Impact of Pharmacotherapy to decrease Interleukin-6 in patients with chronic rhinosinusitis without nasal polyp

Background: Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinuses mucosa, ongoing for more than 12 weeks. Even now it still creates socioeconomic problem in both developed and developing countries. Pharmacotherapy administration is essential for decreasing the severity of symptom, improving quality of life, and decreasing interleukin (IL)-6 level. Objective: To find out the effect of pharmacotherapy on severity of the symptom, quality of life, and IL-6 level. Method: Randomized clinical trial with pre and posttest design, on 20 CRS without polyp patients, divided into two groups based on skin prick test results. Both groups were equally treated with nasal irrigation, nasal corticosteroid, and antibiotic amoxicillin clavulanate for 14 days. All subjects were assessed for Visual Analog Scale (VAS) score, nasoendoscopy (NE) score, Sinonasal Outcome test (SNOT)-22, and IL-6 level. Statistical analysis was performed with Mann Whitney and Wilcoxon methods. Result: There were significant differences in total analysis results on VAS scores, NE scores, SNOT-22, and IL-6 levels in both groups, with values p<0.05. There was improvement in all variables after pharmacotherapy, but there was no significant difference between the case and control groups, with values p>0.05. Conclusion: Pharmacotherapy in both groups resulte’ in reduced severity of symptoms, improved quality of lives, and decreased IL-6 levels

Characteristics of Nasal Foreign Body Cases in Dr. Hasan Sadikin General Hospital Bandung

Background: Nasal foreign bodies are caused by the insertion of an extraneous substance into the nasal cavity. These cases frequently occur in children. Nasal foreign bodies are easily diagnosed, yet the treatment may be burdensome with possible complications and costly management. The study aimed to evaluate the characteristics of nasal foreign body cases.Methods: The study was descriptive and cross-sectional, using secondary data taken from all medical records of the Emergency Room in Dr. Hasan Sadikin General Hospital, Bandung, from 2018 to 2021. Data were presented in tables.Results: Of the 57 cases, most of the patients (64.9%) were aged 3-5 years, with boys as the most prevalent cases (59.7%) and the most common complaint was pain (31.7%). Inorganic foreign bodies (61.4%) were more commonly found, and being frequently found in the right nasal cavity (49.1%). The duration of the foreign body in the nasal cavity and the treatment conducted on the patients were mostly not written in the medical records, however, no complications were found.Conclusions: A higher incidence of nasal foreign bodies can be found in boys aged 3-5 years. Inorganic objects and pain are the most common manifestations, although the condition of all patients has been improved. Raising awareness about foreign body cases to the community, especially the parents, is the key to preventing these cases from occurring

Adaptasi Budaya, Alih Bahasa Indonesia, dan Validasi Sino-Nasal Outcome Test (SNOT)-22

Kuesioner untuk menilai kualitas hidup saat ini semakin meningkat penggunaannya dalam penelitian klinis hasil intervensi medis, baik operatif maupun medikamentosa. SNOT-22 dianggap sebagai alat ukur yang paling sesuai untuk menilai kualitas hidup pasien rinosinusitis kronik.Tujuan penelitian ini melakukan adaptasi budaya, alih bahasa, dan validasi SNOT-22 ke dalam bahasa Indonesia. Penelitian deskriptif analitik potong lintang pada 50 pasien rinosinusitis kronik di Poliklinik Rinologi Alergi Departemen Ilmu Kesehatan Telinga Hidung dan Tenggorok Bedah Kepala dan Leher (THT-KL) Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung periode November 2015–Februari 2016. Diagnosis berdasar atas anamnesis, tingkat berat penyakit, nasoendoskopi berdasa Lund-Kennedy, dan penilaian kualitas hidup dengan SNOT-22. Validasi kuesioner dalam bahasa Indonesia dilakukan dengan menerjemahkan kuesioner SNOT-22 versi bahasa Inggris ke bahasa Indonesia oleh ahli bahasa Indonesia dan diterjemahkan kembali ke bahasa Inggris oleh ahli bahasa Inggris. Dilakukan uji reabilitas menggunakan Cronbach’s alpha dan uji validitas menggunakan Rank Spearman’s. Uji Cronbach’s alpha =0,936 (sangat andal), andal jika ≥0,7 menunjukkan konsistensi yang baik. Uji Rank Spearman’s: rs=0,961 dan rs=0,978 (valid); dan keandalan (korelasi skor genap dengan skor ganjil) rs=0,900. Simpulan, hasil uji statistik menunjukkan bahwa kuesioner SNOT-22 versi bahasa Indonesia merupakan alat ukur yang valid dengan konsistensi yang baik untuk menilai kualitas hidup pasien dengan rinosinusitis kronik.  Kata kunci: Bahasa Indonesia, kualitas hidup, rinosinusitis kronik, SNOT-22, validasi Indonesian Cross-cultural Adaptation,  Translation, and Validation of Sino-Nasal Outcome Test (SNOT)-22 Questionnaires for quality of life (QoL) have been increasingly used in clinical trials to evaluate the impact of medical and surgical procedures. Among these, SNOT-22 was considered as the most suitable tool for assessing QoL in chronic rhinosinusitis. The purpose of this study was to conduct cross-cultural adaptation, translation, and validation of the Indonesian version of SNOT-22. This was a descriptive analitical cross-sectional study on 50 patients with chronic rhinosinusitis at the Rhinology-Allergy Clinic of the ORL-HNS Department, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, during the period of November 2015–February 2016. Diagnosis was made based on anamnesis while the severity of the disease was determined using nasoendoscopic findings (Lund-Kennedy). QoL was measured using SNOT-22. The validation process of the Indonesian questionnaire included translation of original SNOT-22 in to Indonesian by independent Indonesian translators, and backtranslation to English by English translators. The reliability of the questionnaire was measured using Cronbach’s alpha and the discriminant validity was assessed using Rank Spearman’s. Results showed a Cronbach’s alpha of 0,936, suggesting good internal consistency while the Rank Spearman’s correlation results suggested that the translation was valid (rs=0.961 and rs=0.978). Correlation for each individual QoL itemwas also reliable (rs=0.900). Therefore, the Indonesian version of the SNOT-22 is a valid instrument with good internal consistency and validity for assessing QoL in patients with CRS. Key words: Indonesian, chronic rhinosinusitis, quality of life, SNOT-2, validatio

Gambaran Klinis Pasien Laringomalasia di Poliklinik Telinga Hidung Tenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung Periode Januari 2012 - Maret 2015

Latar Belakang: Laringomalasia merupakan salah satu kelainan kongenital yang terjadi akibat jatuhnya struktur supraglotik selama inspirasi sehingga menyebabkan stridor. Laringomalasia terdiri dari 3 tipe. Faktor risiko laringomalasia adalah lahir prematur, kelainan neurologik dan lesi jalan nafas. Faktor komorbid laringomalasia adalah bronkopneumonia, kelainan jantung bawaan dan kelainan neurologik. Laringomalasia diduga memiliki hubungan yang erat dengan refluks isi lambung. Tujuan: memberikan informasi mengenai gambaran klinis laringomalasia berdasarkan tipe laringomalasia, faktor risiko, faktor komorbid, dan gambaran refluks laringofaring sehingga diharapkan penatalaksanaan yang lebih terpadu. Metode: penelitian deskriptif retrospektif dengan pendekatan potong lintang, di Poliklinik THT-KL RSHS Bandung periode Januari 2012-Maret 2015, berdasarkan data rekam medis, dan pemeriksaan laringoskopi serat lentur. Hasil: Terdapat 84 pasien (55 laki-laki dan 29 perempuan). Tipe laringomalasia terdiri dari tipe 1 (63,1%), tipe 2 (23,8%) dan tipe 3 (13,1%). Faktor risiko terbanyak adalah cerebral palsy (13%). Faktor komorbid berupa bronkopneumonia (53,6,5%), dan kelainan jantung bawaan (4,8%). Terdapat 2 gambaran refluks laringofaring, yaitu mukus kental endolaring (48,8%), dan hipertrofi komisura posterior (10,7%). Kesimpulan: Laringomalasia banyak terjadi pada laki-laki dibandingkan perempuan, tipe laringomalasia terbanyak adalah tipe 1 epiglotis berbentuk omega. Faktor risiko kelainan neurologik (cerebral palsy), faktor komorbid bronkopnemonia dan gambaran refluks laringofaring berupa mukus kental endolaring yang banyak terjadi.Kata Kunci : Laringomalasia, Laringoskopi Serat LenturBackground : Laryngomalacia is a congenital anomalies caused by the collapse of the supraglottic structures during inspiration and causing of stridor. Laryngomalacia consists of 3 types. Laryngomalacia risk factor is premature birth, neurological disorders and lesions of the airway. Laryngomalacia comorbidities was bronchopneumonia, congenital heart disease and neurological disorders. Laryngomalacia expected to have close links with the laryngopharyngeal reflux (LPR). Aim: provide information on the clinical manifestation of Laryngomalacia based on type Laryngomalacia, risk factors, comorbidities, and laryngopharyngeal reflux so expect a more unified management. Methods : retrospective descriptive study with cross-sectional approach in the outpatient of Otolaryngology-Head and Neck Surgery, Hasan Sadikin Hospital, Padjadjaran University, period January 2012-March 2015 from the medical sheats records and record video flexible fiberoptic laryngoscopy (FFL). Results : Eighty four patients were included in the study (59 males and 29 females). Risk factor in this study is cerebral palsy (13%) and the comorbid factor is bronchopneumonia (53,6,5%), cerebral palsy and congenital heart diseases (4,8%). The two clinical findings from LPR is endolaring mucus (48,8%), posterior commissure hypertrophy (10,7%). Conclusions : Laryngomalacia more common in men than women, the most Laryngomalacia type is type 1 omega-shaped epiglottis. Risk factors is neurological disorders (cerebral palsy), comorbidities bronchopneumonia and laryngopharyngeal reflux picture in form of viscous mucus that frequently occurred.Keyword : Laryngomalacia, Flexible Fiberoptic Laryngoscopy

Efektivitas Terapi Kortikosteroid Intranasal pada Hipertrofi Adenoid Usia Dewasa berdasarkan Pemeriksaan Narrow Band Imaging

Adenoid hypertrophy is a process in which adenoid size becomes enlarged and causes clinical symptoms, especially nasal obstruction. Adenoid hypertrophy can be due to physiological, inflammatory, or malignancy processes. Adenoid inflammatory process can be assessed using a flexible fiberoptic nasoendoscopy with narrow band imaging (NBI). Intranasal corticosteroid is one of the choices to treat adenoid hypertrophy in children; however, more experiments are needed to use it in adults. This study was performed in the period of November 2012 to January 2013 at the outpatient clinic of the Otorhinolaryngology-Head and Neck Surgery Department of Dr. Hasan Sadikin General Hospital Bandung, using pre- and post-test open-labeled quasiexperimental design. Sample was selected through consecutive sampling, involving 11 subjects. Diagnosis was based on research subject’s anamnesis, ear nose and throat (ENT) physical examination, NBI-equipped fiberoptic nasoendocopy examination, and adenoid mucosal biopsy. Subjects were given intranasal corticosteroid therapy for four weeks. NBI-equipped fiberoptic nasoendocopy examination and biopsy examination were performed after therapy. Data were analyzed using Wilcoxon test, showing significant improvement of the adenoid inflammation after intranasal corticosteroids therapy (p<0.05). McNemar test results showed a significant reduction in adenoid size (p<0.05). Spearman rank test showed a significant correlation between histopathologic findings and NBI examination result (p<0.05). In conclusion, intranasal corticosteroids are effective for adult adenoid hypertrophy treatment based on NBI examination. [MKB. 2016;48(4):228–33

Penggunaan Terkini Oksimetazolin Pada Praktik Klinik Sehari - Hari dan Rekomendasi Kelompok Studi Rinologi Indonesia

Abstract Latar belakang: Oksimetazolin adalah bahan aktif dekongestan topikal yang digunakan untuk rinitis alergi maupun inflamasi mukosa hidung lainnya. Cara pemakaian oksimetazolin yang baik dan benar akan memengaruhi keberhasilan pengobatan. Efek samping rinitis medikamentosa merupakan komplikasi yang sering terjadi dan sebaiknya dapat dicegah. Tujuan: Penulisan tinjauan pustaka ini untuk memberikan pemahaman terkini tentang berbagai indikasi oksimetazolin pada praktik klinik Telinga Hidung Tenggorok sehari-hari, cara pemakaian yang tepat, efek samping dan komplikasi yang terjadi berdasarkan studi kepustakaan yang dipublikasikan di PubMed, Google Scholar, dan Scopus dalam 10 tahun terakhir (2007–2016) oleh tim adhoc anggota Kelompok Studi (KODI) Rinologi Indonesia. Tinjauan pustaka: Oksimetazolin memiliki indikasi yang diperluas jika digunakan bersama dengan bahan aktif lain. Oksimetazolin semprot hidung 0,05% yang digunakan bersama dengan steroid intranasal dilaporkan memberikan manfaat pada penatalaksanaan rinitis alergi, rinitis kronis, dan polip hidung. Oksimetazolin digunakan juga dalam bedah sinus endoskopik untuk mendapatkan visualisasi lapang operasi yang baik karena efek hemostatik vasokonstriktor intranasal. Keuntungan yang dilaporkan juga diiringi dengan kemungkinan efek samping dan komplikasi yang sudah dikenal sampai yang membahayakan hingga kematian akibat koarktasio aorta, infark miokard elevasi non-ST, dan krisis hipertensi. Kesimpulan: Rekomendasi yang dibuat oleh KODI Rinologi berdasarkan analisis secara sistematik dengan telaah kritis, diharapkan dapat meningkatkan pengetahuan dan pemahaman tentang penggunaan oksimetazolin yang bermanfaat dan dapat mencegah efek samping yang berbahaya