Perbandingan terapi radiofrekuensi disertai steroid topikal dan steroid topikal saja pada rinitis alergi persisten

Abstract

Latar belakang: Kasus rinitis alergi dengan gejala persisten sedang-berat di RSCM ditemukan pada 357pasien selama 2 tahun. Terjadinya gejala sedang-berat pada rinitis alergi lebih sering menimbulkan penurunankualitas hidup dan produktivitas kerja. Efektivitas terapi steroid topikal adalah 67%, dibandingkan plasebo 39%.Penelitian yang menilai efek tambah reduksi konka radiofrekuensi terhadap terapi rinitis alergi persisten sedangberat(steroid topikal hidung) belum pernah ada. Tujuan: Untuk mendapatkan gambaran hasil terapi reduksikonka radiofrekuensi disertai dengan steroid topikal dibandingkan steroid topikal saja pada rinitis alergi persistensedang-berat. Metode: Penelitian pendahuluan dengan metode uji klinis acak. Sebanyak 14 pasien dilakukanreduksi konka radiofrekuensi disertai steroid topikal hidung, 16 pasien mendapat steroid topikal saja. Penilaianskala analog visual (SAV) terhadap 4 gejala utama rinitis alergi, nasoendoskopi untuk menilai ukuran konkainferior, pemeriksaan peak nasal inspiratory flow (PNIF) dilakukan sebelum terapi dan minggu ke-6 pascaterapi.Hasil: Perbedaan bermakna pada minggu ke-6 pascaterapi antara kedua kelompok didapati pada nilai SAV gatalhidung. Perbedaan bermakna nilai SAV bersin, gatal hidung, ingus encer, dan sumbatan hidung, sebelum terapidengan minggu ke-6 pascaterapi, ditemukan baik pada kelompok reduksi konka radiofrekuensi maupunkelompok steroid topikal saja. Perbedaan bermakna nilai PNIF sebelum terapi dengan minggu ke-6 pascaterapihanya ditemukan pada kelompok terapi reduksi konka radiofrekuensi disertai steroid topikal. Kesimpulan: Baikreduksi konka radiofrekuensi disertai steroid topikal maupun steroid topikal saja memberikan perbaikan gejalarinitis alergi persisten sedang-berat. Pada penelitian ini, penambahan terapi reduksi konka radiofrekuensimengurangi keluhan gatal hidung dan meningkatkan nilai PNIF pada minggu ke-6 pascaterapi.

Kata kunci: rinitis alergi persisten sedang-berat, reduksi konka radiofrekuensi, steroid topikal hidung, skalaanalog visual, peak nasal inspiratory flow.

ABSTRACT

Background: There were 357 patients with moderate/severe persistent allergic rhinitis in 2 years period at Dr.Cipto Mangunkusumo Hospital. Moderate/severe symptoms in allergic rhinitis reduce quality of life and productivity.Efectivity of nasal steroid in controlling allergic rhinitis symptoms is 67% compared to placebo 39%. The effect ofradiofrequency turbinoplasty added to nasal steroid in controlling allergic rhinitis symptoms were sought. Purpose:This study was performed to evaluate added value of radiofrequency turbinoplasty to nasal steroid in treatment ofmoderate/severe allergic rhinitis. Methods: A pilot study of randomized clinical trial was designed. Fourteen patientswere given combined treatment consist of radiofrequency turbinoplasty and nasal steroid, sixteen patients were givennasal steroid only. Visual analogue scale (VAS) for 4 major symptoms of allergic rhinitis (sneezing, nose itching,rhinorhea, nose obstruction), nasoendoscopy to evaluate inferior turbinate size, peak nasal inspiratory flow (PNIF)were performed before treatment and 6 weeks after treatment. Results: Statistical significance was found only in noseitching symptom if compared between 2 treatment group at 6 weeks after treatment. If comparison performed withintreatment group itself (before treatment and 6 weeks after treatment), there were improvement in all major symptomsof allergic rhinitis. Peak nasal inspiratory flow was found statiscally significance within group, only in group treatedwith combined treatment. Conclusion: Both treatment groups give improvement in all symptoms of allergic rhinitis. Inthis research, addition of radiofrequency turbinoplasty reduces nose itching compared to nasal steroid alone and alsoincreases result of PNIF within 6 weeks of treatment.

Keywords: moderate/severe persistent allergic rhinitis, radiofrequency turbinoplasty, nasal steroid, visualanalogue scale, peak nasal inspiratory flow.