Oto Rhino Laryngologica Indonesiana

Otoacoustic emission examination results on down syndrome students

Haidar Haikal Fasya — 2023-07-15

Background: Down syndrome (DS) is a genetic disorder that occurs due to an excess of genetic material on chromosome 21. Down syndrome was associated with various congenital abnormalities and dysfunction of several organs, one of which was hearing. DS patients often experience sensorineural hearing loss. Evaluation of sensorineural hearing loss in DS patients could be done in several ways, one of which is the Otoacoustic Emission (OAE) examination. Purpose: This study aimed to describe the results of the OAE examination in elementary school children at special need schools in Padang City in 2022. Methods: This research was a descriptive study, using a cross sectional study design. Data were collected and processed using consecutive sampling technique. The research subjects who met the criteria were 31 samples. Results: The results showed that the majority of DS subjects received “refer” results 25/31 on OAE examination, OAE “refer” results occurred both in one ear or both ears. The “refer” results of the OAE were greater in male DS patients 20/24 than female 5/7 and more common in the 18-21 year old age group. Conclusion: Conclusions based on this study, people with DS are more at risk of having sensorineural hearing loss.

Validity and reliability of Eustachian Tube Dysfunction Questionnaire (ETDQ-7) adaptation in Bahasa Indonesia

Ratna Dwi Restuti — 2023-07-15

Background: Eustachian tube dysfunction occurred in 0.9% of world’s population. An instrument called Eustachian Tube Dysfunction Questionnaire (ETDQ-7) in English Language was developed as a scoring system to evaluate patients’ problems for the past month with 100% sensitivity and specificity value (p<0.001). This questionnaire is proven useful internationally to evaluate patients’ complaints, disease course and to determine the therapeutic outcome. However, Indonesia has not had the adapted version of ETDQ-7. Purpose: To evaluate the validity and reliability of ETDQ-7 adapted to Bahasa Indonesia. Method: This was a descriptive cross-sectional study on 31 adult subjects whose primary language were Indonesian. Subjects were required to fill the questionnaire that went through cross-cultural adaptation. The data was analyzed using Spearman coefficient correlation for validity and Cronbach-α score for reliability. Result: The results showed that each ETDQ-7 question were significantly correlated to the total score of ETDQ-7 (p<0.05) with r value ranging from 0.568-0.790 and Cronbach-α value is 0.801. Conclusion: ETDQ-7 adapted to Bahasa Indonesia was a valid and reliable questionnaire to determine disease progression in patients with Eustachian tube dysfunction whose primary language are Indonesian.

Keyword: ETDQ-7, validity, reliability, Bahasa Indonesia

Comparison between Eustachian tube angle and length in chronic otitis media and contralateral ear

Eggi Erlangga — 2023-07-15

Background: Chronic suppurative otitis media (CSOM) is still a significant public health problem, especially in developing countries. Eustachian tube dysfunction is one of the factors that influence the occurrence of CSOM. The pathogenesis of acute and chronic otitis media is initiated by negative pressure in the middle ear. One theory of the event of CSOM is the continuum theory. The eustachian tube as one of the factors that influence the occurrence of CSOM has been proven from various studies comparing CSOM patients and the average population and CSOM with and without cholesteatoma. With the advanced technology, CT scan helps diagnose pathological conditions in the ear as a diagnostic tool and evaluation modality. CT scan imaging with a multiplanar reconstruction technique can provide a clear image of the anatomical shape of the Eustachian tube. Objective: This study aims to determine the relationship between the angle and length of the Eustachian tube in the ear with CSOM and the contralateral ear's angle and length. Method: An analytic study with a cross-sectional design involving 30 samples of CSOM patients with the contralateral ear. The measurement of the angle and length of the Eustachian tube using the multiplanar HRCT temporal reconstruction technique. Result: Statistical analysis with paired t-test showed that the Eustachian tube angle was significantly more horizontal in the CSOM ear than the contralateral ear (p<0.05). Eustachian tube length was shorter in CSOM than contralateral (p<0.05). Conclusion: The angle of the eustachian tube in the CSOM ear is smaller (more horizontal) and shorter than the contralateral ear.

Hearing and speech outcomes in children with cochlear nerve hypoplasia who underwent cochlear implantation

Rindy Yunita Pratamisiwi — 2023-07-15

Background: Data on hearing and speech outcomes following cochlear implantation in prelingual sensorineural hearing loss (SNHL) children with cochlear nerve hypoplasia, especially in Indonesia, is still limited. Purpose: To evaluate the hearing and speech function of prelingual SNHL children who had undergone cochlear implantation. Method: A retrospective cross-sectional study was conducted on 28 children who had undergone cochlear implantation procedures at the Department of Otorhinolaryngology and Head and Neck Surgery, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, for more than 12 months. The hearing and speech function of the subjects were assessed using the modified Categories of Auditory Performance (CAP-II) and the speech intelligibility rating (SIR) scores. Result: Children with cochlear nerve hypoplasia showed an increase in CAP-II and SIR scores after using cochlear implants for more than 12 months (versus pre-surgery, high CAP score [≥5]: 89.3% [25/28 children] vs 3.6% [1/28 children] and high SIR score [≥3]: 82.1% [23/28 children] vs 7.1% [2/28 children]; both p<0.001). Post-operative CAP-II and post-operative SIR scores were highly positively correlated (r=0.705, p<0.001). Type of cochlear nerve hypoplasia (unilateral vs bilateral) were not significantly associated with post-operative CAP-II and SIR scores (p=0.382 and p=0.459, respectively). Conclusion: Prelingual SNHL children with cochlear nerve hypoplasia may still get the benefit from cochlear implantation, as shown by a remarkable improvement in hearing and speech function as assessed with the CAP-II and SIR scores.

Keywords: auditory perception, cochlear implants, cochlear nerve hypoplasia, prelingual sensorineural hearing loss, speech intelligibility

The effect of performing istinsyaq on the degree of nasal obstruction in allergic rhinitis

Dolly Irfandy — 2023-07-15

Abstrak

Latar Belakang: Rinitis alergi adalah inflamasi mukosa hidung yang menyerang 30% populasi dunia. Sebuah penelitian menunjukkan bahwa istinsyaq dapat mengurangi derajat sumbatan hidung.

Objektif: Penelitian ini bertujuan untuk mengetahui pengaruh melakukan istinsyaq dalam wudhu terhadap derajat sumbatan hidung pada penderita rinitis alergi.

Metode: Jenis penelitian ini adalah pre-eksperimental dengan desain one group pretest-posttest. Populasi adalah siswa kelas X dan XI di SMA IT Imam Syafi’I Kota Batam tahun ajaran 2020/2021 yang menderita rinitis alergi dan bersedia untuk berpartisipasi. Skrining rinitis alergi menggunakan kuesioner SFAR dan derajat sumbatan hidung dinilai dengan menggunakan kuesioner NOSE.

Hasil: Didapatkan sampel berjumlah 24 siswa. Rata–rata total skor NOSE sebelum edukasi perlakuan istinsyaq adalah 30 ± 18, dan setelah perlakuan istinsyaq di hari ke-14 menurun menjadi 21 ± 18 dan di hari ke-28 menurun kembali menjadi 14 ± 16. Didapatkan penurunan bermakna rata–rata total skor NOSE dengan menggunakan uji Wilcoxon yaitu nilai p value (0,019) < 0,05 di hari ke-14 dan nilai p value (0,002) < 0,05 di hari ke-28 setelah perlakuan istinsyaq.

Kesimpulan: Istinsyaq dapat menurunkan rata–rata total skor kuesioner NOSE pada siswa dengan rinitis alergi. Dengan demikian, istinsyaq efektif untuk mengurangi derajat sumbatan hidung pada penderita rinitis alergi.

Kata kunci: Istinsyaq, Rinitis Alergi, Score For Allergic Rhinitis, Nasal Obstruction Symptom Evaluation

Abstract

Background: Allergic rhinitis is an inflammation of the nasal mucosa that affects 30% of the world's population. A study showed that istinsyaq can reduce the degree of nasal obstruction.

Objective: This study aims to determine the effect of performing istinsyaq in wudhu on the degree of nasal obstruction in patients with allergic rhinitis.

Methods: This study is a pre-experimental with one group pretest-posttest design. The population is class X and XI students at SMA IT Imam Syafi'I Batam City for the 2020/2021 academic year who suffer from allergic rhinitis and are willing to participate. Allergic rhinitis was screened using the SFAR questionnaire and the degree of nasal obstruction was assessed using the NOSE questionnaire.

Results: The sample obtained was 24 students. The average total NOSE score before istinsyaq treatment education was 30 ± 18, and after istinsyaq treatment on the 14th day it decreased to 21 ± 18 and on the 28th day it decreased again to 14 ± 16. There was a significant decrease in the average total NOSE score using the Wilcoxon test, namely the p value (0.019) < 0.05 on the 14th day and p value (0.002) < 0.05 on the 28th day after istinsyaq treatment.

Conclusion: In conclusion, istinsyaq can reduce the average total score of the NOSE questionnaire in students with allergic rhinitis. Thus, istinsyaq is effective in reducing the degree of nasal obstruction in patients with allergic rhinitis.

Keyword: Istinsyaq, Allergic Rhinitis, Score For Allergic Rhinitis, Nasal Obstruction Symptom Evaluation

Profile and characteristic of laryngeal cancer in Radiotherapy Department of Hasan Sadikin General Hospital

Afifah Pinakaratna — 2023-07-15

Background: A laryngeal cancer diagnosis is often in the advanced stage, while the screening has not much done at this time. Studies on laryngeal cancer that uses radiotherapy are also still difficult to find, especially in Indonesia. Purposes: This study aimed to describe patients' profiles with laryngeal cancer who received radiotherapy treatment in the 2018 to 2019 period. Methods: This research was a descriptive quantitative with a cross-sectional study conducted at Radiotherapy Department, Hasan Sadikin General Hospital. Results: The patient's medical record was collected, and 38 patients with laryngeal cancer were found. Most of the patients are male (86,8%), ranging from age 51-60 (55,3%), work as staff office/traders (21,1%), and have a smoking history (52%). The chief complaint is often in the form of hoarseness (76,3%), the location of the cancer is No Other Specified (31,6%), most of the cells were squamous cell carcinoma (86,8%), and the stage was mainly in stage IV (60,5%). Surgery with radiotherapy is the most common management (50%), and surgery that is commonly used is total laryngectomy (36,8%). Some patients also have a tracheostomy before management (36,8%). Radiotherapy is more often for adjuvant purposes (52,6%). Conclusions: Laryngeal cancer is still uncommon, but we need to increase awareness and screening because of the advanced stage that more commonly occurs.

Vitamin D blood level in nasopharyngeal carcinoma of the Minangkabau ethnic group

Sukri Rahman — 2023-07-15

Background: The etiology of nasopharyngeal carcinoma (NPC) is not yet known with certainty, but is suspected to be an interaction of multiple factors. Nasopharyngeal carcinoma is closely related to Epstein-Barr virus (EBV) infection which interacts with genetic susceptibility and environmental factors. Various studies have reported the relationship of vitamin D with the risk of various cancers, but very little research has a relationship with NPC. Objective: This study was conducted to analyze the association of vitamin D levels with nasopharyngeal carcinoma in the Minangkabau ethnic group. Methods: This study was a cross-sectional study comparing plasma levels of vitamin D (25(OH)D) in new patients with NPC of the Minangkabau ethnic who were treated at Dr. M. Djamil Padang with healthy control plasma. Result: This study found that the average vitamin D level in the NPC group was higher than the control group. Vitamin D levels in this study varied in both cases and controls. In the NPC group, vitamin D levels varied from 14.64 to 75.56 ng/ml. Most of the NPC group had normal vitamin D levels (69.6%), and in controls, vitamin D levels also varied from 6.06 to 73. .96 ng/ml, and most of them were also with normal levels (52.2%). There was no statistically significant difference between cases and controls (p>0.05). Conclusion: This study found no association between the level of vitamin D and the incidence of nasopharyngeal carcinoma in the Minangkabau ethnic group.

Self-perceived health-related factors in Deaf Community in East Java, Indonesia

Yunisa Astiarani — 2023-07-15

Background: Little is known about the perceived health of the Indonesian Deaf despite the rapid growth of the Deaf community and social organizations. Objective: The study aimed to investigate self-perceived health and related determinants among deaf adults in a Deaf community in East Java, Indonesia. Method: A survey study was conducted on 102 community members. Perceived health was assessed using a question: ‘In a scale of 1 to 10, how much will you give to rate your health?’. After stepwise suggestion and collinearity analysis, the association of demographic and health conditions was analyzed using logistic regression.Result: A High perceived health scale was reported from 77% of the members. Low perceived health was mainly stated by individuals from the 25–45 age, female, married, and working groups. Although most had no health complaints in the last month, 60% were hospitalized in the previous year. Lower educational levels, owned health insurance, frequently consuming vegetables, and fruits, and never being hospitalized were associated (p<0.05) with higher self-perceived health. Conclusion: Despite the high self-perceived health reported from most Deaf community members, the overall self-reported health conditions of Deaf community members are still a concern due to the high rate of hospitalization and lack of objective health assessment.

Efficacy of topical povidone iodine ear drops 5% in chronic suppurative otitis media

Bambang Suprayogi Resi Utomo — 2023-07-15

Background: Povidone Iodine (PVP-I) is a well-known antiseptic and chemical compound to kill and inhibit the growth of microorganisms. Povidone Iodine 5% antiseptics are expected to have similar or better clinical efficacy compared with topical antibiotics in Chronic Suppurate Otitis Media (CSOM) patients but this is not fully clear. Topical antibiotics can also come in the form of ear drops. Topical antibiotics are the standard in CSOM patient therapy. This study aimed to discover Povidone Iodine 5% in terms of clinical efficacy in CSOM patients. Method: This research was conducted in accordance with the Cochrane Handbook for Systematic Review and Intervention, in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. All clinical trial studies comparing Povidone Iodine with topical antibiotics in CSOM management were performed in several databases including Google Scholar, PubMed, Springer Link, and Cochrane. The collected data from a number of samples have improved each study, seen by the clinical signs and symptoms. Results: A total of 407 research articles were included in this analysis then we had 24 works of literature. Final decision, only 2 literature met the criteria to review. Al-Abbasi et al study, PVP-I 5% recovered 13/16 (81.2%), Neomycin + Dexamethasone 11/16 (68.7%) and saline 4/16 (25%). Jaya et al study, PVP-I-5% recovered: 16/18 (88.8%), Ciprofloxacin 0.3%: 19/21 (90.4%), and no side effects were found in both studies. Conclusion: Our analysis revealed that PVP-I 5% have similar treatment as great as the efficacy of topical antibiotics, and there were no side effects of treatment. More evidence-based research is needed to determine the effectiveness of topical PVP-I 5% in the treatment of CSOM.

Caustic esophageal injury in clinical settings

Puspa Zuleika — 2023-07-15

Background: esophageal stricture is loss of esophageal lumen patency and may involve injuries after ingesting caustic substances. This systematic review aims to review clinical presentations, diagnostic modalities involved, treatments and outcomes, and complications of esophageal strictures following caustic injuries.

Methods: this systematic review involves original researches conducted between 2002-2022 indexed in PubMed and EuropePMC searched using following MeSH terms: “((caustic injury) OR (caustic burn)) AND (ingestion) AND (inflammation)” following PRISMA algorithm. Biases were assessed using STROBE checklist and presented as narratives.

Results: searches yielded 326 results with 16 studies included in this review. Majority of caustic ingestion and strictures involved pediatric population due to accidental ingestion. Alkali ingestion has more severe presentation. Radiological imaging, including CT and MRI, may help in determining damages involved. Degrees of damages are related with mortalities or morbidities, and dilatation may improve quality-of-life in some cases.

Conclusion: pediatric patients are at risk for accidental ingestions and alkali ingestion creates more severe damage. Radiological imaging may assist in determining involvement of underlying tissues.

Role of Radiotherapy in Oncologic Emergency

Andreas Ronald Barata Sebastian — 2023-07-15

Background: Oncologic emergencies often occur in patients who have metastases. This condition requires a prompt and accurate diagnosis. Radiotherapy (RT) plays a substantial role in palliative aspect with the aim of reducing tumor size, reducing symptoms, and improving quality of life. Purpose: To discuss the role of radiotherapy in an oncologic emergency. Literature review: The most common cases requiring radiation in emergency management are superior vena cava syndrome, acute airway obstruction, uncontrolled tumor bleeding, spinal cord compression due to malignancy, and brain metastases. The selection of radiation dose and techniques may vary, taking into consideration patient factors such as poor general condition, the likelihood of receiving curative treatment afterward, severe comorbidities, tumor factors such as histology of malignancy, whether it is a metastatic disease or not, therapeutic factors such as previous radiation history and response to previous systemic therapy. Conclusion: Radiotherapy plays a significant role in oncologic emergency, particularly to reduce symptoms and improve quality of life. Several considerations should be evaluated before determining the appropriate radiation treatment are patient factors, previous radiation therapy and response to previous systemic therapy.

Management of recurrent chronic suppurative otitis media with cholesteatoma

Finna Christianty — 2023-07-15

Background: Chronic suppurative otitis media (CSOM) is a chronic inflammation involving the middle ear space and it became a burden especially in developing countries. Mastoidectomy remains the main treatment in CSOM with cholesteatoma. Recurrent cholesteatoma and suppurating process indicated the need of revision mastoidectomy. Purpose: Until now, study about the mechanism of recurrent cholesteatoma and its management still need further research. Case report: This paper reports a case of chronic suppurative otitis media with recurrent cholesteatoma which underwent revision mastoidectomy. Clinical Question : What are the factors associated with the occurrence of recurrent cholesteatoma and how to managed it? Methods: Evidence base literature study about chronic suppurative otitis media with recurrent cholesteatoma and surgery treatment was performed through PubMed, ProQuest, and Google Scholar database. Results: Recurrent cholesteatoma that occurred after mastoidectomy can be caused by residue of the cholesteatoma itself or new forming of retraction pocket. Revision mastoidectomy is necessary to evacuated the cholesteatoma and provide good drainage to the mastoid. Conclusion: Routine follow up after mastoidectomy is an important thing to help prevent recurrence of CSOM especially with cholesteatoma.

Hearing loss in a child with hydrocephalus

Muyassaroh - — 2023-07-15

Background: Hydrocephalus can cause hearing loss through the mechanism of the relationship between pressure cerebrospinal fluid (CSF), perilymph, and endolymph. Hidrocephalus is rare, estimated at 10 per mil. Most cases in infants (46.25%), neonates (5%). Men are more likely to experience hydrocephalus. Changes in pressure and loss of CSF cause endolymph hydrops which results in inner ear dysfunction Objective : To study how cases of hydrocephalus cause hearing loss. Case:Reported a case of a woman aged 1 year 7 months with hearing loss and hydrocephalus Methods: Search literature through Pubmed, Google Scholar. with the keywords hearing loss AND hydrocephalus AND children obtained 101 journals. The results of the screening obtained 4 analyzed journals. Result : Hearing loss was caused by IV ventricular pressure. Improvement of CSF pressure with VP shunt or ventriculotomy can improve inner ear function Conclusion: Hydrocephalus causes endolymph hydrops which results in hearing loss.

Laryngeal carcinoma with hemorraghic varicella : a rare case report

Rano Aditomo — 2023-07-15

Background : Hemorrhagic varicella is a complication that usually occurs in patients with immune disorders or those on immunosuppressive therapy or hematologic malignancies such as leukemia. Purpose: This case report aimed to further examine the complications of a rarely found hemorrhagic varicella in neck head malignancies / laryngeal carcioma. Case report : This is a case report of laryngeal carcinoma with hemorrhagic varicella in a 44-year-old man. Examination of dermatological status revealed hemorrhagic, polymorphic vesicles, generalized pustular psoriasis, erosion and, crusting. Tzanck test of the scrapes of the base of lesion of the vesicles is helpful in establishing the diagnosis of varicella and discovered multinucleated giant cells (MGCs) and epithelial cells with acidophilic intranuclear inclusion bodies The patient died after 3 days of treatment in the isolation room. A previous study also reported cases of hemorrhagic varicella in a 3-year-old girl with the main complaint of pus-filled red spots throughout the body. A previous history of chickenpox was denied. The physical examination showed dark red, polymorphic lession, generalized pustular psoriasis, erosion and crusting. Hemorrhagic varicella in the head and neck malignancy is a very rare form of varicella. Clinical question: In patient with immunocompromised during chemotheraphy suffer from varicella, is it necessary to have a comprehensive diagnostic examination panel, and therapy? Review methods: Evidence-based literature search with keywords “immunocompromised” AND “Hemorrhagic varicella” was performed through Cochrane, PubMed and Medline database. Result : The literature search obtained 318 articles in PubMed, 11 articles in Medline,and none in Cochrane, which were relevant with the topic. Only 1 article screened with inclusion and exclusion criteria. A research was conducted by Elizabeth et al in Philipina (2011) on Pediatric Infectious Disease and Hematology-Oncology Services. Out of 26 immunocompromised patients who developed varicella during the study period, only 22 charts were available for review. Of these patients, 13 were male and 9 were female. The highest incidence occurred from 0 to 5 years old (41%). Twenty patients had an underlying malignancy in the form of leukemia (14%) and solid organ tumors (6%) including nasopharyngeal cancer. Diagnosis based on the characteristic generalized papulovesicular rash

Conclusion : This requires a comprehensive diagnostic panel test for the delivery of appropriate therapy and improved outcome.