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

Management of Anaesthesia for a High-Risk Aerosol-Generating Procedure in a Paediatric Patient with COVID-19

Introduction. Paediatric patients represent a small portion of the COVID-19 disease population. Nevertheless, the possibility of a paediatric patient requiring surgery, especially high-risk aerosol-generating surgery on the airway, while having the SARS-CoV-2 infection may potentially result in problems during the perioperative period due to concerns regarding patient, family, and staff safety. When unplanned and unrehearsed, this scenario may cause delays and efficiency issues. Our aim is to report on an 8-year-old patient with a foreign object lodged in the oesophagus with COVID-19 that required emergency surgery. Case Report. An 8-year-old female patient came to the emergency room with a history of difficulty in swallowing for 12 hours before admission, having accidentally swallowed a metal coin while playing. She did not have any recent history of disease, but her parents had noticed that, for the previous 4 days, she had had a mild fever and dry cough. Her parents and other relatives in the house had no similar complaints, and they assured us they had not been in contact with any suspected or confirmed COVID-19 patients. Our goal was to create a safe paediatric anaesthesia environment with safe working conditions for the surgical team. In this case report, we will describe our approach to patient transport, parental presence, preventions of aerosol risk, personal protection, the anaesthesia induction technique, and postoperative management. Conclusion. Safe paediatric anaesthesia, especially in a high-risk aerosol-generating procedure, during the COVID-19 era requires consideration and preparation of both the patient and healthcare provider. Multidisciplinary team work with an emphasis on a systematic and planned approach is required to improve efficiency

Management of Anaesthesia for a High-Risk Aerosol-Generating Procedure in a Paediatric Patient with COVID-19

Introduction. Paediatric patients represent a small portion of the COVID-19 disease population. Nevertheless, the possibility of a paediatric patient requiring surgery, especially high-risk aerosol-generating surgery on the airway, while having the SARS-CoV-2 infection may potentially result in problems during the perioperative period due to concerns regarding patient, family, and staff safety. When unplanned and unrehearsed, this scenario may cause delays and efficiency issues. Our aim is to report on an 8-year-old patient with a foreign object lodged in the oesophagus with COVID-19 that required emergency surgery. Case Report. An 8-year-old female patient came to the emergency room with a history of difficulty in swallowing for 12 hours before admission, having accidentally swallowed a metal coin while playing. She did not have any recent history of disease, but her parents had noticed that, for the previous 4 days, she had had a mild fever and dry cough. Her parents and other relatives in the house had no similar complaints, and they assured us they had not been in contact with any suspected or confirmed COVID-19 patients. Our goal was to create a safe paediatric anaesthesia environment with safe working conditions for the surgical team. In this case report, we will describe our approach to patient transport, parental presence, preventions of aerosol risk, personal protection, the anaesthesia induction technique, and postoperative management. Conclusion. Safe paediatric anaesthesia, especially in a high-risk aerosol-generating procedure, during the COVID-19 era requires consideration and preparation of both the patient and healthcare provider. Multidisciplinary team work with an emphasis on a systematic and planned approach is required to improve efficiency

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