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Tracheal Stenosis due to Trachesotomy Attaufany, Fahmi; Dewi, Yussy Afriani; Samiadi, Dindi; Permana, Agung Dinasti; Aroeman, Nurakbar
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
Publisher : Perdatin Pusat

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Tracheal stenosis is a condition where there is a narrowing of the diameter of the trachea. This condition can occurin congenital or acquired. Approximately 90% due to trauma: internal (prolonged intubation, tracheostomy, etc)with remaining due to external trauma (blunt trauma or penetrating trauma).The incidence of tracheal stenosisapproximately 4%–13% in adults and 1%–8% in neonates. The incidence of tracheal stenosis in Dept ORL-HNSDr. Hasan Sadikin General Hospital Bandung from January 2012–August 2013 as much as ive cases. We presenteda a man, 27 years old, suffer with complain of dyspnea. We found tracheal stenosis grade II (Myer-Cotton) afterlexible bronchoscopic examination due to previous tracheostomy.Tracheostomy was perform followed byinstallation tracheal tube and observation. Two years later the tracheal tube removed and continued with stomalclosure.

Terapi necrobiotic xanthogranuloma dengan siklofosfamid-metilprednisolon Lesmono, Bayu; Dewi, Yussy Afriani; Ratunanda, Sinta Sari; Aroeman, Nur Akbar
Oto Rhino Laryngologica Indonesiana Vol 46, No 2 (2016): Volume 46, No. 2 July - December 2016
Publisher : PERHATI-KL

Latar belakang: Necrobiotic xanthogranuloma (NXG) merupakan suatu penyakit yang langka, kronis, dan progresif. NXG ditandai dengan lesi kulit ulseratif pada daerah indurasi, dan berwarna kuning, atau berupa nodul yang mengenai sel histiosit non Langerhans. Daerah predileksi tersering ialah pada wajah, orbita, dan ekstremitas. Etiologi belum diketahui, tetapi sering dikaitkan dengan monoclonal gammopathy. Gambaran histopatologi NXG yaitu ditemukan makrofag dan terdapat sel busa pada dermis, jaringan subkutan, nekrobiosis luas, sel datia Touton, dan folikel limfoid. Penderita memiliki lesi yang bersifat asimtomatik, parestesi, rasa terbakar, dan terkadang timbul rasa nyeri. Tata laksana NXG sampai saat ini masih sangat bervariasi. Tujuan: Memaparkan hasil penatalaksanaan dua pasien NXG. Laporan kasus: Dilaporkan pasien pertama, laki-laki 44 tahun dengan lesi pada kedua pipi dan dahi sejak 5 bulan sebelumnya. Terapi diberikan metilprednisolon dengan dosis 0,8 mg/kgBB tappering off selama 1 bulan dengan hasil perbaikan. Pasien kedua, wanita 29 tahun dengan lesi pada kedua pipi dan telinga sejak 5 bulan sebelumnya. Terapi diberikan siklofosfamid 750 mg/m2 per 3 minggu dengan hasil membaik. Metode: Pencarian dilakukan melalui PubMed dan Dermatol. Setelah menyaring judul dan abstrak yang sesuai dengan kriteria inklusi dan eksklusi, didapatkan lima artikel utuh. Kemudian, tiga artikel terpilih untuk ditelaah secara konsensus, meliputi kesahihan (validity), kepentingan (importancy), dan aplikabilitas (applicability) pada pasien necrobiotic xanthogranuloma. Hasil: Telaah artikel-artikel tersebut menunjukkan bahwa semua artikel memiliki karakteristik yang serupa dalam hal kesahihan (validity), hasil atau kesimpulannya. Walau demikian, ada beberapa kekuatan dan kelemahan pada masing-masing artikel. Kesimpulan: Penatalaksanaan NXG masih diperlukan penelitian lebih lanjut dengan jumlah sampel yang banyak untuk mengetahui keefektifitasan penatalaksanaan NXG.Kata kunci: Siklofosfamid, metilprednisolon, necrobiotic xanthogranulomaABSTRACT Background: Necrobiotic Xanthogranuloma (NXG) is a rare, chronic, and progressive disease that provokes skin lesions, such as damage of the histiocytes of non-Langerhans cell, skin lesions (yellowish or noduled ulcerative lesions) in the induration skin. The most common predilection areas of this are on the face, orbital, and extremities. The etiology is still unknown, but sometimes associates with monoclonal gammopathy. NXG histopathologic contained macrophages and foam cells in the dermis, subcutaneous tissue, extensive necrobiosis, touton giant cells, and lymphoid follicles. Some patients who had lesions are asymptomatic, sometimes they will feel paresthesias, burning pain. Nowadays, this management is still vary widely. Objective: Sets forth the results of two patients NXG. Case: There were two patients. Patient number one, a 44-years-old man, with some lesions on both cheeks and forehead since 5 months ago. He was treated with methylprednisolon 0.8 mg/kg body weight, and tappered off for a month with improved results. Patient number two, a 29-years-old woman, with some lesions on both cheeks and ears since 5 months ago. She was treated with Cyclosphosphamide 750 mg/m2 with improved results within three weeks. Method: Searching for literature was conducted in PubMed and Dermatol. After screening titles and abstracts with inclusion and exclusion criteria, five articles were available as full texts. Three articles were selected to be reviewed for their validity, importancy and applicability in patient with necrobiotic xanthogranuloma. Results: The review showed that all those articles had a similar characteristic in validity, result, and conclusion. Nevertheless, each articles had its own strong points and weaknesses. Conclusion: NXG treatment still required further research by the number of samples that much to find out the efficiency management NXG.Keywords: Cyclophosphamide, methylprednisolon, necrobiotic xanthogranuloma

Displasia Mondini sebagai faktor risiko terjadinya komplikasi meningitis berulang Arifianto, Aditya; Lasminingrum, Lina; Aroeman, Nurakbar; Boesoirie, Shinta Fitri
Oto Rhino Laryngologica Indonesiana Vol 45, No 2 (2015): Volume 45, No. 2 July - December 2015
Publisher : PERHATI-KL

Latar belakang: Displasia Mondini adalah kasus yang jarang ditemukan namun merupakan penyebab penting terjadinya meningitis berulang pada anak dan membutuhkan indeks kecurigaan klinisyang tinggi sehingga dapat dilakukan diagnosis sedini mungkin. Displasia Mondini adalah kelainankongenital berupa malformasi koklea yang terjadi akibat dari gangguan perkembangan embrio pada telingabagian dalam, di minggu ke tujuh. Anomali kongenital tulang temporal dapat menyebabkan fistulisasiantara telinga tengah dan ruang subarakhnoid. Tujuan: Mempresentasikan kasus displasia Mondini dengan komplikasi meningitis berulang. Kasus: Satu kasus displasia Mondini disertai hipertrofi adenoiddan meningitis berulang pada anak laki-laki usia enam tahun. Penatalaksanaan: Medikamentosa denganpemberian antibiotik dan adenoidektomi. Kesimpulan: Displasia Mondini dengan faktor predisposisihipertrofi adenoid disertai meningitis berulang yang dilakukan adenoidektomi memberikan hasil yangbaik dengan tidak didapatkan kembali meningitis berulang pada pasien setelah tiga tahun. Kata kunci : displasia Mondini, hipertrofi adenoid, adenoidektomi, meningitis berulang ABSTRACTBackground: Mondini dysplasia is a rare case but has an important role for recurrent pyogenic meningitis in children and requires a high index of clinical suspicion for early diagnosis. Mondinidysplasia is malformation of the cochlea due to impairment of the embryonic development of the innerear during the seventh week of fetal life. Congenital anomalies of temporal bone may cause fistulisation between the middle ear and subarachnoid space. Purpose: To present a case of Mondini dysplasia with recurrent meningitis complication. Case: A case of Mondini dysplasia accompanied by hypertrophyadenoid and recurrent meningitis in a six year old boy. Management: Medical treatment with antibioticand adenoidectomy. Conclusion: Adenoidectomy for management of Mondini dysplasia with recurrentmeningitis accompanied by adenoid hypertrophy, gave a good result with no recurrent meningitis afterthree years. Key words: Mondini dysplasia, adenoid hypertrophy, adenoidectomy, recurrent meningitis

KORELASI ANTARA VISUAL ANALOGUE SCALE (VAS) DAN PEAK NASAL INSPIRATORY FLOW (PNIF) SEBELUM DAN SESUDAH SEPTOPLASTI Tamus, Augustien Yuliet; Boesoirie, M. Thaufiq S.; Aroeman, Nur Akbar
Majalah Kedokteran Bandung Vol 47, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Deviasi septum merupakan keadaan yang sering terjadi, bervariasi dari ringan yang tidak mengganggu sehingga deviasi septum berat yang dapat menyebabkan obstruksi hidung. Diagnosis obstruksi hidung sangat kompleks dan bervariasi, selain berdasarkan anamnesis dan pemeriksaan fisis juga diperlukan pemeriksaan penunjang untuk pengukuran obstruksi hidung. Skor obstruksi hidung dengan menggunakan visual analogue scale (VAS) merupakan salah satu parameter untuk menilai obstruksi hidung secara subjektif, sedangkan secara objektif dengan peak nasal inspiratory flow (PNIF). Penelitian ini bertujuan menganalisis korelasi antara visual analogue scale (VAS) dan peak nasal inspiratory flow (PNIF) sebelum dan sesudah septoplasti. Penelitian yang dilakukan adalah penelitian quasiexperimental pre and post test design, dengan pemilihan sampel secara consecutive sampling. Sampel penelitian diambil dari pasien yang datang ke Poliklinik THT-KL Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung periode Mei 2013?Juni 2014 yang memenuhi kriteria inklusi. Hasil penelitian menunjukkan septoplasti memperbaiki gejala klinis pasien septum deviasi, didapatkan peningkatan nilai PNIF dan penurunan nilai VAS sesudah satu bulan dilakukan septoplasti. Simpulan, terdapat korelasi antara visual analogue scale (VAS) dan peak nasal inspiratory flow (PNIF) sebelum dan sesudah septoplasti. [MKB. 2015;47(3):186?91]Kata kunci: Obstruksi hidung, peak nasal inspiratory flow, septum deviasi, septoplasti, visual analogue scaleCorrelation between Visual Anologue Scale (VAS) and Peak Nasal Inspiratory Flow (PNIF) Before and After SeptoplastyAbstractSeptal deviation is a frequently found state that varies from minor without interferences to severe cases of septal deviation that can cause nasal obstruction. Diagnosis of nasal obstruction is very complex and varies based on the anamnesis and physical examination due to the fact that it also requires supports from nasal obstruction measurement results. Nasal obstruction severity is defined by using scores. Visual analogue scale (VAS) is one of the parameters used for assessing nasal obstruction subjectively while peak nasal inspiratory flow (PNIF) is used for objective assessment. This study aimed to analyze the correlation between VAS and PNIF before and after septoplasty. This was a quasiexperimental study with pre- and post- test design. Sampling was performed using consecutive sampling method. Sample was taken from patients who visited ORL-HNS clinic of Dr. Hasan Sadikin General Hospital Bandung in May 2013?June 2014 according to the inclusion criteria . The results showed that septoplasty improved the clinical symptoms in patients with septum deviation, increase PNIF score, and decrease VAS score after one month. In conclusions, there is a correlation between VAS and PNIF before and after septoplasty. [MKB. 2015;47(3):186?91]Key words: Nasal obstruction, peak nasal inspiratory flow, septum deviation, septoplasty, visual analogue scale DOI: 10.15395/mkb.v47n3.601

Pengaruh Alfa Tokoferol pada Efek Ototoksik Sisplatin Santosa, Yanuar Iman; Samiadi, Dindy; Aroeman, Nur Akbar; Fianza, Pandji Irani
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kemoterapi sisplatin memiliki efek samping ototoksik, diperantarai radikal bebas, mengakibatkan kematian selÂ rambut luar koklea, menyebabkan gangguan dengar. Alfa tokoferol memiliki efek otoprotektif terhadap sisplatinÂ pada hewan coba. Diperlukan penelitian lebih lanjut pada manusia. Tujuan penelitian mengukur fungsi pendengaranÂ untuk mengetahui pengaruh pemberian alfa tokoferol per oral pada pencegahan efek ototoksik sisplatin. DilakukanÂ penelitian uji klinis acak di Rumah Sakit Dr. Hasan Sadikin Bandung (RSHS) periode Desember 2011â€“FebruariÂ 2012 pada dua kelompok. Kelompok perlakuan menjalani pengobatan standar kemoterapi sisplatin denganÂ tambahan alfa tokoferol per oral dengan dosis 400 International Unit (IU) per hari sejak 1 hari sebelum kemoterapiÂ selama 30 hari. Kelompok kontrol menjalani pengobatan standar kemoterapi sisplatin. Pemeriksaan fungsiÂ pendengaran dilakukan dengan timpanometri, audiometri, dan distortion product otoacoustic emission (DPOAE)Â sebelum dan setelah kemoterapi siklus pertama dan kedua. Didapatkan hasil kejadian ototoksik setelah siklusÂ pertama lebih rendah secara bermakna pada kelompok 1 (33,3%) dibandingkan dengan kelompok 2 (66,7%)Â (p=0,046; IK=95%). Demikian juga dengan kejadian ototoksik setelah siklus kedua lebih rendah secara bermaknaÂ pada kelompok 1 (50%) dibandingkan dengan kelompok 2 (88,9%) (p=0,027; IK=95%). Simpulan, terapi alfaÂ tokoferol 400 IU per oral dapat mencegah efek ototoksik sisplatin. [MKB. 2012;44(4):205â€“12].Kata kunci: Alfa tokoferol, ototoksik, sisplatinEffects of Alpha Tocopherol Againts Cisplatinâ€“Induced OtotoxicityOtotoxicity is a known side effect of cisplatin chemotherapy due to formation of free radicals causing death toÂ cochlear outer hair cells, resulting in hearing loss. Alpha tocopherol has otoprotective effects towards cisplatin inÂ animal studies. Further human studies are needed. The objective of this study was to measure hearing function toÂ know the otoprotective effects of alpha tocopherol against cisplatin. A randomized control trial was performed atÂ Dr. Hasan Sadikin Hospital Bandung in December 2011â€“February 2012 in 2 groups. The treatment group receivedÂ standard cisplatin chemotherapy treatment and alpha tocopherol 400 International Unit (IU)/day since day 1 beforeÂ a 30-day-treatment. the control group received standard cisplatin chemotherapy treatment. Hearing evaluationÂ was done using tympanometry, audiometry and distortion product otoacoustic emission (DPOAE) before andÂ after the first and second cycles of chemotherapy. Results showed that ototoxic incidence after the first cycle ofÂ chemotherapy was significantly lower in group 1 (33.3%) than group 2 (66.7%) (p=0.046, CI=95%). OtotoxicÂ incidence after the second cycle of chemotherapy was significantly lower in group 1 (50%) than group 2 (88.9%)Â (p=0.027, CI=95%). In conclusion, oral alpha tocopherol 400 IU can prevent cisplatin-induced ototoxicity. [MKB.Â 2012;44(4):205â€“12]Key words: Alpha tocopherol, cisplatin, ototoxicityÂ DOI:Â http://dx.doi.org/10.15395/mkb.v44n4.176

RADIOTERAPI EKSTERNAL TERHADAP NILAI AMBANG EKSITABILITAS SARAF FASIALIS PADA RADIOTERAPI EKSTERNAL PENDERITA KARSINOMA NASOFARING Altila, Yunaldi; Samiadi, Dindy; Aroeman, Nur Akbar
Majalah Kedokteran Bandung Vol 45, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Radioterapi eksternal (external beam radiation therapy/EBRT) merupakan pengobatan utama karsinoma nasofaring. Efek samping radioterapi eksternal yaitu neuropati saraf tepi. Radioterapi eksternal menyebabkan perubahan perbandingan antara akson dan area total serabut saraf. Tujuan penelitian ini menilai pengaruh radioterapi eksternal pada perubahan nilai ambang eksitabilitas saraf fasialis pada penderita karsinoma nasofaring. Jenis penelitian adalah studi analitik observasional dengan rancangan pre-post design. Penelitian dilakukan di Departemen Ilmu Kesehatan Telinga Hidung Tenggorok?Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung bulan September?November 2012. Pada penelitian ini dilakukan pemeriksaan nerve excitability test (NET) praradioterapi, fraksinasi radiasi ke-15, fraksinasi ke-33, dan 4 minggu pascaradioterapi. Hasil penelitian ini dihitung dengan menggunakan uji-t berpasangan. Terdapat 26 subjek mengalami peningkatan nilai NET selama radioterapi sesuai dengan kemaknaan jumlah fraksinasinya (p<0,001). Hal tersebut tidak mempunyai hubungan yang signifikan dengan jenis kelamin dan usia penderita. Simpulan, terjadi peningkatan nilai NET sesuai bertambahnya fraksinasi radiasi, namun 4 minggu pascaradioterapi mengalami penurunan nilai NET mendekati >nilai praradioterapi pada penderita karsinoma nasofaring. [MKB. 2013;45(3):167?73]Facial Nerve Excitability Values on Nasopharyngeal Carcinoma Patients who Undergo External Beam RadiotherapyExternal radiotherapy is the main treatment for nasopharyngeal carcinoma. One of complication of the external beam radiotherapy (EBRT) is peripheral neuropathy. External radiotherapy could cause changes in ratio between axons and the total area of the nerve fibers. The purpose of this study was to assess the influence of EBRT to the changes in the value of the facial nerve excitability in nasopharyngeal carcinoma. This research was observational analytic study by pre and post design and it was performed in the months September until November, year 2012 at the Otolaryngology?Head and Neck Surgery Department of Dr. Hasan Sadikin Hospital Bandung. Nerve excitability test (NET) examination was performed just before EBRT, fractionation the 15th, fractionation the 30th, and four weeks after EBRT. Analytical statistic calculated by using paired t-test. They were 26 subjects had significant of NET value increased during radiotherapy according to the number of fractionation (p<0.001). It does not have a significant relationship with gender and age of the patient. In conclusions, there is increased NET value corresponding increase in fractionation radiation, but they would be decreases approaching the original value as before EBRT on nasopharyngeal carcinoma patients. [MKB. 2013;45(3):167?73] DOI: http://dx.doi.org/10.15395/mkb.v45n3.147

CORRELATION BETWEEN S100 PROTEIN EXPRESSION WITH CLINICAL STAGING NASOPHARYNGEAL CARCINOMA TYPE III Cahyadi, Ismi; Dewi, Yussy Afriani; Aroeman, Nur Akbar
INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA Vol. 2 No. 02 (2020): International Journal of Nasopharyngeal Carcinoma
Publisher : TALENTA PUBLISHER

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/ijnpc.v2i02.3898

Abstract Introduction: Nasopharyngeal carcinoma is the most found head and neck cancer, which originated from a nasopharyngeal epithelial cell, and predilection site commonly at rosen muller fossa. S100 protein inflammatory mediators are involved in the regulation of cellular processes including inflammation and malignancy. S100 protein plays a central role in the proliferation, regulation of cell apoptosis and metastasis causing continuing growth of cancer cells through activation of STAT3 by IL-6, NF-ÎºB, ROS. Objective: This study aimed to determine the correlation between S100 protein expression levels to the clinical stage of NPC WHO type III. Method: This research is a cross-sectional analytic study. This study was held in the Anatomical Pathology Department of Hasan Sadikin Hospital from August until October 2015. The study was conducted using 29 pieces of secondary data, medical records and paraffin blocks anatomical pathology of NPC patients were examined S100 protein immunohistochemistry. Result: This study was performed from 29 subjects (18 males and 9 females). There was a strong positive correlation between histoscore S100 protein expression with clinical staging p<0.05. There is a significant correlation between S100 protein expression with the clinical stage of NPC WHO type III using double regression analysis (F=15.676, p=0.000). Conclusion: There were significant correlation S100 protein expression levels to clinical stage nasopharyngeal carcinoma WHO type III.

Hubungan Antara Nilai Indeks Pertumbuhan Vertikal Wajah dan Kejadian Otitis Media Kronik pada Subras Deutero Melayu Dewasa Widyastuti, Henny; Aroeman, Nur Akbar; Wijana, -
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nilai indeks pertumbuhan vertikal wajah (VERT) menggambarkanÂ pertumbuhan kraniofasial. Nilai ini berdampak pada pertumbuhan tuba eustakius. Perbedaan morfologi kraniofasial berkorelasi dengan fungsi dan anatomi tuba eustakius serta otot tensor veli palatini yang berperan pada patogenesis otitis media kronik (OMK). Telah dilakukan penelitian yang bertujuan untuk mengetahui pengaruh nilai indeks pertumbuhan vertikal wajah (VERT) dan sefalometri terhadap kejadian OMK yang merupakan penelitian kasus-kontrol dengan subyek yang berobat jalan di poliklinik Telinga Hidung Tenggorok-Bedah Kepala Leher (THT-KL) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Septemberâ€’November 2013. Dilakukan pengukuran sefalometri dua kelompok, yaitu kelompok penderita OMK dan kontrol, perbedaan nilai rata-rata ke duanya dihitung dengan uji t atau uji Mann-Whitney, kemudian dihitung indeks VERT rata-rata, dan hubungan antara kedua variabel dianalisis dengan Rasio Odds. 4 dari 7 subjek kelompok kasus merupakan tipe wajah bulat pendek/brakfasial dengan sudut kedalaman wajah lebih besarÂ (t = 3,408,Â p=0,005) dan sudut bidang mandibula lebih kecil (t= - 4,055; p= 0,002). Subyek dengan indeks VERT > +0,5 (brakhifasial) memiliki risiko 8x untuk menjadi OMK (OR: 8; IK 95%: 0,41â€“309,1). Simpulan, indeks VERT berhubungan dengan kejadian OMK pada subras Deutero Melayu dewasa. Kata kunci: Indeks vertikal, otitis media kronik, sefalometriAssociation between Vertical Growth Index and Chronic Otitis Media Incident in Adult Deutero MalaysVertical growth index (VERT) describes craniofacial growth. This value affects the eustachian tube growth. Differences in craniofacial morphology correlates with eustachian tube anatomy function and tensor veli palatini muscles that play a role in the pathogenesis of chronic otitis media (COM). This study aimed to determine the effect of vertical growth index (VERT) and cephalometry on COM incident. The design was case-control with subjects from the outpatient clinic of otolaryngology head and neck surgery, Dr. Hasan Sadikin General Hospital during the period of September to November 2013. Subjects were divided into two groups: COM group and control group. Cephalometric measurements were performed and the mean values difference of both groups were calculated using t test or Mann-Whitney test. The mean index VERT was then calculated for each groups and relationship between risk factors and effects were analyzed using Odds Ratio. Four of 7 subjects in the COM group have a short roundÂ face/brachifacial type withÂ greater facialÂ depthÂ angle (t=3.408, p=0.005) with smaller mandibular plane angle are (t = - 4.055, p=0.002). Subjects with VERT index > +0.5 (brachyfacial type) have eight times higher risk to be COM (OR: 8; 95% CI: 0.41 to 309.1). In conclusion, the VERT index has an association with COM incident in adult Deutero Malays. Key words: Cephalometry, chronic otitis media, vertical indexÂ DOI: 10.15395/mkb.v46n3.312

Penatalaksanaan Angiofibroma Nasofaring Belia di Rumah Sakit Hasan Sadikin Bandung I Putu Aditya Bawa; Yussy Afriani Dewi; Nur Akbar Aroeman
Jurnal Sistem Kesehatan Vol 5, No 2 (2019): Volume 5 Nomor 2 Desember 2019
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jsk.v5i2.25662

Angiofibroma nasofaring belia (ANB) merupakan tumor yang bersifat jinak secara histologis, namun ganas secara klinis. Sampai saat ini penatalaksanaan utama ANB adalah dengan pembedahan. Penelitian ini bertujuan untuk mengetahui gambaran penatalaksanaan ANB di Rumah Sakit Hasan Sadikin (RSHS) Bandung periode 2011-2017. Penelitian ini merupakan penelitian observasional deskriptif dan bersifat potong lintang menggunakan data rekam medik pasien rawat inap dengan diagnosis ANB pada periode tahun 2011-2017. Dalam rentang waktu tersebut didapatkan jumlah 87 sampel. Data rekam medik yang diambil antara lain usia, jenis kelamin, stadium, keluhan utama, dan jenis penatalaksanaan. Hasil penelitian menunjukkan bahwa 98,8% sampel berjenis kelamin laki-laki, dan 96,6% sampel berusia 10-20 tahun. Stadium ANB terbanyak yang ditemukan merupakan stadium IIB (40,2%). Tahap perioperatif yang terbanyak dilakukan adalah embolisasi (72,4%), dan tahap operatif yang terbanyak dilakukan adalah teknik transpalatal (90,8%). Tatalaksana pembedahan ANB di RSHS dilakukan dengan embolisasi sebagai tahap perioperatif dan teknik transpalatal sebagai tahap operatif. Kata kunci: Angiofibroma nasofaring belia, embolisasi, stadium, transpalatal.

Sinekia Palatum Molle dan Pilar Tonsil ke Dinding Faring Posterior pada Pasien Tuberkulosis Paru Desno Marbun; Sinta Sari Ratunanda; Nur Akbar Aroeman; Agung Dinasti Permana
Global Medical & Health Communication (GMHC) Vol 4, No 2 (2016)
Publisher : Universitas Islam Bandung

Tuberkulosis paru masih merupakan penyakit infeksi yang sering dijumpai dan masalah kesehatan di dunia. Sinekia yang disebabkan oleh infeksi kronik tuberkulosis pada daerah faring merupakan kasus yang jarang terjadi. Pembentukan sinekia ini menyebabkan obstruksi saluran napas bagian atas dan dapat menyebabkan gangguan menelan. Laporan kasus ini dimaksudkan untuk memaparkan penatalaksanaan pasien tuberkulosis paru disertai kelainan sinekia palatum molle dan pilar tonsil ke dinding faring posterior. Seorang pasien laki-laki usia 40 tahun terdiagnosis tuberkulosis milier yang telah mendapatkan pengobatan antituberkulosis 4 bulan datang dengan keluhan hidung tersumbat, suara sengau, dan gangguan menelan sejak 2 bulan sebelum masuk rumah sakit. Dilakukan pelepasan sinekia dengan cara reseksi dan insisi palatum molle pendekatan intraoral dengan panduan endoskopi, didapatkan massa jaringan granuloma pada tepi sinekia tersebut. Hasil pemeriksaan histopatologi berupa jaringan granuloma tuberkulosis. Pascaoperasi pasien dapat bernapas lancar melalui hidung dan gangguan menelan menghilang. Simpulan, operasi pelepasan sinekia diputuskan mengingat gangguan obstruksi saluran napas atas. Penatalaksanaan sinekia palatum molle dan pilar tonsil ke dinding faring posterior dengan operasi memberikan hasil yang baik untuk patensi jalan napas dan fungsi menelan. SINECHIA OF SOFT PALATE AND TONSILLAR PILLAR TO THE POSTERIOR PHARYNGEAL WALL AT PATIENT WITH PULMONARY TUBERCULOSISPulmonary tuberculosis is still a common infection and world health problem. Sinechia at the pharyngeal region due to chronic infection of tuberculosis is a rare case. The sinechial formation causes upper airway obstruction and difficulty of swallowing. This case report was ment to present management of pulmonary tuberculosis with sinechia of soft palate and tonsilar pillar to the posterior pharyngeal wall. A 40-year-old man was diagnosed with milliary tuberculosis that had been undergone four months antituberculosis therapy complained nasal obstruction, hot potato voice and difficulty of swallowing since 2 months ago. Sinechia release had been performed with ressection and incission of soft palate transoral approach guiding endoscopy. We founded masses of granuloma at the edge of sinechia with histopatology result as tuberculosis granuloma. After the procedure, patient can breathed and swallowed normally. In conclusion, operational procedure had been decided due to upper airway obstruction. Operatif management for sinechia of soft palate and tonsillar pillar to the posterior pharyngeal wall brings a good result for upper airway pattency and swallow function.

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