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

Sinta Sari Ratunanda, Jipie Iman Satriyo, Dindy Samiadi, Teti Madiadipoera, Ratna Anggraeni

Abstract


Hipertrofi adenoid merupakan proses perubahan ukuran adenoid yang membesar, merupakan penyebab utama hidung tersumbat. Hipertrofi adenoid dapat terjadi karena proses yang fisiologis, akibat inflamasi, atau suatu keganasan. Proses inflamasi adenoid dapat dinilai menggunakan nasoendoskopi serat lentur dengan pencahayaan narrow band imaging (NBI). Kortikosteroid intranasal menjadi pilihan terapi medikamentosa pada penatalaksanaan hipertrofi adenoid pada anak, namun belum banyak diteliti penggunaannya pada hipertrofi adenoid usia dewasa. Tujuan penelitian ini menilai efektivitas terapi kortikosteroid intranasal untuk mengurangi ukuran adenoid dewasa berdasarkan pemeriksaan NBI. Penelitian dimulai bulan November 2012–Januari 2013 di poliklinik Telinga Hidung Tenggorok-Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin (THT-KL RSHS) Bandung dengan metode kuasieksperimental open labeled pre and posttest design. Pemilihan sampel berdasarkan urutan kedatangan, ditentukan 11 subjek penelitian. Penegakan diagnosis pada subjek penelitian berdasarkan anamnesis, pemeriksaan fisis THT, pemeriksaan nasoendoskopi serat lentur dilengkapi dengan NBI, dan dilakukan biopsi mukosa adenoid. Subjek penelitian diberikan terapi kortikosteroid intranasal selama empat minggu, kemudian dilakukan evaluasi ulang pemeriksaan NBI dan biopsi. Data dianalisis dengan uji Wilcoxon, hasilnya didapatkan perbaikan nilai derajat inflamasi adenoid secara signifikan pascaterapi kortikosteroid intranasal (p<0,05). Uji McNemar didapatkan hasil signifikan untuk penurunan ukuran adenoid (p<0,05). Uji rank Spearman untuk menganalisis hubungan gambaran histopatologi dengan penilaian NBI pra dan pascaterapi, hasilnya didapatkan korelasi bermakna (p<0,05). Simpulan, kortikosteroid intranasal efektif diberikan pada inflamasi penyebab hipertrofi adenoid usia dewasa berdasarkan pemeriksaan NBI. [MKB. 2016;48(4):228–33]

Kata kunci: Hipertrofi adenoid, kortikosteroid intranasal, narrow band imaging


Effectiveness of Intranasal Corticosteroids Treatment on Adult Adenoid Hypertrophy based on Narrow Band Imaging Examination

Abstract

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]

Key words: Adenoid hypertrophy, intranasal corticosteroids, narrow band imaging


Keywords


Hipertrofi adenoid, kortikosteroid intranasal, narrow band imaging

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DOI: http://dx.doi.org/10.15395/mkb.v48n4.914

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