 41, No 1 (2011): Volume 41, No. 1 January - June 2011
Publisher : PERHATI-KL

Background: The effect of noisy school environment is not only affecting student’s consentration level, but also causing problem to teachers’s voice. Purpose: To know the influence of noisy school environment techers voice intensity of the lecturer toward the lecturer’s speaking exhaustion at a number of elementary school located in Medan. Method: The research used case control method upon 90 elementary school teachers as the subject. The teachers came from schools influenced by noisy environment and schools with quite environment located in the city of Medan. The exhaustion level of speaking is identified by score of voice handicap index (VHI). The statistical tests used were “t-test”, Chi-square test and the multinomial logistic regression test. Result: Average level of noise in case group was 80.8 dB, in control group was 54.6 dB, with voice intensity of 79.6 dB and 61 dB. The voice disturbance in both group identified as medium level with the score of VHI ranges from 20-40 (p=0.03). By statistical analysis using “Xtest”, we found significant corelations between the VHI score with school noise (p=0.03), the lecturer’s voice (p=0.03) and sex (p=0.01). The result of multinomial logistic regression test shows that voice exhaustion disruption were influenced by school noise intensity (OR=3.4, IK95%=1.05-10.94) and the lecturer’s voice intensity (OR=3.2, IK95%=1.04-10.07).Conclusion: Teachers at schools with noisy environment had 3.4 times higher risk than teachers from schools with quite environment, and teachers who used high intensity voice had 3.2 times higher risk than teachers with low intensity for voice disturbance. Key words: voice exhaustion, noise intensity, voice intensity Abstrak : Latar belakang: Lingkungan sekolah yang bising selain mempengaruhi konsentrasi belajar-mengajar, dapat juga menyebabkan masalah bersuara pada guru. Tujuan: Untuk mengetahui pengaruh bising lingkungan sekolah dan intensitas suara mengajar terhadap kelelahan bersuara pada guru di beberapa sekolah dasar negeri di kota Medan. Metode: Desain penelitian ini adalah studi kasus kontrol dengan subjek penelitian 90 guru yang mengajar di sekolah yang terpajan bising dan sekolah yang tidak terpajan bising di kota Medan. Tingkat kelelahan bersuara diidentifikasi melalui skor voice handicap index (VHI). Uji statistik yang digunakan uji t, uji X dan uji regresilogistic multinomial. Hasil: Rerata intensitas bising pada kelompok kasus sebesar 80,8 dB, sedangkan pada kelompok kontrol sebesar 54,6 dB. Intensitas suara guru saat mengajar, masing-masing sebesar 79,6 dB dan 61 dB. Gangguan kelelahan bersuara pada kedua kelompok tergolong ringan, dengan skor VHI sebesar 20-40 untuk kedua kelompok (p=0,03). Setelah dilakukan analisis statistik terhadap variabel yang diduga mempengaruhi skor VHI dengan menggunakan uji X2didapatkan hubungan yang bermakna antara intensitas bising sekolah (p=0,03) intensitas suara guru (p=0,03) dan jenis kelamin (p=0,01) dengan skor VHI. Hasil uji regresi logistik multinomial menunjukkan bahwa hanya intensitas bising sekolah (OR=3,4, IK95%= 1,05-10,94) dan intensitas suara guru (OR=3,2, IK95%=1,04-10,07) berpengaruh terhadap gangguan kelelahan bersuara.Kesimpulan: Guru yang mengajar di sekolah yang terpapar bising memiliki risiko kelelahan bersuara 3,4 kali lebih tinggi dibandingkan dengan guru di sekolah yang tidak terpapar bising, dan guru dengan intensitas suara yang tinggi saat mengajar akan mengalami kelelahan bersuara 3,2 kali lebih sering dibandingkan guru dengan intensitas suara rendah. Kata kunci: kelelahan bersuara, intensitas bising, intensitas suara

Rekonstruksi defek mandibula menggunakan jabir bebas fibula Dini Widiarni; Indah Saraswati
Oto Rhino Laryngologica Indonesiana Vol 44, No 2 (2014): Volume 44, No. 2 July - December 2014
Publisher : PERHATI-KL

Latar belakang: Perkembangan teknik pembedahan mikrovaskular telah menghasilkan jabir bebas fibula yang dapat digunakan untuk rekonstruksi oromandibular. Jabir bebas fibula merupakan salah satu jabir tulang yang sering digunakan untuk mengatasi defek pada daerah wajah, terutama dalam rekonstruksi mandibula. Jabir ini memiliki banyak keunggulan dibandingkan dengan jabir tulang lainnya, seperti jabir skapula dan jabir iliaka. Jabir ini memiliki angka kesuksesan yang cukup tinggi yaitu mencapai 95%, namun untuk mencapai angka keberhasilan tersebut diperlukan perencanaan yang tepat sebelum dilakukannya pengambilan jabir mulai dari preoperatif, perioperatif, intraoperatif, dan pascaoperatif. Tujuan: Para ahli THT dapat mengetahui perencanaan yang tepat sebelum melakukan rekonstruksi mandibula. Tinjauan pustaka: Jabir bebas fibula memiliki angka keberhasilan yang tinggi dan merupakan jabir pilihan untukrekonstruksi mandibula. Kesimpulan: Perencanaan yang tepat mulai dari preoperatif sampai pascaoperatif sebelum dilakukan pengambilan jabir bebas fibula sangat diperlukan untuk mendapatkan hasil yang optimal.Kata kunci: Jabir bebas fibula, pembedahan mikrovaskular, rekonstruksi mandibula ABSTRACTBackground: Development in microvascular surgery technique has created a flap that can be used for oromandibular reconstruction. Free fibular flap is one of the bone flaps that frequently use for facial defects, especially mandibular reconstruction. This flap has lots of advantages than other bone flaps, such as scapula flap and iliac crest flap. Free fibular flap has a high successful rate up to 95%, but it needs meticulous planning before harvesting the bone; preoperative, perioperative, intraoperative, and postoperative is needed to get the high successful rate. Purpose: To inform ENT specialists about the appropriate planning before mandibular reconstruction. Literature review: Free fibular flap has a high successful rate and one of the excellent choices for mandibular reconstruction. Conclusion: The right preoperative to postoperative planning before doing the free fibularflap is very important to obtain optimal outcome. Keywords: Free fibular flap, microvascular surgery, mandibular reconstruction

Peningkatan functional oral intake scale dan kualitas hidup pada miastenia gravis pasca rehabilitasi menelan Erlina Julianti; Teti Madiadipoera; Ratna Anggraeni; Bambang Purwanto; Sinta Sari Ratunanda
Oto Rhino Laryngologica Indonesiana Vol 46, No 1 (2016): Volume 46, No. 1 January - June 2016
Publisher : PERHATI-KL

Latar belakang: Miastenia gravis (MG) merupakan penyakit autoimun yang mengganggu transmisineuromuskular karena berkurangnya reseptor asetilkolin di tautan saraf otot sehingga dapat menyebabkandisfagia orofaring. Disfagia pada MG dapat menyebabkan aspirasi yang meningkatkan morbiditas,mortalitas, dan menurunnya kualitas hidup.Tujuan: Menganalisis perbaikan disfagia orofaring padapasien MG dengan melihat peningkatan functional oral intake scale (FOIS) pada pemeriksaan fiberopticendoscopic evaluation of swallowing (FEES) dan untuk mengetahui perbaikan kualitas hidup denganmenggunakan swallowing quality of life (SWAL-QoL) pasca program rehabilitasi menelan.Metode:Penelitian ini merupakan quasi experimental open label pre and post-test design dan data dianalisisdengan menggunakan uji Wilcoxon. Penelitian berlangsung di Poliklinik Ilmu Kesehatan Telinga HidungTenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung sejak Januari − April 2013 pada10 subjek penelitian. Diagnosis dibuat berdasarkan anamnesis, pemeriksaan fisik, penilaian FOIS denganmelihat konsistensi makanan yang aman ditelan berdasarkan temuan pemeriksaan FEES sebelum dansesudah mengikuti program rehabilitasi menelan selama 6 minggu dan penilaian kualitas hidup dengankuesioner SWAL-QoL.Hasil: Didapatkan perbedaan bermakna (p=0,002) pada hasil FOIS dan perbedaanbermakna pada seluruh domain kuesioner SWAL-QoL setelah program rehabilitasi menelan (p<0,05).Kesimpulan: Terdapat peningkatan FOIS sebagai perbaikan disfagia orofaring, serta peningkatan kualitashidup pada pasien MG sesudah program rehabilitasi menelan. Kata kunci: Disfagia, miastenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopicevaluation of swallowing (FEES), kualitas hidup ABSTRACTBackground: Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmissionassociated with acetylcholine receptor deficiency at the neuromuscular junction which may causeoropharyngeal dysphagia. Oropharyngeal dysphagia in MG patients can cause aspiration which result inmorbidity, mortality, and decreased quality of life. Objective: To analyze the improvement of oropharyngealdysphagia in MG patients by evaluating the functional oral intake scale (FOIS) on fiberoptic endoscopicevaluation of swallowing (FEES) examination and to determine the improvement of quality of life byswallowing quality of life (SWAL-QoL). Method: This study was an open label quasi experimental pre andpost-test design and the data was analyzed using the Wilcoxon statistical test. This study was conductedin Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin General Hospital duringJanuary until April 2013 towards 10 subjects. Diagnosis based on anamnesis, physical examination,FOIS assessment in order to describe the consistency of safe food ingested during FEES examinationand SWAL-QoL questionnaire assessment before and after swallowing rehabilitation programme for 6weeks. Results: There were significant differences (p=0.002) in FOIS result and significant differencesin all domains SWAL-QoL questionnaire after swallowing rehabilitation program (p<0.05). Conclusion:There was an improvement of oropharyngeal dysphagia as seen in increased FOIS score and improvementof quality of life after swallowing rehabilitation program. Keywords: Dysphagia, myasthenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopyevaluation of swallowing (FEES), quality of life Alamat korespondensi: Dr. Erlina Julianti, Sp.THT-KL.,M.Kes. RSUD Kabupaten Bekasi, CibitungBekasi. Email: erlina.julianti@gmail.com.

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