Pengaruh Radioterapi Eksternal Terhadap Fungsi Sel Rambut Luar Koklea Penderita Karsinoma Nasofaring

Abstract

Pilihan utama pengobatan karsinoma nasofaring adalah radioterapi. Pemberian radioterapi dosis tinggi menimbulkan kerusakan struktur jaringan, salah satunya adalah gangguan pendengaran. Gangguan di koklea timbul akibat kerusakan struktur sel rambut akibat degenerasi stria vaskularis, atrofi spiral ligamen, dan membran basilaris. Tujuan penelitian adalah untuk mengetahui fungsi sel rambut luar koklea akibat radioterapi penderita karsinoma nasofaring. Tipe penelitian adalah studi analitik observasional dan dilakukan di Bagian IK.THT-KL/RS. Hasan Sadikin Bandung mulai Maret sampai September 2007. Dilakukan pemeriksaan audiometri, timpanometri, dan emisi otoakustik (otoacoustic emission)/OAE sebelum radioterapi, serta pemeriksaan timpanometri serta OAE saat radioterapi dan satu bulan pascaradioterapi. Untuk menguji pengaruh radioterapi eksternal digunakan uji McNemar dan uji Z. Diperoleh 42 telinga dari 27 subjek penelitian yang memenuhi kriteria inklusi. Didapat 18 lakilaki dan 9 perempuan. Hasil penelitian menunjukkan insidens gangguan fungsi sel rambut luar koklea sebesar 9,6% pada dosis 2.000 cGy, 61,5% pada 4.000 cGy, 81,1% pada 6.600 cGy, dan 82,8% satu bulan pascaradiasi. Hubungan gangguan fungsi sel rambut luar koklea memberikan nilai sangat bermakna pada dosis 4.000 cGy sampai 6.600 cGy (p<0,001). Kesimpulan penelitian radioterapi eksternal penderita karsinoma nasofaring menyebabkan gangguan fungsi sel rambut luar koklea.

Effect of External Radiotherapy to Cochlear Outer Hair Cells Function on Nasopharyngeal Carcinoma Patients

Radiotherapy is the main treatment of nasopharyngeal carcinoma. Exposure to high dose radiotherapy can cause damage to the surrounding tissue structure and hearing loss is one of it. Depraved cochlea is occur due to damaged outer hair cells (OHC) because of degeneration of striae vascularis, spiral ligament, and bacillar membrane atrophy. The purpose of this study was to understand the OHC's function due to radiotherapy in nasopharyngeal carcinoma patients. The type of study was observational analytic study with prospective design to determine the influence of radiotherapy to the function of OHC in the department of ENT-HNS Hasan Sadikin General Hospital Bandung and performed from March to September 2007. Pure tone audiometry examination, tympanometry, and otoacoustic emission (OAE) was performed before radiotherapy. Tympanometry and OAE was measured when radiotherapy performed and one month after radiotherapy. McNemar and Z test was performed to calculate the effects of radiotherapy to OHC. In this study 42 ears from 27 subjects that meet the inclusion criteria 18 men and 9 women. The result of this study showed that the prevalence of damaged OHC were 9.6% at 2,000 cGy, 61.5% at 4,000 cGy,81.1% at 6,600 cGy, and 82.8% after one month of radiotherapy. Damaged OHC's function was significance at dose radiation exposure from 4,000 to 6,600 cGy (p<0.001). The conclusion of this study is radiotherapy can alter OHC's function in patients with nasopharyngeal carcinoma.

DOI: http://dx.doi.org/10.15395/mkb.v42n2.12