Oto Rhino Laryngologica Indonesiana (ORLI) https://orli.or.id/index.php/orli Oto Rhino Laryngologica Indonesiana en-US journalorli@gmail.com (Dini Widiarni) journalorli@gmail.com (Ahmad Syafii. SKom) Sun, 01 Jan 2023 07:21:40 +0700 OJS http://blogs.law.harvard.edu/tech/rss 60 Relationship mastoid pneumatization and eustachian tube shape with tympanic cavity in chronic otitis media https://orli.or.id/index.php/orli/article/view/457 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is one of the causes of morbidity and mortality in developing countries. The worldwide prevalence of CSOM according to WHO is estimated at 330 million people. Pneumatic type mastoid pneumatization, narrow Eustachian tube angle, and narrow Eustachian tube diameter in the diseased ear can result in cholesteatoma formation. <strong>Objective:</strong> This study aimed to determine the relationship between mastoid pneumatization, Eustachian tube angle and diameter with tympanic cavity abnormalities in CSOM patients. <strong>Methods:</strong> This was a retrospective analysis study using cross sectional method. The data were taken from the patient’s medical records at Dr. Kariadi Hospital, Semarang, from January 2020 to June 2021. Subjects were CSOM sufferers. Mastoid multisliced computed tomography (MSCT) scan examination was carried out in the Radiology Section, using the AW Volume Share 5 application, to assess the type of mastoid pneumatization, Eustachian tube angle, Eustachian tube diameter, and tympanic cavity abnormalities in the form of cholesteatoma, granulation, and erosion of the ossicles. Statistical analysis using Chi Square test, and multivariate test. <strong>Result:</strong> There were 90 subjects with CSOM, 44 (48.9%) had tympanic cavity abnormalities and 46 (51.1%) without tympanic cavity abnormalities. Sclerotic mastoid pneumatization was more than pneumatic (p=0.001), narrow Eustachian tube angle (p=0.041), and narrow Eustachian tube diameter (p=&lt;0.001). Logistic regression results showed that mastoid pneumatization had a dominant relationship to abnormalities in the tympanic cavity. <strong>Conclusion:</strong> There was a relationship between sclerotic mastoid pneumatization, narrow Eustachian tube angle, and narrow Eustachian tube diameter with abnormalities in the tympanic cavity.</p><p> </p><p><em><strong>ABSTRAK</strong></em></p><p><em><strong>Latar belakang:</strong> Otitis media supuratif kronik (OMSK) merupakan salah satu penyebab morbiditas serta mortalitas di negara berkembang. Prevalensi OMSK menurut </em>WHO<em> di seluruh dunia diperkirakan 330 juta orang. Pneumatisasi mastoid tipe pneumatik, sudut tuba Eustachius yang sempit, dan diameter tuba Eustachius yang lebih sempit pada telinga yang sakit dapat menyebabkan terjadinya kolesteatoma. <strong>Tujuan:</strong> Penelitian bertujuan untuk mengetahui hubungan pneumatisasi mastoid, sudut dan diameter tuba Eustachius dengan kelainan kavum timpani pada penderita OMSK. <strong>Metode:</strong> Merupakan penelitian analisis retrospektif menggunakan metode </em>cross sectional.<em> Data diambil dari rekam medis pasien di RSUP Dr.Kariadi Semarang, dari Januari 2020 sampai Juni 2021. Subjek adalah penderita OMSK. Pemeriksaan </em>multisliced computed tomography (MSCT)<em> scan mastoid dilakukan di Bagian Radiologi, dengan aplikasi AW Volume Share 5, untuk menilai jenis pneumatisasi mastoid, sudut tuba Eustachius, diameter tuba Eustachius, dan kelainan kavum timpani berupa kolesteatoma, granulasi, dan erosi pada osikula. Analisis statistik menggunakan uji </em>Chi Square<em>, dan uji multivariat. <strong>Hasil:</strong> Didapatkan 90 subjek penderita OMSK, adanya kelainan kavum timpani 44 (48,9%) dan yang tidak adanya kelainan kavum timpani 46 (51,1%). Pneumatisasi mastoid sklerotik lebih banyak daripada pneumatik (p=0,001), sudut tuba Eustachius sempit (p=0,041), dan diameter tuba Eustachius pendek (p=&lt;0,001. Hasil regresi logistik menunjukan bahwa pneumatisasi mastoid memiliki hubungan yang dominan terhadap kelainan pada kavum timpani. <strong>Kesimpulan:</strong> Terdapat hubungan antara pneumatisasi mastoid sklerotik, sudut tuba Eustachius sempit, dan diameter tuba Eustachius kecil dengan kelainan pada kavum timpani.</em></p><p> </p><p> </p> Ferry Herjanto, Zulfikar Naftali, Yanuar Iman Santosa, Farah Hendaraningrum Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/457 Sun, 01 Jan 2023 00:00:00 +0700 Pharyngeal transit time in different consistency of food using Fiberoptic Evaluation of Swallowing https://orli.or.id/index.php/orli/article/view/537 <p><strong>ABSTRACT</strong></p><p><strong></strong><strong>Background:</strong> In Indonesia, no research has been carried out or reported on pharyngeal transit time and a view of the swallowing process in a sample without complaints of dysphagia using the Flexible Endoscopic Evaluation of Swallowing (FEES) method and using five food consistencies.<strong> Purpose:</strong> To obtain the value of pharyngeal transit time and a view of the swallowing process in subjects without dysphagia problems.<strong> Method:</strong> Twenty-eight subjects without dysphagia (based on Ohkuma’s Dysphagia Screening) underwent FEES to determine pharyngeal transit time and dysphagia profile based on leakage, standing secretion, residue, penetration, and aspiration. <strong>Result:</strong> The median value of pharyngeal transit time on puree consistency was 0.799(0.499-5.666), gastric rice 0.966(0.433-5.733), oatmeal 0.849(0.533- 4.399), thick liquid 0.982(0.399-4.633), thin liquid 0.566(0.366-1.366). The pharyngeal delay time on the puree consistency was 0.566(0.199-5.333), gastric rice 0.799(0.233-2.799), oatmeal 0.899(0.099-3.633), thick liquid 0.833(0.033-3.733), and thin liquid mean was 0.294 (± 0.232). The pharyngeal response time on the puree consistency was 0.566(0.167-1.300), gastric rice 0.583(0.300-2.934), oatmeal 0.583(0.367- 1.233), thick liquid 0.549(0.333-1.533), thin liquid 0.549(0.366-1.399). There was no standing secretion, pre-swallowing leakage, penetration, and aspiration found in FEES. A grade 1 residue was found in 3(10.7%) subjects of puree, in 2(7.2%) subjects of gastric rice, in 3(10.7%) subjects of oatmeal, and in 9(32.2%) subjects of thick liquid. <strong>Conclusion:</strong> There was no prolonged pharyngeal transit time, pre-swallowing leakage, standing secretion, penetration, and aspiration in all subjects without dysphagia complaints at all food consistencies. There was minimal residue within normal limits in some subjects.</p><p> </p><p><em><strong>ABSTRAK</strong></em><br /><em><strong>Latar belakang:</strong></em> <em>Di Indonesia, belum pernah dilaporkan penelitian mengenai waktu transit faring dan gambaran proses menelan pada sampel tanpa keluhan disfagia dengan menggunakan metode</em> Flexible Endoscopic Evaluation of Swallowing (FEES) <em>dan menggunakan lima konsistensi makanan. <strong>Tujuan:</strong> Penelitian ini bertujuan untuk memperoleh nilai waktu transit faring dan gambaran proses menelan pada subjek tanpa masalah disfagia. <strong>Metode:</strong> Dua puluh delapan subjek tanpa disfagia (berdasarkan Skrining Disfagia Ohkuma) menjalani</em> FEES u<em>ntuk menentukan waktu transit faring dan profil disfagia berdasarkan</em> leakage, standing secretion, residue, penetration, <em>dan</em> aspiration. <strong>Hasil:</strong> <em>Nilai median waktu transit faring pada konsistensi</em> puree <em>adalah 0,799(0,499-5,633),</em> gastric rice <em>0,966(0,433-5,733)</em>, oatmeal<em> 0,849(0,533-4,399),</em> thick liquid <em>0.982(0.399-4.633),</em> thin liquid <em>0.566(0.366- 1.366).</em> <em>Waktu tunda faring pada konsistensi</em> puree <em>adalah 0,566 (0,199-5.333),</em> gastric rice <em>0,799 (0,233-2,799),</em> oatmeal <em>0,899 (0,099-3,633),</em> thick liquid <em>0,833 (0,033-3,733), dan rerata</em> thin liquid <em>0,294 (± 0,232). Waktu respon faring terhadap konsistensi</em> puree <em>adalah 0,566 (0,167-1,300),</em> gastric rice <em>0,583 (0,300-2,934),</em> oatmeal <em>0,583 (0,367-1,233),</em> thick liquid <em>0,549 (0,333-1,533),</em> thin liquid <em>0,549 (0,366-1,399).</em> <em>Tidak didapati adanya</em> leakage, standing secretion, penetration, <em>dan</em> aspiration<em> pada pemeriksaan</em> FEES. Residu grade <em>1 ditemukan pada 3 (10,7%) subjek</em> puree, <em>pada 2 (7,2%) subjek</em> gastric rice, <em>pada 3 (10,7%) subjek</em> oatmeal, <em>dan pada 9 (32,2%) subjek</em> thick liquid. <strong>Kesimpulan:</strong> <em>Tidak terdapat perpanjangan waktu </em>transit faring, leakage, standing secretion, penetration,<em> dan</em> aspiration<em> pada semua subjek tanpa keluhan disfagia dengan semua konsistensi makanan. Terdapat residu minimal dalam batas normal pada beberapa subjek.</em></p> Susyana Tamin, Mochamad Iqbal, Elvie Zulka Kautzia Rachmawati, Rahmanofa Yunizaf, Ratna Dwi Restuti, Aria Kekalih Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/537 Sun, 01 Jan 2023 00:00:00 +0700 The effect of neutrophil-lymphocyte ratio on neck nodule size in nasopharyngeal carcinoma chemotherapy https://orli.or.id/index.php/orli/article/view/490 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Nasopharyngeal carcinoma (NPC) is a cancer of the head and neck, that ranks as the 4th most malignant cancer in Indonesia. The prognosis of NPC patients is determined from the clinical stage based on the Tumor, Nodule, Metastatic (TNM) classification system. These prognosis factors are not entirely reliable for predicting treatment outcomes. The Neutrophil Lymphocyte Ratio (NLR) represents an index of pro-tumor and anti-tumor activity, that can be used to predict the outcome of neoadjuvant chemotherapy and the patient’s well-being as assessed by Karnofsky status, Body Mass Index (BMI), and neck nodule size (NNS). <strong>Purpose:</strong> To study the effect of NLR on Karnofsky status, BMI, and NNS in WHO type III NPC patients who underwent 3 cycles of neoadjuvant chemotherapy. <strong>Method:</strong> Analytical observational research with a cohort-retrospective approach on WHO type III NPC subjects who underwent platinum-based regimen neoadjuvant chemotherapy. NLR pre-chemotherapy was analyzed for its effect on Karnofsky status, BMI, and NNS. <strong>Result:</strong> NLR had no significant effect on Karnofsky status pre- and post-chemotherapy, BMI pre- and post-chemotherapy, NNS pre-chemotherapy, changes in Karnofsky status and BMI pre-and post-chemotherapy, but had significant effect on the size of neck nodules post-chemotherapy, and changes in the size of neck nodules. <strong>Conclusion:</strong> NLR has no significant effect on Karnofsky status, on BMI pre- and post-chemotherapy, and neck nodule size pre-chemotherapy. However, NLR had a significant effect on neck nodule size post-chemotherapy and neck nodule size changes.</p><p> </p><p><em><strong>ABSTRAK</strong></em></p><p><em><strong>Latar belakang:</strong></em> <em>Karsinoma Nasofaring (KNF) merupakan keganasan dalam bidang THT yang menempati urutan ke-4 keganasan di Indonesia. Prognosis pasien KNF terutama ditentukan dari stadium klinis berdasarkan sistem klasifikasi Tumor, Nodul, Metastasis (TNM) yang tidak sepenuhnya dapat diandalkan untuk memprediksi hasil pengobatan. Sedangkan Ratio Netrofil-Limfosit (RNL) mempresentasikan indeks aktivitas protumor dan antitumor sehingga dapat digunakan sebagai pelengkap stadium klinis untuk memprediksi hasil kemoterapi neoadjuvan dan kesejahteraan subjek melalui status Karnofsky, Index Massa Tubuh (IMT) dan ukuran nodul leher. <strong>Tujuan:</strong> Mempelajari efek Rasio Netrofil-Limfosit (RNL), Index Massa Tubuh (IMT), dan ukuran nodul leher pada subjek dengan KNF WHO tipe III yang telah menjalani 3 siklus kemoterapi neoadjuvan. <strong>Metode:</strong> Penelitian observasional analitik dengan pendekatan kohort-retrospektif menggunakan data rekam medis penderita KNF tipe III WHO yang menjalani kemoterapi neoadjuvan menggunakan regimen berbasis platinum. RNL sebelum kemoterapi dianalisis pengaruhnya terhadap status Karnofsky, IMT dan ukuran nodul leher. <strong>Hasil:</strong> RNL berpengaruh tidak signifikan terhadap status Karnofsky sebelum dan sesudah kemoterapi, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, perubahan status Karnofsky, perubahan IMT, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher. <strong>Kesimpulan:</strong> RNL berpengaruh tidak signifikan terhadap status Karnofsky, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher.</em></p> Soehartono -, Dwi Novitasari, Iriana Maharani Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/490 Sun, 01 Jan 2023 00:00:00 +0700 Correlation between Tinnitus Handicap Inventory Correlation between Tinnitus Handicap Inventory https://orli.or.id/index.php/orli/article/view/582 <p><strong>ABSTRACT</strong></p><p><strong></strong><strong>Background:</strong> Complaints of tinnitus sufferers are generally subjective, while there is no objective examination in establishing the diagnosis of tinnitus so far, so that a questionnaire is needed to help establish it. The limitations of objectively assessing tinnitus have led to self-report questionnaires as the best option for evaluating tinnitus symptoms and measuring the extent to which quality of life is negatively impacted. <strong>Objective:</strong> to compare the scores between the Indonesian Tinnitus Handicap Inventory (THI) and the Indonesian version of the 12-item Tinnitus Primary Function Questionnaire (TPFQ). <strong>Method:</strong> A descriptive analytic study with a cross sectional design, where both variables were observed at the same time. This research was conducted at the Neurotology Outpatient Unit (URJ) RSUD Dr. Soetomo Hospital, Surabaya from September 2019 to April 2020. <strong>Result:</strong> A total of 29 tinnitus patients who met the criteria were divided by age, gender, degree of hearing loss, THI score, THI severity, and TPFQ score. <strong>Conclusion:</strong> The results of the correlation test between the degree of hearing loss with THI-Indonesia and the degree of hearing loss with the Indonesian 12-item TPFQ showed no difference in the results, namely both were not correlated, so the Indonesian 12-items TPFQ was valid and reliable, and it could be used to shorten the assessment time of tinnitus sufferers in hectic outpatient clinics.</p><p> </p><p><strong><em>ABSTRAK</em></strong></p><p><strong><em></em></strong><em><strong>Latar belakang</strong>: Keluhan penderita tinitus umumnya bersifat subyektif, sedangkan sampai saat ini belum ada sarana pemeriksaan obyektif dalam menegakkan diagnosis tinitus, maka diperlukan kuesioner untuk membantu. Keterbatasan menilai tinitus secara obyektif telah menjadikan kuesioner mandiri</em> (self-report)<em> sebagai pilihan terbaik untuk mengevaluasi gejala tinitus dan mengukur sejauh mana kualitas hidup terkena dampak negatif. <strong>Tujuan:</strong> membandingkan skor antara </em>Tinnitus Handicap Inventory (THI)<em> Indonesia dengan </em>Tinnitus Primary Function Questionnaire (TPFQ)<em> 12-item versi Indonesia.<strong> Metode:</strong> Penelitian ini bersifat deskriptif analitik dengan desain potong lintang, dimana kedua variabel diamati dalam waktu yang bersamaan. Penelitian ini dilakukan di Unit Rawat Jalan (URJ) Neurotologi RSUD Dr. Soetomo pada bulan September 2019 sampai dengan April 2020. <strong>Hasil:</strong> Sebanyak 29 pasien tinitus yang memenuhi kriteria dibagi berdasarkan kategori usia, jenis kelamin, derajat gangguan pendengaran, skor </em>THI<em>, derajat keparahan </em>THI<em>, dan skor </em>TPFQ<em>. <strong>Kesimpulan:</strong> Hasil uji korelasi antara derajat gangguan pendengaran dengan THI-Indonesia maupun derajat gangguan pendengaran dengan </em>TPFQ 12-item<em> Indonesia menunjukkan tidak ada perbedaan hasil, yaitu sama-sama tidak berkorelasi, sehingga </em>TPFQ 12-item<em> Indonesia adalah valid dan handal dapat digunakan untuk mempersingkat penilaian penderita tinitus di klinik rawat jalan yang sibuk</em></p> Nyilo Purnami, Sofia Tiarini, Nico Probosutejo, Budi Utomo, Makhmudyah Indri Cahyani Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/582 Sun, 01 Jan 2023 00:00:00 +0700 Correlation between duration of chronic renal failure patients undergoing hemodialysis and sensorineural hearing loss https://orli.or.id/index.php/orli/article/view/453 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Along with the increasing incidence of chronic renal failure patients receiving hemodialysis, recently, the incidence of sensorineural hearing loss (SNHL) among patients with end-stage kidney disease undergoing hemodialysis had also increased. The cochlea and kidney have many anatomical, physiological, pharmacological and pathological similarities. Dialysis sometimes causes worsening of hearing function. <strong>Objective:</strong> To determine the correlation between the duration of renal failure patients undergoing hemodialysis and the degree of sensorineural hearing loss. <strong>Method:</strong> A retrospective study using cross sectional method, conducted from August–September 2018. The study began by identifying patients with chronic renal failure and then continued with Oto Acoustic Emission (OAE) examination and pure tone audiometry. <strong>Result:</strong> The results of the Spearman rank statistical test for the correlation between duration of hemodialysis and the degree of SNHL in the right and left ears in patients with chronic renal failure found a significant positive correlation r= 0.498 and p=0.001 (right) , and r= 0.400 and p=0.006 (left). <strong>Conclusion:</strong> There was a significant correlation between the length of hemodialysis and the degree of sensorineural hearing loss.</p><p> </p><p><em><strong>ABSTRAK</strong></em></p><p><em><strong>Latar belakang:</strong> Seiring dengan peningkatan angka kejadian pasien gagal ginjal kronik yang mendapatkan hemodialisa, akhir-akhir ini didapati peningkatan angka kejadian Sensorineural Hearing Loss (SNHL) di antara pasien dengan penyakit ginjal stadium akhir yang menjalani hemodialisa. Koklea dan ginjal memiliki banyak kesamaan anatomis, fisiologis, farmakologis dan patologis. Dialisa terkadang menyebabkan memburuknya fungsi pendengaran. <strong>Tujuan:</strong> Untuk mengetahui hubungan lama pasien gagal ginjal yang menjalani hemodialisa dengan derajat gangguan pendengaran tuli sensorineural. <strong>Metode:</strong> Penelitian retrospektif dengan metode potong lintang, dilakukan dari Agustus-September 2018. Penelitian dimulai dengan mengidentifikasi pasien gagal ginjal kronik kemudian dilanjutkan dengan pemeriksaan tes</em> Oto Acoustic Emission (OAE)<em> dan audiometri nada murni. <strong>Hasil:</strong> Hasil uji statistik </em>Spearman rank<em> untuk korelasi lama hemodialisa dengan derajat SNHL telinga kanan dan kiri pada pasien gagal ginjal kronik didapatkan korelasi positif yang signifikan: r= 0,498 dan p=0,001 (kanan) dan r= 0,400 dan p=0,006 (kiri). <strong>Kesimpulan:</strong> Terdapat korelasi yang bermakna antara lama hemodialisis dengan derajat tuli sensorineural.</em></p> Novi Primadewi, Dewi Pratiwi, Taufani Dewi Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/453 Sun, 01 Jan 2023 00:00:00 +0700 Filtration effectiveness of N95 medical mask exposed to repeated ultraviolet germicidal irradiation room https://orli.or.id/index.php/orli/article/view/581 <p><strong>ABSTRACT</strong></p><p><strong></strong><strong>Background:</strong> The global Coronavirus disease (COVID-19) pandemic has created shortages of personal protective equipment (PPE) including N95 respirator medical masks. Ultraviolet Germicidal Irradiation (UVGI) is an effective way for disinfection of N95 masks before reuse. The UVGI chamber is an effective method of disinfection against SARS-CoV-2, however its effect on the N95 medical masks filtration ability is still uncertain. <strong>Purpose:</strong> To evaluate filtration effectiveness of N95 mask after repeated UV-C irradiation in the UVGI chamber. <strong>Method:</strong> This was a parallel two-group experimental study to see the effect of repeated UVGI exposure on the filtration of 2 types of N95 medical masks (type 8210 and 1860), with 25 pieces each group, using an aerosol particle counter, after 10 cycles of repeated UVGI exposure in the UVGI chamber of the ORL-HNS Department Dr. Cipto Mangunkusumo Hospital. <strong>Result:</strong> There were no significant differences in the filtration effectiveness of N95 medical masks after repeated UVGI exposure up to 10 cycles for 2 types of N95 masks and there was no significant change in the filtration ability of the N95 medical masks after repeated UVGI exposure.<strong> Conclusion:</strong> The filtration of N95 medical masks type 8210 and 1860 filtration were maintained &gt;95% after repeated UVGI exposure with cumulative dose of 10,126-16.200 mJ/cm2 in UVGI chamber of ORL-HNS Department, Dr. Cipto Mangunkusumo Hospital.</p><p> </p><p><strong><em>ABSTRAK</em></strong></p><p><strong><em></em></strong><em><strong>Latar belakang:</strong> Pandemi Coronavirus disease 2019 (COVID-19) menyebabkan keterbatasan tersedianya alat pelindung diri (APD) termasuk masker respirator N95. Ultraviolet Germicidal Irradiation (UVGI) merupakan salah satu cara desinfeksi yang menjanjikan dan efektif, sehingga masker N95 dapat digunakan kembali. Bilik UVGI merupakan metode yang efektif dalam disinfeksi terhadap SARS-CoV-2, namun efek paparan UVGI terhadap kemampuan filtrasi masker N95 belum diketahui. <strong>Tujuan:</strong> Untuk mengevaluasi efektivitas filtrasi masker N95 setelah paparan UV-C berulang di Bilik UVGI. <strong>Metode:</strong> Penelitian ini adalah studi ekperimental dua kelompok paralel untuk melihat efek paparan UVGI berulang terhadap filtrasi 2 tipe masker N95 (tipe 8210 dan 1860) sebanyak 25 masker di setiap grup, menggunakan aerosol particle counter setelah paparan UVGI berulang sebanyak 10 siklus di Bilik UVGI Departemen THT-KL RSCM. <strong>Hasil:</strong> Tidak didapatkan perbedaan bermakna pada masker N95 pasca-paparan UVGI berulang sebanyak 10 siklus dengan rerata filtrasi pada 2 tipe masker, serta tidak terdapat perubahan signifikan kemampuan filtrasi masker N95 pasca-paparan UVGI berulang. <strong>Kesimpulan:</strong> Filtrasi masker N95 pada penelitian ini dapat dipertahankan 95% pasca-paparan UVGI berulang hingga dosis kumulatif 10.126˗16.200 mJ/cm2 di bilik UVGI Departemen THT-KL RSCM.</em></p><p> </p> Ratna Dwi Restuti, Harim Priyono, Tara Candida Mariska, Arie Cahyono, Brastho Bramantyo, Dewi S. Soemarko, Prasandhya Astagiri Yusuf, Fitri Arman, Joedo Prihartanto Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/581 Sun, 01 Jan 2023 00:00:00 +0700 Management of otosclerosis with obliterated footplate and round window involvement https://orli.or.id/index.php/orli/article/view/448 <p><strong>ABSTRACT</strong></p><p><strong></strong><strong>Background:</strong> Otosclerosis with obliterated footplate describes a condition with an overgrowth of bone so that the oval window is almost indistinguishable from the surrounding area. The occurence of round window obliteration is uncommon. In such cases, surgery is more difficult to perform and the results are often unsatisfactory. <strong>Purpose:</strong> To find out the management option for obliterative otosclerosis. <strong>Case report:</strong> A 35-year-old-man with suspected bilateral otosclerosis. The patient underwent transcanal endoscopic stapes surgery of the left ear with large fenestra stapedotomy procedure. <strong>Clinical question:</strong> In adult patients with obliterative otosclerosis, does stapes surgery improve hearing function and reduce complication? <strong>Review method:</strong> Using PubMed, EBSCOhost, Scopus and Proquest to search for the evidence of randomised control trial (RCT), cohort and case-control studies. Critical appraisal was conducted using critical appraisal tools from Center for Evidence Based Medicine (CEBM), Oxford University and qFAITH for systematic review/meta-analysis. <strong>Result:</strong> The literature searching used eligibility criteria based on keywords from clinical question found one study regarding the evaluation of intra-operative factors in otoslecrosis surgery outcomes, which was relevant to our clinical question. <strong>Conclusion:</strong> Large fenestra stapedotomy or stapedectomy is the preferred surgical technique for the management of obliterative otosclerosis. The involvement of round window caused a sensorineural hearing loss (SNHL) component and has a worse prognosis of hearing outcome post operatively. A further study is required to assess the best management for obliterative otosclerosis.</p><p> </p><p><strong><em>ABSTRAK</em></strong></p><p><strong><em></em></strong><em><strong>Latar belakang:</strong> Otosklerosis dengan obliterasi footplate menggambarkan suatu kondisi pertumbuhan tulang yang berlebihan sehingga tingkap lonjong hampir tidak dapat dibedakan dengan daerah sekitarnya. Obliterasi sampai ke tingkap bundar jarang terjadi. Hal tersebut menyebabkan operasi lebih sulit dilakukan dan hasilnya seringkali tidak memuaskan. <strong>Tujuan:</strong> Untuk mengetahui pilihan tatalaksana otosklerosis obliteratif. <strong>Laporan kasus:</strong> Laki-laki 35 tahun dengan suspek otosklerosis bilateral. Pasien menjalani operasi stapes telinga kiri dengan pendekatan endoskopi transkanal menggunakan prosedur stapedotomi fenestra besar.<strong> Pertanyaan klinis:</strong> Pada pasien dewasa dengan otosklerosis obliteratif, apakah operasi stapes dapat memulihkan fungsi pendengaran dan mengurangi komplikasi?<strong> Telaah literatur:</strong> Pencarian bukti melalui database </em>PubMed, EBSCOhost, Scopus <em>dan</em> Proquest<em>. Untuk uji coba kontrol acak, kohort dan studi kasus-kontrol, penilaian kritis dilakukan dengan menggunakan penilaian kritis dari </em>CEBM, Oxford University <em>dan</em> qFAITH<em> untuk tinjauan sistematis/meta-analisis. <strong>Hasil:</strong> Penelusuran literatur berdasarkan kriteria dari pertanyaan klinis, didapati satu artikel mengenai evaluasi faktor-faktor intraoperatif yang relevan dengan pertanyaan klinis. <strong>Kesimpulan:</strong> Stapedotomi fenestra besar atau stapedektomi adalah teknik bedah yang lebih dipilih untuk tatalaksana otosklerosis obliteratif. Keterlibatan tingkap bundar menyebabkan komponen gangguan pendengaran sensorineural, dan memiliki prognosis hasil pendengaran pasca operasi yang kurang baik. Dibutuhkan studi lebih lanjut untuk menilai tentang penatalaksanaan terbaik untuk kasus otosklerosis obliteratif.</em></p> Harim Priyono, Anita Amalia Sari, Semiramis Zizlavsky, Widayat Alviandi, Respati W. Ranakusuma Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/448 Sun, 01 Jan 2023 00:00:00 +0700 Infection on post transcartilaginous ear piercing https://orli.or.id/index.php/orli/article/view/543 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Body piercing is getting more popular nowadays as a body modification. Piercing is an invasive procedure with the possibility of complications. Researchers had found the rate of body piercing complications at 20.5%. The often found complications are allergic contact dermatitis, inflammation, bleeding, and infection. Some piercings at different sites of human body have more risks to become infected. The cartilaginous part of the ear has a higher risk of significant infection, because of the avascular nature of auricular cartilage that could lead to poor wound healing. Small local infection can progress into perichondritis or abscess. Perichondritis or perichondral inflammation is a severe and a very frequent complication. Pinna edema and spreading of infection could occur if the treatment is delayed. Subperichondral abscess with possible cartilage ischemic necrosis could be the consequence. <strong>Purpose:</strong> To evaluate the risk of infection after a transcartilaginous piercing. <strong>Case Report:</strong> Presenting 2 cases of auricular perichondritis treated at ENT Head and Neck Surgery Department, Mitra Keluarga Gading Serpong Hospital. <strong>Clinical question:</strong> Is infection the most frequent complication of ear piercing? Review method: Searching literature through PubMed and ProQuest with keyword of “Ear Piercing Infection”. Further selection was performed through clinical question. <strong>Result:</strong> The search found one journal disclosing a case of a 29-year-old patient diagnosed with auricular perichondritis who had the same symptoms as both of our reported patients. <strong>Conclusion:</strong> Piercing is an invasive procedure. Knowledge of the risks, precautions, and potential complications is important to reduce the peril of serious complications of piercing.</p><p> </p><p><em><strong>ABSTRAK</strong></em></p><p><em><strong>Latar belakang:</strong> Saat ini, tindik pada anggota tubuh semakin populer sebagai salah satu bentuk modifikasi tubuh. Tindik merupakan prosedur yang invasif dengan kemungkinan terjadinya komplikasi. Penelitian terdahulu menyatakan komplikasi dari tindik tubuh sebanyak 20.5%. Komplikasi yang paling umum terjadi adalah dermatitis kontak alergi, inflamasi, perdarahan, dan infeksi. Tindik pada lokasi tubuh tertentu memiliki risiko yang lebih tinggi untuk mengalami infeksi. Bagian tulang rawan pada telinga memiliki risiko tinggi untuk mengalami infeksi yang signifikan, karena pada dasarnya tulang rawan tidak memiliki pembuluh darah sehingga proses penyembuhannya kurang baik. Infeksi kecil lokal dapat menjadi perikondritis atau abses. Perikondritis atau inflamasi perikondrial adalah komplikasi berat yang sangat umum terjadi. Edema pada bagian daun telinga dan penyebaran infeksi dapat terjadi apabila tatalaksana tidak segera dilakukan. Sebagai akibatnya, dapat timbul abses subperikondrial dengan kemungkinan nekrosis tulang rawan</em>. <strong>Tujuan:</strong><em> Untuk mengevaluasi risiko infeksi setelah melakukan tindik pada tulang rawan. Laporan kasus: Melaporkan 2 kasus perikondiritis yang ditatalaksana oleh dokter spesialis Telinga, Hidung, dan Tenggorok di Rumah Sakit Mitra Keluarga Gading Serpong.</em> <em><strong>Pertanyaan klinis:</strong> Apakah infeksi merupakan komplikasi yang paling sering terjadi pada tindik telinga? <strong>Metode:</strong> Mencari literatur melalui</em> PubMed <em>dan</em> ProQuest <em>dengan kata kunci ”Infeksi Tindik Telinga”. Pencarian selanjutnya dilakukan melalui pertanyaan klinis.</em> <em><strong>Hasil:</strong> Satu jurnal menyajikan laporan kasus tentang pasien berumur 29 tahun dengan diagnosis perikondiritis yang memiliki gejala yang serupa dengan kedua pasien pada laporan kasus ini. <strong>Kesimpulan:</strong> Tindik adalah tindakan yang invasif. Pengetahuan tentang risiko, pencegahan, dan potensi komplikasi yang dapat terjadi, merupakan hal yang penting untuk menurunkan kemungkinan terjadinya komplikasi serius dari tindik.</em></p> Hemastia Manuhara Harba'i, Nydia Triana Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/543 Sun, 01 Jan 2023 00:00:00 +0700 Caldwell-Luc approach for odontogenic maxillary sinusitis https://orli.or.id/index.php/orli/article/view/500 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Maxillary odontogenic sinusitis is a maxillary sinusitis of dental origin. Odontogenic origin of infection must be suspected in those sinusitis patients who have symptoms of unilateral maxillary sinusitis, sinonasal symptoms such as nasal obstruction, rhinorrhea, and/or foul odour, a history of dental pain or dental/oral surgical treatment, and in those who are resistant to conventional treatment of sinusitis. <strong>Purpose:</strong> To report and analyze the result of Caldwell-Luc approach for odontogenic maxillary sinusitis. <strong>Case report:</strong> One case of odontogenic maxillary dextra sinusitis treated by Caldwell-Luc approach. After 2 months of follow-up, there was no thick and smelly discharge coming out of the nose, no complaints of pain in the nose, nor swelling and numbness of the cheeks and gums.<strong> Clinical question:</strong> “Does Caldwell-Luc approach provide good result for odontogenic maxillary sinusitis?”<strong> Review method:</strong> Literature searching was performed through Cochrane database, PubMed, ClinicalKey, and Google Scholar using keywords “Caldwell-Luc” and “odontogenic sinusitis.” <strong>Result:</strong> The search obtained 76 literatures which were related to clinical question. Afterwards filtered with eligible criteria, had resulted 21 relevant literatures. <strong>Conclusion:</strong> The choice of Caldwell-Luc approach for treating odontogenic maxillary sinusitis is a less invasive procedure and gave a satisfying result. Overlooking to identify a dental cause of maxillary sinusitis could lead to persistent symptoms, and failure of medical, as well as surgical intervention.</p><p> </p><p><strong>ABSTRAK</strong></p><p><em><strong>Latar belakang:</strong> Sinusitis maksilaris odontogenik adalah sinusitis maksilaris yang bersumber dari infeksi gigi. Sumber infeksi odontogenik harus dipikirkan ketika ditemukan gejala sinusitis maksila unilateral, gejala sinonasal seperti obstruksi hidung, rinorea dan bau busuk, riwayat infeksi gigi sebelumnya, trauma atau karena prosedur bedah pada tatalaksana gigi, dan pada pasien yang resisten terhadap pengobatan konvensional sinusitis. <strong>Tujuan:</strong> Melaporkan dan menganalisis hasil pendekatan Caldwell-Luc pada kasus sinusitis maksilaris odontogenik. <strong>Laporan Kasus:</strong> Satu kasus sinusitis maksilaris odontogenik dekstra yang ditatalaksana dengan pendekatan </em>Caldwell-Luc.<em> Setelah 2 bulan follow-up, tidak ada ingus kental dan berbau busuk yang keluar dari hidung, tidak ada keluhan nyeri di hidung, bengkak dan mati rasa pada pipi dan gusi. <strong>Pertanyaan klinis:</strong> “Apakah prosedur </em>Caldwell-Luc<em> memberikan hasil terbaik untuk kasus sinusitis maksilaris odontogenik?” <strong>Telaah literatur:</strong> Dilakukan pencarian melalui </em>database<em> </em>Cochrane, PubMed, CinicalKey<em> dan </em>Google Scholar<em>, menggunakan kata kunci </em>“Caldwell-Luc” <em>dan</em> “sinusitis odontogenic”.<em> <strong>Hasil:</strong> Diperoleh 76 literatur yang terkait dengan pertanyaan klinis. Setelah disaring dengan kriteria riset, terdapat 21 literatur yang relevan. <strong>Kesimpulan:</strong> Pemilihan tatalaksana sinusitis maksilaris odontogenik dengan pendekatan Caldwell-Luc merupakan prosedur invasif minimal, dan memberikan hasil yang memuaskan. Bila sumber infeksi dari gigi pada sinusitis maksilaris tidak terdeteksi, hal itu akan menyebabkan gejala persisten, dan kegagalan dalam tatalaksana medikamentosa maupun intervensi bedah.</em></p> Dolly Irfandy, Bestari Jaka Budiman, Putri Sari Ivanny Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/500 Sun, 01 Jan 2023 00:00:00 +0700 Diagnosis and conservative therapy of retropharyngeal hematoma https://orli.or.id/index.php/orli/article/view/431 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Retropharyngeal hematoma is the accumulation of blood clots in the retropharyngeal space which can cause upper airway obstruction. Until now, controversy over surgical versus conservative therapy is still being debated.<strong> Purpose:</strong> Reporting one rare case of retropharyngeal hematoma. <strong>Case report:</strong> A 72-year-old man was brought to the emergency room with complaints of worsening dyspnea for 12 hours, after slipped and fell in the bathroom. Physical examination revealed purple discoloration on the posterior pharyngeal wall, CT scan showed inhomogeneous hyperdense masses, and coagulopathy. The patient underwent conservative therapy but finally died on the day-10 of treatment. <strong>Clinical question: </strong>How effective is the conservative therapy in retropharyngeal hematoma compared to surgical therapy? <strong>Review method:</strong> A literature search using keywords ”retropharyngeal hematoma” was conducted through Pubmed and Google Scholar. <strong>Result:</strong> Management of retropharyngeal hematoma is still controversial due to the lack of widely accepted guidelines. <strong>Conclusion:</strong> Conservative therapy in cases of retropharyngeal hematoma, should be administered aggressively, comprehensively, and with a strict protocol.</p><p> </p><p><em><strong>ABSTRAK</strong></em></p><p><em><strong>Latar belakang:</strong> Hematoma retrofaring adalah penumpukan bekuan darah di ruang retrofaring yang dapat menyebabkan obstruksi jalan nafas bagian atas. Hingga saat ini, kontroversi mengenai terapi bedah versus konservatif masih menjadi perdebatan. <strong>Tujuan:</strong> Melaporkan satu kasus hematoma retrofaring yang jarang terjadi. <strong>Laporan kasus:</strong> Seorang pria berusia 72 tahun dibawa ke ruang gawat darurat dengan keluhan sesak nafas yang semakin memburuk sejak 12 jam setelah jatuh karena terpeleset di kamar mandi. Pada pemeriksaan fisik didapatkan warna keunguan pada dinding posterior faring, CT scan terlihat massa hyperdense yang tidak homogen, serta koagulopati. Pasien menjalani terapi konservatif namun akhirnya meninggal pada hari ke-10 pengobatan.<strong> Pertanyaan klinis:</strong> Seberapa efektif terapi konservatif pada hematoma retrofaring dibandingkan dengan terapi bedah? <strong>Telaah literatur:</strong> Pencarian literatur menggunakan kata kunci ”retropharyngeal hematoma” dilakukan melalui </em>Pubmed <em>dan</em> Google Scholar<em>. <strong>Hasil:</strong> Penatalaksanaan hematoma retrofaring masih menjadi kontroversi karena belum adanya pedoman yang diterima secara luas. <strong>Kesimpulan:</strong> Terapi konservatif pada kasus hematoma retrofaring sebaiknya diberikan secara agresif, komprehensif, dan dengan protokol yang ketat.</em></p><p> </p> Wahyu Tri Novriansyah, Novialdi Nukman Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/431 Sun, 01 Jan 2023 00:00:00 +0700 Reconstruction of medial upper lip defect with Abbe flap https://orli.or.id/index.php/orli/article/view/579 <p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Reconstruction of upper lip defect is challenging, because the upper lip is formed by two lateral nasolabial subunits and one philtrum subunit. The most effective reconstruction approach for upper lip deformities is still being debated. <strong>Purpose:</strong> To report a case of upper lip defect, and review the Abbe flap and Estlander flap methods for upper lip reconstruction. <strong>Case report:</strong> A 62 years old female subject with full thickness defect of two third of the upper lip, repaired by Abbe flap. <strong>Clinical question:</strong> What is the best surgical preference for upper lip defect reconstruction?<strong> Review method:</strong> A systematic literature search based on clinical questions, inclusion, and exclusion criteria in the PubMed, ProQuest, EBSCO databases, Scopus and hand searching using keywords. <strong>Result:</strong> No eligible studies were pertinent to answer the clinical question.<strong> Conclusion:</strong> Reconstruction options of upper lip defect were based on thickness, size and the defect in the structure involved. The Abbe flap can be used to reconstruct the full thickness medial upper lip, one-third up to two-thirds of the defect area. Lateral defects and commissure involvement can be repaired by Estlander flap.</p><p> </p><p><strong><em>ABSTRAK</em></strong></p><p><em><strong>Latar belakang:</strong> Rekonstruksi defek bibir atas lebih sulit, karena dibentuk oleh dua subunit nasolabial lateral dan satu subunit filtrum. Pendekatan rekonstruksi yang paling efektif untuk kelainan bentuk bibir atas masih diperdebatkan. <strong>Tujuan: U</strong>ntuk menyajikan kasus defek bibir atas, pilihan terapi untuk pasien ini dan meninjau pilihan metode operasi dengan jabir Abbe dan Jabir Estlander untuk rekonstruksi bibir atas. <strong>Laporan kasus:</strong> Seorang wanita 62 tahun dengan defek dua pertiga bibir atas dengan ketebalan penuh, yang direkonstruksi dengan jabir Abbe. <strong>Pertanyaan klinis:</strong> Apakah pilihan bedah rekonstruksi terbaik untuk defek bibir atas? <strong>Telaah literatur:</strong> Pencarian literatur sistematis berdasarkan pertanyaan klinis, kriteria inklusi dan eksklusi di</em> database PubMed, ProQuest, EBSCO host<em> dan pencarian tangan menggunakan kata kunci. <strong>Hasil:</strong> Tidak didapati studi yang memenuhi syarat untuk menjawab pertanyaan klinis. <strong>Kesimpulan:</strong> Pilihan rekonstruksi untuk defek bibir atas adalah berdasarkan ketebalan, luas, dan kecacatan pada struktur yang terlibat. Jabir Abbe dapat digunakan untuk rekonstruksi medial bibir atas dengan ketebalan penuh sepertiga hingga dua pertiga dari area defek. Defek lateral dan keterlibatan komisura dapat diperbaiki dengan jabir Estlander.</em></p> Dini Widiarni Widodo, Wulan Mega Gustria Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/579 Sun, 01 Jan 2023 00:00:00 +0700 Sensorineural hearing loss in a child with congenital hypothyroidism receiving thyroid hormone replacement therapy https://orli.or.id/index.php/orli/article/view/580 <p><strong>ABSTRACT</strong><br /><strong>Background:</strong> Congenital hypothyroidism remains as one of the most common causes of hearing loss in children, considering that thyroid hormone plays an essential role in the development and maturation of auditory organs. <strong>Purpose:</strong> To report a case of hearing loss in a child with congenital hypothyroidism who had received thyroid hormone replacement therapy. <strong>Case report:</strong> Presenting a 3-year-old boy with congenital hypothyroidism, growth and developmental delays, and a very severe bilateral sensorineural hearing loss. He was diagnosed at 6 months old, and even after subsequent therapies, the hearing impairment of the child remained profound. <strong>Clinical question:</strong> Could thyroid hormone replacement therapy improve the prognosis of hearing function in congenital hypothyroid patients accompanied by sensorineural hearing loss? <strong>Review method:</strong> Literature review through database PubMed, ProQuest, EBSCO, EBSCOhost and Embase, using keywords: “congenital hypothyroidism”, “hearing loss”, and “thyroid hormone replacement therapy”. <strong>Result:</strong> Screening on 1088 articles found no studies that were relevant with the clinical question and inclusion criteria. <strong>Conclusion:</strong> This report supported the evidence on the effects of congenital hypothyroidism on hearing loss, and the importance of early diagnosis and prompt treatment in congenital hypothyroid children. A missed diagnosis of congenital hypothyroidism in neonates may result in unfavorable effects on the child’s growth and development. Further studies are needed to assess the improvement of hearing function in congenital hypothyroid patients accompanied by sensorineural hearing loss that received thyroid hormone replacement therapy.</p><p> </p><p><strong><em>ABSTRAK</em></strong></p><p><strong><em></em></strong><em><strong>Latar belakang:</strong> Hipotiroidisme kongenital merupakan salah satu penyebab paling umum gangguan pendengaran pada anak-anak, terutama mengingat hormon tiroid berperan penting dalam perkembangan dan maturasi organ pendengaran. Tujuan: Melaporkan satu kasus gangguan pendengaran pada anak dengan hipotiroidisme kongenital yang menetap setelah terapi sulih hormon tiroid.<strong> Laporan kasus</strong>: Seorang anak laki-laki berusia 3 tahun dengan hipotiroidisme kongenital yang mengalami keterlambatan pertumbuhan dan perkembangan, dan gangguan pendengaran tipe sensorineural bilateral derajat sangat berat. Pasien didiagnosis pada usia 6 bulan, dan walaupun setelah terapi, gangguan pendengaran pada anak tersebut menetap.<strong> Pertanyaan klinis:</strong> Apakah terapi sulih hormon tiroid mempengaruhi prognosis perbaikan fungsi pendengaran pada pasien hipotiroid kongenital yang disertai gangguan pendengaran sensorineural? <strong>Tinjauan literatur:</strong> Melalui </em>database PubMed, ProQuest, EBSCO, EBSCOhost <em>dan</em> Embase,<em> menggunakan kata kunci: “hipotiroidisme kongenital”, “gangguan pendengaran”, “terapi sulih hormon tiroid”. <strong>Hasil:</strong> Setelah skrining 1088 artikel, tidak ada penelitian yang sesuai dengan pertanyaan klinis dan kriteria inklusi. <strong>Kesimpulan:</strong> Laporan ini menambah bukti tentang efek hipotiroidisme kongenital pada gangguan pendengaran, serta pentingnya diagnosis dini dan pengobatan segera pada anak hipotiroid kongenital. Diagnosis hipotiroidisme kongenital yang tidak terdeteksi pada neonatus, dapat mengakibatkan efek buruk pada pertumbuhan dan perkembangan anak. Diperlukan penelitian lebih lanjut untuk menilai prognosis peningkatan fungsi pendengaran pada pasien hipotiroid kongenital dengan gangguan pendengaran sensorineural, yang mendapatkan terapi sulih hormon tiroid.</em></p> Semiramis Zizlavsky, Tri Handayani, Ronny Suwento, Eka Dwi Safitri, Tri Juda Airlangga Copyright (c) 2023 Oto Rhino Laryngologica Indonesiana https://orli.or.id/index.php/orli/article/view/580 Sun, 01 Jan 2023 00:00:00 +0700