Jurnal Otorinolaringologi Kepala dan Leher Indonesia

Metode Penilaian Transport Mukosiliar Dan Patensi Nasal: Tinjauan Fisiologis

Daniel Pradana Andrian Wicaksono, Arin Dwi Iswarini — Fri, 26 Jun 2026 00:00:00 +0000

Methods for Assessing Mucociliary Transport and Nasal Patency: A Physiological Review

Background: Mucociliary transport and nasal patency are essential physiological components in maintaining respiratory function and upper airway defense mechanisms. Impairment of these systems may reduce mucosal clearance efficiency, increase airflow resistance, and contribute to inflammatory and infectious conditions of the nasal cavity and paranasal sinuses. Accurate evaluation of mucociliary function and nasal patency is therefore important in both clinical practice and rhinology research. Objective: This literature review aims to discuss various methods for assessing mucociliary transport and nasal patency based on their underlying physiological principles. Literature Review: Mucociliary transport can be assessed using subjective methods such as the saccharin test and objective methods including digital high-speed videomicroscopy and scintigraphy radioisotope clearance test. Nasal patency may be evaluated using subjective approaches such as the Visual Analog Scale (VAS) and Nasal Obstruction Symptom Evaluation (NOSE), as well as objective techniques including Peak Nasal Inspiratory Flow (PNIF), rhinomanometry, and acoustic rhinometry. Each method has distinct principles, advantages, and limitations in representing structural and functional aspects of nasal physiology. Conclusion: Understanding the physiological basis and characteristics of each assessment method is essential to improve clinical interpretation and to guide the appropriate selection of evaluation techniques in rhinology practice and research.

Peran Probiotik dalam Modulasi Respons Imun pada Rinitis Alergi: Tinjauan Literatur

Fri, 26 Jun 2026 00:00:00 +0000

The Role of Probiotics in Modulating Immune Response in Allergic Rhinitis: A Literature Review

Background: Allergic rhinitis is an inflammation of the nasal mucosa that occurs as a result of a hypersensitivity reaction mediated by immunoglobulin E (IgE) following exposure to allergens. This condition is commonly characterized by symptoms such as recurrent sneezing, rhinorrhea, nasal congestion, and nasal itching. The pathogenesis of allergic rhinitis involves complex immune responses, including mast cell activation, eosinophil infiltration, and the release of various inflammatory mediators. The complexity of these mechanisms has led to the development of therapeutic approaches that focus not only on symptom control but also on the modulation of immune responses, one of which involves the use of probiotics. Objective: To identify and understand the role of probiotics in modulating the immune response in allergic rhinitis. Literature Review: Probiotics have the potential to be used as an adjuvant therapy in allergic rhinitis due to their ability to modulate immune responses involved in the pathogenesis of the disease. Several probiotic strains, particularly from the genera Lactobacillus and Bifidobacterium, have been shown to regulate the Th1/Th2 balance, reduce the production of allergen-specific IgE, and enhance the activity of regulatory T cells that help suppress allergic inflammatory reactions. In addition, probiotic metabolites such as short-chain fatty acids (SCFAs) can inhibit inflammatory pathways and promote the production of anti-inflammatory cytokines. Findings from several clinical studies indicate that probiotic administration may help improve symptoms and quality of life in patients with allergic rhinitis, suggesting their potential use as an adjunct to conventional therapy. Conclusion: Probiotics have the potential to serve as a promising adjuvant therapy for allergic rhinitis through their immunomodulatory effects. However, their clinical effectiveness still depends on the specific strain, dosage, and duration of administration; therefore, further research is required to establish optimal therapeutic standards.

Diagnosis dan Tatalaksana pada Neuritis Vestibular

Clarissa Fiolly Refieska, Rossy Rosalinda — Fri, 26 Jun 2026 00:00:00 +0000

Diagnosis and Management of Vestibular Neuritis

Background: Vestibular neuritis is one of the most common peripheral vestibular disorders, characterized by the sudden loss of unilateral vestibular function, resulting in acute vertigo without associated cochlear or neurological symptoms. Objective: To know and understand the diagnosis and management of vestibular neuritis. Literature Review: The exact etiology of neuritis vestibular remains unclear, but three main mechanisms are thought to play a role viral infection of the vestibular nerve, ischemia of the anterior vestibular artery, and immunological mechanisms. The clinical findings of neuritis vestibular include sudden-onset severe spinning vertigo lasting more than 24 hours, often accompanied by nausea and vomiting, typically occurring in middle-aged individuals, without cochlear symptoms or other neurological manifestations. Accurate diagnosis of neuritis vestibular requires supportive examinations such as the head impulse test (HIT), caloric test, and vestibular-evoked myogenic potential (VEMP) Treatment for vestibular neuritis includes symptomatic therapy, specific pharmacological therapy, and vestibular rehabilitation, which have been studied and applied to reduce symptoms, accelerate vestibular compensation, and improve patients’ quality of life. Conclusion: Vestibular neuritis, also known as vestibular neuronitis, is a distinctive form of peripheral vertigo and a major cause of acute vestibular dysfunction. Its etiology remains uncertain but is thought to involve viral infection, ischemia, and immunological mechanisms. Clinically, the main symptom is severe spinning vertigo lasting more than 24 hours, often accompanied by nausea and vomiting in middle-aged patients. Diagnosis is established through physical examination and ancillary tests. Treatment consists of specific pharmacological therapy and vestibular rehabilitation.

Diagnosis dan Pilihan Tatalaksana pada Akalasia

Fajar Dirgantara Edward, Ade Asyari — Fri, 26 Jun 2026 00:00:00 +0000

Diagnosis and Management Options for Achalasia

Background: Achalasia is a rare esophageal motility disorder characterized by increased lower esophageal sphincter tone and loss of esophageal peristalsis. The main symptoms include difficulty swallowing, vomiting, chest pain, weight loss, heartburn, and respiratory complications due to regurgitation. Objective: To know and understand the diagnosis and management options for achalasia. Literature Review: All treatment methods aim to reduce outflow resistance and improve dysphagia. It is widely recognized that medical management without endoscopic or surgical intervention plays a minor role in the treatment of achalasia. Standard endoscopic methods include pneumatic dilation, botulinum toxin injection, and, more recently, the increasing availability and acceptance of peroral endoscopic myotomy. Time-tested surgical therapies include Heller myotomy with or without anti-reflux procedures, as well as esophagectomy for advanced-stage achalasia or failure of other surgical methods. Conclusion: Achalasia is a chronic and progressive esophageal motility disorder characterized by failure of lower esophageal sphincter relaxation and loss of esophageal peristalsis. Available management methods include pharmacological and non-pharmacological therapy or surgery, with each intervention selected based on indications and carrying its own side effects and complications.

Diagnosis dan Tatalaksana Superior Canal Dehiscence Syndrome

Rio Mulya Riharta, Rossy Rosalinda, Muhammad Dilga Caesario — Fri, 26 Jun 2026 00:00:00 +0000

Diagnosis and Management of Superior Canal Dehiscence Syndrome

Background: Superior Canal Dehiscence Syndrome (SCDS) is a vestibulocochlear disorder caused by a bony defect in the superior semicircular canal, creating a pathological third window in the labyrinth. This condition produces a variety of vestibular and auditory manifestations that significantly impair quality of life. Objective: To know and understand the diagnosis and management of superior canal dehiscence syndrome. Literature Review: The etiology of SCDS may be congenital or acquired. The primary pathophysiology relates to the third window mechanism that disrupts acoustic energy transmission and generates abnormal pressure pathways within the labyrinth. Characteristic vestibular symptoms include the Tullio phenomenon, Hennebert sign, oscillopsia, and disequilibrium, while cochlear symptoms encompass autophony, bone-conduction hyperacusis, pulsatile tinnitus, and low-frequency conductive hearing loss. Diagnosis is established based on the Barany Society triadic criteria: clinical symptoms, neurophysiological testing (VEMP, audiometry), and High-Resolution Computed Tomography (HRCT) imaging with multiplanar reconstruction. Conservative management is indicated for mild cases, while surgical treatment, via the middle cranial fossa (MCF) or transmastoid (TM) approach, is recommended for patients with severe, debilitating symptoms. Conclusion: Superior canal dehiscence syndrome (SCDS) is a third mobile window disorder caused by a bony defect of the superior semicircular canal, resulting in vestibular and auditory symptoms. Diagnosis is established through an integrative approach based on the Bárány Society criteria, incorporating clinical correlation, VEMP and/or audiometry, and high-resolution CT imaging. Management is stepwise, with surgical intervention (plugging or resurfacing) serving as the definitive treatment in severely symptomatic cases to eliminate the pathological pathway and improve clinical outcomes.

Diagnosis dan Tatalaksana Autoimmune Inner Ear Disease

Muhammad Arifudin, Rossy Rosalinda — Fri, 26 Jun 2026 00:00:00 +0000

Diagnosis and Management of Autoimmune Inner Ear Disease

Background: Autoimmune Inner Ear Disease is an autoimmune disease of sensorineural hearing loss, with an incidence of less than 1% worldwide. Symptoms of Autoimmune Inner Ear Disease often resemble the symptoms of other types of sensorineural hearing loss, making the diagnosis difficult. Objective: To understand all aspects of Autoimmune Inner Ear Disease. Literature Review: Autoimmune Inner Ear Disease is a rare autoimmune disease characterized by progressive and fluctuating sensorineural hearing loss. Autoimmune Inner Ear Disease is more common in women, aged between 20 and 50 years. Autoimmune Inner Ear Disease can be primary or secondary. The mechanism of Autoimmune Inner Ear Disease can be damage mediated by autoantibodies, immune complex deposition, T-cell inflammation. Typical symptoms and signs include bilateral sensorineural hearing loss, tinnitus, sometimes vestibular disorders and response to corticosteroid treatment. Complete blood count, erythrocyte sedimentation rate, antinuclear antibodies, and other immunological profiles can confirm the diagnosis. Magnetic resonance imaging was performed to rule out retrocochlear pathology and demyelination. High-dose corticosteroids are the first-line treatment. Conclusion: Autoimmune Inner Ear Disease is an autoimmune disease characterized by progressive sensorineural hearing loss, which may be accompanied by tinnitus and vestibular disorders. Corticosteroids are the first-line treatment.

Gambaran Perluasan Tumor Primer Karsinoma Glotis T3-T4 di RSUP Dr. M. Djamil Padang

Aisyah Suci Ayudya, Sukri Rahman, Hasmiwati Hasmiwati — Fri, 26 Jun 2026 00:00:00 +0000

Primary Tumor Extension Profiles of T3-T4 Glottic Carcinoma at RSUP Dr. M. Djamil Padang

Background: Laryngeal carcinoma is a malignant tumor arising from the laryngeal epithelium, and most cases originate from the glottis (60–75%). In Indonesia, laryngeal carcinoma ranks 17th, with approximately 4,000 cases and a mortality rate of 1%. Symptoms of glottic carcinoma are commonly nonspecific, such as hoarseness, and are therefore often overlooked, leading many patients to present at an advanced stage. Treatment selection and prognosis are influenced by the extent of tumor spread to surrounding tissues. Computed tomography (CT) is used to detect invasion and to assist in staging. This study aimed to describe the pattern of primary tumor extension in T3-T4 stage glottic carcinoma at Dr. M. Djamil General Hospital, Padang. Methods: This quantitative study used a descriptive design with a retrospective approach based on medical records. A total of 19 patients with T3-T4 stage glottic carcinoma at Dr. M. Djamil General Hospital, Padang, were included. Data were analyzed using univariate analysis and presented as frequencies and percentages. Results: The most common T stage was T4 (68.4%). In T3 disease, the most frequent extension was invasion of the inner cortex of the thyroid cartilage (71.4%). In T4 disease, the most frequent extension was invasion of the outer cortex of the thyroid cartilage (42.3%). Conclusion: Most advanced-stage glottic carcinomas were T4; the most frequent extension pattern in T3 was invasion of the inner cortex of the thyroid cartilage, whereas in T4 it was invasion of the outer cortex of the thyroid cartilage.

Faktor-Faktor Risiko Non Viral pada Karsinoma Nasofaring di RSUP Dr. M. Djamil Padang

Khansa Nihlatiyah Izzati, Sukri Rahman, Fathiya Juwita Hanum — Fri, 26 Jun 2026 00:00:00 +0000

Profile of Non-Viral Risk Factors in Nasopharyngeal Carcinoma at RSUP Dr. M. Djamil Padang

Background: Nasopharyngeal carcinoma is a malignancy originating from the nasopharyngeal epithelium and is one of the rarest cases of malignancy in the world. There are several non-viral factors that influence nasopharyngeal carcinoma. The purpose of this study was to determine the frequency distribution of non-viral risk factors for nasopharyngeal carcinoma, namely age, gender, occupation, family history, smoking, alcohol consumption, consumption of salted fish, and exposure to wood smoke and wood dust. Methods: This study is a descriptive study with a case-control design, with nasopharyngeal carcinoma patients as cases and patients with diagnoses other than nasopharyngeal carcinoma as controls. The sample size for this study was 20 for each case and control sample, analyzed using cross-tabulation tests. Results: The nasopharyngeal carcinoma patient showed that the majority of patients were aged between 46 and 55 years old and were predominantly male. The most common occupation was in the service and sales sector. Most patients had no family history of nasopharyngeal carcinoma. The majority of patients were non smokers, had never consumed alcohol, and rarely consumed salted fish. The most common patients were those who had never been exposed to wood smoke and wood dust. Conclusion: Non-viral risk factors associated with nasopharyngeal carcinoma were age 46–55 years, male sex, and employment in trade and sales services.

Gambaran Kualitas Hidup Pasien Karsinoma Nasofaring di Departemen THT-BKL RSUP Dr. M. Djamil Padang

Iffah Nisrina Reyatri, Sukri Rahman, Lili Irawati — Fri, 26 Jun 2026 00:00:00 +0000

Quality of Life Profile of NPC Patients at ENT-HNS Department of RSUP Dr. M. Djamil Padang

Background: Nasopharyngeal carcinoma (NPC) and its treatment modalities, such as chemotherapy and radiotherapy, can impact various aspects of life, thereby affecting the patient's quality of life (QoL). This study aims to determine the QoL profile of NPC patients at the ENT-HNS Department of Dr. M. Djamil General Hospital, Padang. Methods: The study design used a quantitative descriptive approach. Primary data collection was conducted subjectively using questionnaires from the European Organization for Research and Treatment of Cancer (EORTC): the general QoL instrument (QLQ-C30) and the head and neck cancer-specific module (QLQH&N43), administered through interviews with NPC patients. Results: The majority of patients were male (67.4%), aged 25–64 years (89.1%), and at an advanced stage (80.4%). The majority had undergone or were undergoing concurrent chemoradiotherapy (43.5%). The worst QoL scores from the QLQ-C30 questionnaire were observed advanced-stage patients (QoL 63.96±16.44; functional 62.86±22.98; symptom 41.07±25.64) and patients before therapy (QoL 59.37±17.50; functional 58.29±62.85; symptoms 51.47±18.61). The worst QoL scores from the QLQ-H&N43 questionnaire were found in advanced-stage patients (multi-item 37.06±20.35; single item 36.42±24.18) and patients who had undergone and/or were undergoing concurrent chemoradiotherapy (multi-item 41.80±16.60; single item 39.76±22.08). Conclusion: Disease stage and treatment status significantly influencing QoL in NPC patients. General QoL was lower among advanced-stage and patients before therapy, whereas head and neck-specific complaints were more severe in advancedstage patients and those who had completed or were undergoing therapy.

Timpanomastoidektomi Canal Wall Down dan Dekompresi Nervus Fasialis Pada Pasien dengan Parese Nervus Fasialis Akibat Otitis Media Supuratif Kronis Tipe Kolesteatoma

Leon Gaya, Jacky Munilson — Fri, 26 Jun 2026 00:00:00 +0000

Canal Wall Down Tympanomastoidectomy and Facial Nerve Decompression in Patients with Facial Nerve Palsy Caused By Cholesteatoma-Type Chronic Suppurative Otitis Media

Background: Facial nerve palsy is a neurological complication that can occur in patients with chronic suppurative otitis media (CSOM) of the cholesteatoma type. Cholesteatoma can damage the facial nerve through mechanisms such as compression, erosion of the facial nerve canal, and chronic inflammation. Management of peripheral facial nerve palsy caused by cholesteatoma-type CSOM can be effectively achieved through surgical intervention. Case Report: A 36-year-old male presented with a 10-year history of discharge from the right ear, who developed right-sided facial paralysis classified as House-Brackmann grade V, with a lesion level at the geniculate ganglion due to cholesteatoma-type CSOM. The patient underwent Canal Wall Down (CWD) tympanomastoidectomy, including cholesteatoma excision, facial nerve decompression, underlay graft placement, and reconstruction of the ear canal wall. Conclusion: Facial nerve palsy is a complication of cholesteatoma-type chronic suppurative otitis media (CSOM), which can be caused by direct or indirect compression of the facial nerve. Surgical intervention with Canal Wall Down (CWD) tympanomastoidectomy, including complete cholesteatoma excision and indirect facial nerve decompression, provides a good recovery of nerve function.