Hypoxia-Inducible Factor-1 α

Objectives. This research aimed to determine the association between hypoxia-inducible factor-1α (HIF-1α) expression and laryngeal squamous cell carcinoma clinical stage. Methods. We retrospectively analyzed paraffin-embedded tissue from 47 laryngeal squamous cell carcinoma (LSCC) patients from 2011 to 2014. HIF-1α expression was analyzed by immunohistochemistry using an anti-HIF-1α mouse monoclonal antibody. The association between HIF-1α expression and clinical stage was analyzed using the chi square test. Results. The glottis was the predominant site of laryngeal squamous cell carcinoma occurrence, and 43/47 (91.5%) patients presented at an advanced stage. Of the advanced stage patients, 27/43 stained positive for HIF-1α expression and 16/43 stained negative. Of the early stage patients, 2/4 stained positive for HIF-1α expression and 2/4 stained negative. Statistical analysis did not demonstrate significant association of HIF-1α expression. Conclusion. There was no statistically significant association between HIF-1α expression and the clinical stage or histological differentiation of LSCC

Risk factors of sensory hearing loss in nasopharyngeal carcinoma patients obtaining conventional radiotherapy

Previous studies proven that cochlear hair cells’ death plays an important role in sensorineural hearing loss due to radiation exposure. Other studies compared the differences between the impact of conventional radiotherapy (CRT) and intensity modulated radiation therapy (IMRT) on hearing loss in patients with nasopharyngeal carcinoma. Although, few differences found in some clinical manifestation, however no statistical analysis had been carried out. The aim of study was to evaluate the risk of sensory hearing loss in nasopharyngeal carcinoma patients who received CRT compared to IMRT.  A case control study was performed on nasopharyngeal carcinoma patients who received radiotherapy at Dr. Sardjito General Hospital, Yogyakarta. The result of DPOAE between NPC patients who received CRT and IMRT was compared in this study. Statistical analysis was performed using chi square test and multivariate analysis. The result showed that patients who received CRT significantly altered the risk for sensory hearing loss in the contralateral ear as much as 11.2 times according to the multivariate analysis (CI 95%: 2.2 – 56.6; p=0.004). In conclusion, the risk of sensory hearing loss in patients with nasopharyngeal carcinoma who received CRT is a greater compared to IMRT

Sinonasal or nasopharyngeal undifferentiated Carcinoma?: diagnostic pitfall and the role of Epstein-Barrvirus (EBV) and human papillomavirus(HPV) examination

Undifferentiated carcinoma of the head and neck is frequently observed in nasopharynx, however it may also occur in oropharynx, salivary gland and sinonasal. Overlapping lesions in those regionscreate difficulty in determining the origin of the tumor. Thus, it causes diagnostic pitfall not only for pathologists, but also for clinicians. A 40 yearold man, presented with nasal obstruction, epistaxis, diplopia, and headache for a yearand showed nasal cavitysinistra and nasopharynx masses on CT-scan. Lymph node enlargement was not detected. First biopsywas performed and histopathologically diagnosed as nasopharyngeal undifferentiated carcinoma(NPC), extended into nasal cavity. Chemo-radiation protocol for NPC was conducted, and showing uncomplete response. Second biopsy was done, and reviewed with the first biopsy result. Thetumourwas arranged insolid, syncytial and trabecular pattern, with vesicular nuclei, prominent nucleoli, and lack of lymphoplasmacytic infiltrat. Immunohistochemistry (IHC) analysis of p16, EBNA1 and LMP1 were negative. PCR analysis of HPV-18 was positive, while EBV detection showed negative result. General association of EBV with NPC suggests that the presence of latent EBV infection can serve as a positive marker for NPC. Therefore, in this case, the EBV negativity and strong HPV association led to diagnosis of SNUC. The distinction of sinonasal undifferentiated carcinoma (SNUC) or from NPC was important for appropriate management and therapy

The Primary Tumor and Regional Lymph Node Clinical Status of Distant Metastasis in Nasopharyngeal Carcinoma

Background: Nasopharyngeal carcinoma (NPC) is a squamous cell carcinoma derived from nasopharyngeal epithelium. NPC characteristic is highly invasive and can metastasize rapidly. The presence of distant metastasis is a major factor in determining the patient’s management and prognosis. The magnitude of radiologic and molecular costs encouraging the need to know the clinical variables associated with distant metastasis of NPC. Methods: Cross-sectional analytical retrospective studies of undifferentiated NPC (WHO type III) patients at initial diagnosis in the ORL-HNS Department of Dr. Sardjito Hospital Yogyakarta from January 2014 to December 2016. Results: At 276 NPC patients with the ratio of 197 men (71.4%) and 79 women (28.6%) was 2.5:1, mean age 48.5 years, distant metastasis was found in 37 patients (13.4%). There was no significant difference in the frequency of sex (p = 0.346), age (p = 0.784), and primary tumor clinical status (p = 0.297) between NPC with distant metastasis and without distant metastasis. There was significant difference in the frequency of regional lymph node clinical status between NPC with distant metastasis and without distant metastasis (p = 0.004; PR = 3.866). Conclusions: There is no statistically significant difference of primary tumor clinical status between NPC with and without distant metastasis. There is statistically significant difference of lymph node clinical status between NPC with and without distant metastasis

Effect of tonsillectomy with or without adenoidectomy on formant sound frequency

ABSTRACT Vocal tract resonance characteristics are reflected by formant frequencies which determined by the size and shape of the vocal tract. Tonsillectomy may cause changes in the structure of the oral cavity as a resonator in the speech process. The aim of this study is to determine the effect of tonsillectomy on formant sound frequency. This study used a pre-test and post-test only design experimental. The study underwent in the Otorhinolaryngology Department between August up to November 2012. Inclusion criteria were: 1) chronic tonsillitis, 2) tonsil size was T3-T4, 3) age up to 5 years. The exclusion criteria were craniofacial abnormality and neurological disorders. All patients performed a sound analysis by recording vowel / a /, / e /, / i /, / o /, and / u / in 1 day before and 4 weeks after surgery. The sample consisted of 24 (60%) women and 16 (40%) men. The T3-T3 tonsil size were 25 (62.5%) samples and the lowest than T3-T4/T4-T3 were 6 (15%) samples. Based on paired T test there was a statistically significant increase of all F1 vowels (p 0,05) and decrease of F2 / e / and F3 / u / (p >0,05). Based on these results it can be concluded that tonsillectomy affects the F1 mean difference almost in all vowel except the vowels / i /, F2 & F3

ANGKA KETAHANAN HIDUP 3 TAHUN PASIEN KARSINOMA NASOFARINGS YANG MENDAPAT CONCURRENT CHEMORADIOTHERAPY DI BAGIAN TELINGA HIDUNG TENGGOROK RSUP DR. SARDJITO PADA TAHUN 2008-2010

Background: Nasopharyngeal carcinoma (NPC) is an epithelial malignancy on posterior nasal cavity. NPC is the most common malignancy in Ear Nose Throat � Head Neck Department of RSUP. Dr. Sardjito. On its early stage, NPC can be treated with radiotherapy alone. But on the more advance stage, chemotherapy is needed. Previous studies show that concurrent chemoradiotherapy (CCRT) gives better patient�s survival rate. Determining survival rate is something that�s have to be done because it can be a determinant of disease�s prognostic. Objective: To determine the 3-years survival rate of patients with NPC that acquired concurrent chemoradiotherapy in Ear Nose Throat Department of RSUP Dr. Sardjito in 2008-2010. Method: A descriptive-analytical study using Kaplan- Meier survival analysis to determine the 3-years survival rate of NPC patients who undergo CCRT. Samples are obtained from January 2008 to December 2010, where 20 NPC patients met the inclusion and exclusion criteria. Result: The 3-years survival rate of NPC patients who acquired concurrent chemoradiotherapy in Ear Nose Throat Department of RSUP. Dr. Sardjito in 2008-2010 is 50% with mean survival time of 22,8 months altogether

ANGKA KETAHANAN HIDUP 3 TAHUN PASIEN KARSINOMA NASOFARINGS YANG MENDAPAT NONCONCURRENT CHEMOTHERAPY DI BAGIAN TELINGA HIDUNG TENGGOROK � KEPALA LEHER RSUP DR. SARDJITO PADA TAHUN 2008-2010

Background: Nasopharyngeal carcinoma (NPC) is one of those cancers whose incidence and mortality rate are still high in Indonesia. The standard therapy for NPC is a chemotherapy that is given concurrently with radiotherapy (concurrent chemoradiotherapy). However, not all patients receive concurrent chemoradiotherapy because of other factors such as its availability and patient's type of insurance. These patients will undergo a different type of therapy, an adjuvant chemotherapy or a neoadjuvant chemotherapy or other, which are not the standard therapy. Objective: To determine the 3-years survival rate of patients with NPC that acquired any therapy other than CCRT in RSUP Dr. Sardjito, Yogyakarta. Method: A descriptive-analytical study using Kaplan-Meier survival analysis to the 3-years survival of NPC patients who did not undergo CCRT. Samples are obtained from January 2008 to December 2010, where 64 NPC patients met the inclusion and exclusion criteria. Result: The 3-years survival rate of NPC patients who acquired any other therapy than CCRT is 32,8% with a mean survival of 21 months altogether