Indications of Tonsillectomy and Adenoidectomy in Dr. Hasan Sadikin General Hospital Bandung

  Background: Tonsillectomy is the intervention to take out the palatine tonsils either whole or sub capsular, while adenoidectomy is the intervention of extraction of the adenoid gland which is commonly done with curettage method. Both interventions are done to eliminate repeated infections and also obstructions due to inflammation and hypertrophy of the tonsils and adenoids. This study was conducted to examine the indications of tonsillectomy and adenoidectomy in the Departement of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital Bandung in the period of January 2009–December 2011. Methods: A cross-sectional descriptive study was conducted in October–November of 2012 using 207 medical records of patients who had tonsillectomy and adenoidectomy executed in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung in the period of January 2009–December 2011. Data collected were age, gender, main complaint, tonsil size, history of repeated infections, history of snoring as well as of Obstructive Sleep Apnea Syndrome (OSAS). The indication for tonsillectomy and adenoidectomy such as infection, obstruction and neoplasia was selected.Results: The indications of tonsillectomy and adenoidectomy were infection at 106 (51.2%) patients, obstruction at 100 (48.3%) patients, and neoplasia at 1 (0.05%) patient.Conclusions: The most numerous indications for tonsillectomy and tonsilloadenoidectomy in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital were infection.Keywords: Adenoid, adenoidectomy, indication, tonsil, tonsillectomy DOI: 10.15850/amj.v2n1.447

IgG levels in Human Papillomavirus Infection Associated with Clinical Stage of Head and Neck Squamous Cell Carcinoma

Background: Head and neck squamous cell carcinoma (HNSCC) is an invasive neoplasm of epithelial tissue in the head and neck and one of the etiologies of HNSCC is human papillomavirus (HPV) which maybe associated with the clinical stage of HNSCC. HPV infection in squamous cell epithelium produces specific IgG antibodies against HPV. IgG titer of HPV can help identify patients who are at risk for HPV-related cancers. This study aimed to explore the association between IgG titer of HPV with the clinical stages of HNSCC.Methods: The design of this study was analytic cross sectional, conducted at the Outpatient Clinic of Otorhinolaryngology-Head and Neck Surgery, Division of Oncology, Dr. Hasan Sadikin General Hospital Bandung period September-December 2017. Patients with HNSCC were recruited, and history was taken. Furthermore, histopathologic examination and HPV IgG serology examination was performed using the ELISA method. The HPV IgG levels were compared by stage and data were analyzed using the Shapiro Wilks test and Unpaired T test.Result: The HPV IgG was high in 75% (n=21) of HNSCC patients in the advanced stage and low in 25% (n=7) of patients in the early stage. There was  a significant relationship between HPV IgG titer and early and advanced stage of  HNSCC (p=0.001).Conclusion: The HPV IgG titer is related to the clinical stage of HNSCC indicating that the higher the HPV IgG level, the more advanced the clinical stage. Further study is needed to explore HPV IgG levels as a prognostic marker in HNSCC

Vascular Endothelial Growth Factor Expression in Correlation with Stage Juvenile Nasopharyngeal Angiofibroma

Background: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign tumor of mesenchymal tissue, originating from the stromal and blood vessels with dense collagen. However, JNA has a malignant tumor-like property because it can cause erosion of surrounding bone. Vascular Endothelial Growth Factor (VEGF) plays a role in the angiogenesis process. The expression of VEGF is the best marker to determine the occurrence of angiogenesis in JNA. This study aimed to determine the correlation between VEGF expression and JNA clinical stage. Methods: This was a cross-sectional correlational analytic observational study on medical records and paraffin blocks of all patients with JNA at Dr. Hasan Sadikin General Hospital Bandung during the period of 2016 to 2019. Immunohistochemistry examination of VEGF expressions was performed and VEGF expression was rated based on staining intensity, percentage distribution, and histoscore. Data were then analyzed using the Spearman correlation test.Results: Of 24 patients, 23 males and 1 female, 58% demonstrated a strong intensity of staining. The positivity of VEGF cell percentage was identified as 26–50% (n=6 patients), 51–75% (n=11), and >75% (n=7). The median VEGF histoscores were 2.5, 6.5, and 12 in JNA stage I, stage II, and stage 3, respectively, with the greater VEGF histoscore had a higher clinical stage with a correlation coefficient of (rs) 0.723 (p=0.002). Conclusions: There is a strong correlation between increased VEGF expression and JNA clinical stage. VEGF expression can be used as a prognostic factor of JNA

THE IMPACT OF COVID-19 PANDEMIC TO HEAD AND NECK CANCER CARE IN HASAN SADIKIN HOSPITAL BANDUNG, INDONESIA

Objective: This study represents head and neck cancer patient’s care at Departement of Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) in Hasan Sadikin General Hospital during COVID-19 pandemic. Methods: The study is done using a retrospective descriptive method based on medical record data in patients with head and neck cancer at Oncology Departement of ORL-HNS, Hasan Sadikin General Hospital, Bandung from March to July 2020. Samples were selected with total sampling. All existing subjects who met the study criteria were enrolled. The inclusion criteria in this study were head and neck cancer patients from March to July 2020. The exclusion criteria were incomplete medical records data. Results: The number of outpatient visits at ORL-HNS Departement, Dr. Hasan Sadikin General Hospital Bandung from March to July was 3723 patients with 1796 of them are oncology outpatients. There was a significant decrease in the number of ORL-HNS outpatient in April and May and began to increase steadily in June and July. This is in line with the start of the big-scale social restriction at the end of March and the start of the ‘new normal’ era in early June. Conclusion: The study demonstrates the significant impact of the COVID-19 crisis on oncological care. During COVID-19 pandemic, the treatment of HNC patients has been severely disrupted and caused a decrease in the number of procedures at Dr. Hasan Sadikin General Hospital Bandung

Cancer Antigen 125 Serum Level in Head and Neck Diffuse Large B-Cell Lymphoma

Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common subtype of the Non-Hodgkin Lymphoma (LNH). Until now, lactate dehydrogenase (LDH) is the only tumor marker to assess DLBCL progression; however, increased LDH is a relatively non-specific biomarker. Cancer antigen 125 (CA-125) serum level have been used as a tumor marker in ovarian cancer. The aim of this study was to explore the possible role of CA-125 serum level as a tumor marker in head and neck DLBCL.Methods: This was an observational descriptive study among consecutively sampled DLBCL patients. CA-125 serum level examination was carried out (ADVIA Centaur CA-125II) and described along with the clinical characteristics of DLBCL patients.Results: DLBCL was mostly observed in males (54.05%), most often in the 55-65 year age group (51.3%), with stage 1 DLBCL was the most prevalent (71.9%). The mean CA-125 serum level was 22.9 U/ml and increased in patients with advanced DLBCL.Conclusions: Increased CA-125 serum level in DLBCL, especially at advanced stages, suggests that CA-125 serum level may be of benefit as a tumor marker in the head and neck DLBCL. Further study is in need to explore the role of CA-125.1.       Kementerian Kesehatan Republik Indonesia. Data dan kondisi penyakit limfoma di Indonesia. InfoDatin Pusat Data dan Informasi Kementerian Kesehatan RI. 2015 [cited 2020 March 18] Available from: https://www.kemkes.go.id/resources/download/pusdatin/infodatin/infodatin-limfoma.pdf2.       Dwianingsih EK, Indrawati, Hardianti MS, Malueka RG , Iswar RR, Sutapa S, et al. Histopathological features of lymphoma in Yogyakarta, Indonesia. Asian Pac J Cancer Prev. 2016;17(9):4213–16.3.       Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar (RISKESDAS) 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 20134.       Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014; 32(27):3059–67.5.       Ziepert M, Hasenclever D, Kuhnt E, Glass B, Schmitz N, Pfreundschuh, et al. Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+B-cell lymphoma in the rituximab era. J Clin Oncol. 2010;28(14):2373-2380.6.       Gutiérrez A, Martínez-Serra J, Barceló B, Sampol A, Vinas L, Gonzales G, et al. Prognostic value of serum CA125 levels in diffuse large B-cell lymphoma: potential role of a new sex and age adjusted reference value. Int J Lab Hematol. 2010; 32(6 Pt 2): 582–9.7.       Dilek I, Ayakta H, Demir C, Meral C, Ozturk M. CA 125 levels in patients with Non-Hodgkin lymphoma and other hematologic malignancies. Clin Lab Haematol. 2005;27(1):51–5.8.       Memar B, Aledavood A, Shahidsales S, Ahadi M, Farzadnia, Raziee HR, et al. The prognostic role of tumor marker CA-125 in B-Cell non-Hodgkin’s Lymphoma. Iran J Cancer Prev. 2015;8(1):42–6.9.       Garg S, Goyal B. Evaluation of CA-125 as a prognostic marker in patients with Non-Hodgkin’s lymphoma. International Journal of Medical and Health Research. 2017;3(4):13–5.10.   Paoli CJ, Bach BA, Quach D, Tsai KT, Wong B, Kallich J. Performance status of real-world oncology patients before and after first course of chemotherapy. The Journal of Community and Supportive Oncology. 2014; 12(5):163–70.11.   Yadav C, Ahmad A, D’Souza B, Agarwal A, Nandini M, Prabhu KA, et al. Serum lactate dehydrogenase in Non-Hodgkin’s lymphoma: a prognostic indicator. Indian J Clin Biochem. 2016;31(2):240–2

Indications of Tonsillectomy and Adenoidectomy in Dr. Hasan Sadikin General Hospital Bandung

  Background: Tonsillectomy is the intervention to take out the palatine tonsils either whole or sub capsular, while adenoidectomy is the intervention of extraction of the adenoid gland which is commonly done with curettage method. Both interventions are done to eliminate repeated infections and also obstructions due to inflammation and hypertrophy of the tonsils and adenoids. This study was conducted to examine the indications of tonsillectomy and adenoidectomy in the Departement of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital Bandung in the period of January 2009–December 2011. Methods: A cross-sectional descriptive study was conducted in October–November of 2012 using 207 medical records of patients who had tonsillectomy and adenoidectomy executed in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung in the period of January 2009–December 2011. Data collected were age, gender, main complaint, tonsil size, history of repeated infections, history of snoring as well as of Obstructive Sleep Apnea Syndrome (OSAS). The indication for tonsillectomy and adenoidectomy such as infection, obstruction and neoplasia was selected.Results: The indications of tonsillectomy and adenoidectomy were infection at 106 (51.2%) patients, obstruction at 100 (48.3%) patients, and neoplasia at 1 (0.05%) patient.Conclusions: The most numerous indications for tonsillectomy and tonsilloadenoidectomy in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital were infection.Keywords: Adenoid, adenoidectomy, indication, tonsil, tonsillectomy DOI: 10.15850/amj.v2n1.447

Diagnostic Value of Narrow Band Imaging in Diagnosing Nasopharyngeal Carcinoma

Background: Carcinoma is the most common tumor in nasopharynx. Endoscopy is used to determine the presence of lesions suspected of malignancy. Narrow Band Imaging is an endoscopic technique that uses narrow–band spectrum as a filter to determine any mucosal vascular changes in carcinoma. Narrow Band Imaging can early detect superficial mucosal lesions that are difficult to detect with conventional endoscopy, so that diagnosing is more accurate and occurrence of unnecessary biopsies can be reduced. This study aimed to determine diagnostic value of Narrow Band Imaging in diagnosing nasopharyngeal carcinoma.Methods: This diagnostic test study was conducted at Department of Otorhinolaryngology-Head and Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung from September to October 2014. Twenty four patients with clinical signs and symptoms of nasopharyngeal carcinoma that fulfilled the study criteria were assigned using consecutive sampling to examine with Narrow Band Imaging and histopathology examination. The data were then analyzed with 2x2 table to determine sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.Results: In this study, the results of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in diagnosing nasopharyngeal carcinoma using Narrow Band Imaging were 93.75%, 62.5%, 83.3%, 83.3%, and 83.3%, respectively. Conclusions: Sensitivity of Narrow Band Imaging is 93.75%. [AMJ.2017;4(1):133–7] DOI: 10.15850/amj.v4n1.103

Quality Of Life of Laryngeal Carcinoma Patients after Total Laryngectomy

Background: Management of laryngeal carcinoma has been widely developed, either by surgery, radiotherapy, and/or chemotherapy. The treatment has a major impact on physical, social, and psychological health that can change the quality of life of patients. This study aimed to determine the quality of life of laryngeal carcinoma patients after total laryngectomy.Methods: This descriptive study was conducted from May to August 2018. Patients with post total laryngectomy at the Division of Ear, Nose, Throat, Head and Neck Surgery, Dr. Hasan Sadikin General Hospital, Bandung were recruited. Short Form 36 (SF-36) Study Questionnaire and the European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H & N35) were used, and data were presented in the form of descriptive narratives and tables.Results: In total, 23 patients were included consisting of 19 men (82.61%) and women (17.39%), aged 56-65 years old. The mean score of quality of life in physical components of SF-36 was 87.55 ± 2.35 and in mental components was 85.35 ± 3.92. The highest score of quality of life of EORTC QLQ-H & N35 on the speech problem scale was 51.69 ± 6.36. Conclusion: The quality of life of laryngeal carcinoma patients after total laryngectomy is generally good, however, speech is the main problem and needs to be further elaborated to enhance the quality of life

Epidemiologi Penderita Tumor Ganas Kepala Leher di Departemen Telinga Hidung Tenggorokan - Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung, Indonesia, Periode 2010–2014

Latar Belakang: Tumor ganas kepala leher adalah kanker yang berasal dari traktus aerodigestif bagian atas seperti traktus sinonasal, rongga mulut, faring dan laring. Tumor ganas kepala leher merupakan masalah kesehatan dengan mortalitas tinggi. Insidensinya meningkat dan menyerang berbagai individu. Penelitian bertujuan untuk mengetahui epidemiologi penderita tumor ganas kepala leher di Departemen Telinga Hidung Tenggorokan (THT-KL), Rumah Sakit Dr. Hasan Sadikin Bandung 2010–2014.Metode: Penelitian dilakukan secara deskriptif dari rekam medis penderita tumor ganas kepala leher di Departemen THT-KL, Rumah Sakit Dr. Hasan Sadikin Bandung periode 2010–2014, yang diambil secara total sampling.Hasil: Terdapat 1439 pasien penderita tumor ganas kepala leher. Sebanyak 1081 penderita diinklusi; 631 laki-laki dan 450 perempuan. Kebanyakan berpendidikan SD (44.2%), bekerja sebagai ibu rumah tangga (30.6%), dan berusia 46–55 tahun (28.7%). Tumor berlokasi di nasofaring (39.4%), sinonasal (16.9%), laring (13.7%), orofaring (6.4%), tiroid (6.1%), rongga mulut (3.5%), hipofaring (2.5%), dan kelenjar parotis (2.2%). Histopatologi terbanyak yaitu undifferentiated carcinoma (47.3%) dan karsinoma sel skuamosa (31.2%), dengan Stadium I (6.8%), II (13.3%), III (24.5%), IV (55.4%). Simpulan: Kasus tumor ganas kepala leher di departemen THT-KL adalah sebanyak 1439 orang, yang tertinggi adalah karsinoma nasofaring. Lebih banyak terjadi pada laki-laki, lanjut usia, berpendidikan SD, profesi ibu rumah tangga, penderita dengan stadium lanjut dan histopatologi undifferentiated carcinoma Saran: Perbaikan kelengkapan serta sistem penyimpanan data rekam medis. Prevensi, edukasi dan deteksi dini pada masyarakat umum mengenai tumor ganas kepala leher.Kata Kunci: Epidemiologi, tumor ganas kepala leherIntroduction: Head and neck cancer is carcinoma that arises from upper aerodigestive tract such as sinonasal tract, oral cavity, pharynx, and larnyx. Head and neck cancer is a health problem with a high mortality rate which are increasing and effect many individuals from diverse backgrounds. Aims: Aim of this research is to ascertain the epidemiology of head and neck cancer patients at the Otorhinolaringology-Head and Neck Surgery Department, Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2010–2014 Methods: A descriptive method from medical records of head neck cancer patients at Department of Otorhinolaringology-Head and Neck Surgery, Dr. Hasan Sadikin General Hospital Bandung in 2010–2014 that used the total sampling method. Results and Discussion: There were 1,439 head and neck cancer patients in this research, 1081 were included, of them 631 were men and 450 were women. Most of them were elementary educated (44.2%), housewives (30.6%), and those aged 46–55 years old (28.7%). There were nasopharyngeal (39.4%), sinonasal (16.9%), larnyx (13.7%), oropharnyx (6.4%), thyroid gland (6.1%), oral cavity (3.5%), hypopharynx (2.5%), and parotid gland (2.2%) cancer. The major histopathological findings were undifferentiated carcinoma (47.3%) and squamous cell carcinoma (31.2%). Patients with stage I (6.8%), II (13.3%), III (24.5%), and IV (55.4%). Head neck cancer patients at the Otorhinolaringology-Head and Neck Surgery Department, Dr. Hasan Sadikin General Hospital Bandung are 1439 cases, with nasopharyngeal carcinoma cases being most predominant. There was a higher instance in middle aged and older, men, and elementary school educated. On the other hand, housewives were also highly affected. Patients came with advanced stages; undifferentiated carcinoma was the major histopathologyKeywords: Epidemiology, head and neck cance