Hubungan Gambaran Histopatologi Dan Derajat Konka Hipertrofi Dengan Sumbatan Hidung Pada Rinosinustis Kronik
DOI:
https://doi.org/10.36408/mhjcm.v7i2.516Keywords:
Rinosinusitis kronik, sumbatan hidung, konka hipertrofiAbstract
Latar belakang : Hidung tersumbat dapat disebabkan karena kelainan struktur hidung seperti deviasi septum, atresia koana, konka hipertrofi, celah palatum, hipertrofi adenoid, dan neoplasma. Dua puluh persen populasi dengan hidung tersumbat disebabkan konka hipertrofi. Konka hipertrofi merupakan pembesaran konka akibat bertambahnya ukuran sel konka, yang disebabkan hiperplasia dan hipertrofi lapisan mukosa dan tulang konka. Gambaran hipertrofi dan hiperplasi dapat dilihat melalui pemeriksaan histopatologi. Tujuan penelitian ini untuk mengetahui hubungan gambaran histopatologi dan derajat konka hipertrofi dengan sumbatan hidung pada pasien rinosinusitis kronik (RSK).
Metode : Desain penelitian korelasi dengan metode belah lintang pada pasien RSK dengan konka hipertrofi yang menjalani operasi Bedah Sinus Endoskopik Fungsional (BSEF) dan konkotomi. Derajat konka hipertrofi dinilai berdasarkan nasoendoskopi, sedangkan sumbatan hidung menggunakan kuesioner Nasal Obstruction Symptom Evaluation (NOSE). Uji hipotesis yang digunakan adalah uji korelasi Spearman.
Hasil : Karakteristik subyek penelitian sebanyak 33 orang, perempuan 60% lebih banyak daripada laki-laki 40%. Derajat sumbatan hidung ringan (30%), sedang (27%), berat (30%) dan sangat berat (13%). Konka hipertrofi terbanyak yaitu derajat 3 (54,5%). Hasil analisis dengan uji korelasi Spearman menunjukkan terdapat korelasi positif dengan nilai korelasi sedang antara derajat konka hipertrofi dengan derajat sumbatan hidung (p=0.02 dan rho = 0.404. Tidak terdapat hubungan yang bermakna antara derajat sumbatan hidung dengan gambaran histopatologi konka inferior (hiperplasia sel goblet, pembentukan kelenjar submukosa, eosinofil, limfosit, neutrofil).
Simpulan : Derajat konka hipertrofi berpengaruh terhadap sumbatan hidung. Gambaran histopatologi konka hipertrofi tidak berpengaruh terhadap derajat sumbatan hidung pada pasien RSK.
Kata kunci : Rinosinusitis kronik, sumbatan hidung, konka hipertrofi
Background: Nasal congestion can be caused by abnormalities of nasal structures such as deviation of the septum, choanal atresia, turbinate hypertrophy, cleft palate, adenoid hypertrophy, and neoplasms. Twenty percent of the population with nasal congestion is due to turbinate hypertrophy. Turbinate hypertrophy is an enlargement of turbinate due to an increase in the size of turbinate cells, which is caused by hyperplasia and hypertrophy of the mucosal layers and turbinate bones. Description of hypertrophy and hyperplasia can be seen through histopathological examination. The purpose of this study was to determine the relationship between histopathological features and the degree of turbinate hypertrophy with nasal obstruction in patients with chronic rhinosinusitis (CRS).
Methode: The correlative study design with a cross-sectional method in CSR patients with turbinate hypertrophy who underwent Functional Endoscopic Sinus Surgery (FESS) and turbinectomy. The degree of turbinate hypertrophy was assessed based on nasoendoscopy, whereas nasal obstruction used the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. The hypothesis test used is the Spearman correlation test.
Result: The characteristics of the study subjects were 33 people, more women (60%) than men (40%). The degree of nasal obstruction is mild (30%), moderate (27%), severe (30%) and very severe (13%). Turbinate hypertrophy grade 3 was the most (54,5%). The analyzed using Spearman correlative test showed a positive correlation with a moderate correlation between the degree of turbinate hypertrophy with the degree of nasal obstruction (p=0.02 dan rho = 0.404). There was no significant relationship between the degree of nasal obstruction with histopathological features of the inferior turbinate (goblet cell hyperplasia, the formation of submucosal glands, eosinophils, lymphocytes, and neutrophils).
Conclusion: The degree of turbinate hypertrophy affects nasal obstruction. Histopathological features of turbinate hypertrophy do not affect the degree of nasal obstruction in CSR patients.
Keyword: Chronic rhinosinusitis, nasal obstruction, turbinate hypertrophy
Downloads
References
2. Ponikau J, Sherris D, Kephart G. Features of airway Remodeling and eosinophilic inflammation in chronic rhinosinusitis: is the histopathology similar to asthma? J Allergy Clin Immunol. 2003;112: p.877- 82.
3. Farmer SEJ, Eccles R. Chronic inferior turbinate enlargement and implications for surgical intervention. Rhinology 2006; 44: p.234-8
4. Mrig S, Agaward AK, Passey JC. Preoperative computed tomographic evaluation of inferior nasal concha hypertrophy and its role in deciding surgical treatment modality in patients with deviated nasal septum. Int J Morphol 2009; 27(2): p.503-6
5. Sapci T et al. Evaluation of radifrequency thermal ablation results in inferior turbinate hypertrophies. Laryngoscope; 117: p.623-7
6. Camacho M, Zaghi S, Certal V, Abdullatif J, Means C, Acevedo J, et al. Inferior turbinate classification system, grades 1 to 4: Development and validation study. Laryngoscope. 2015; 125: p.296–302.
7. Naclerio R, Bachert C, Baraniuk JN. Pathophysiology of nasal congestion. Int J Gen Med. 2010;3: p.47.
8. Van Spronsen E, Ingels KJ O, Jansen H, Graamans K, Fokkens WJ. Evidence-based recommendations regarding the differential diagnosis and assessment of nasal congestion: Using the new grade system. Allergy Eur J Allergy Clin Immunol. 2008;63(7): p.820–33.
9. Proimos EK, Kiagiadaki DE, Chimona TS, Seferlis FG, Maroudias NJ, Papadakis CE. Comparison of acoustic rhinometry and nasal inspiratory peak flow as objective tools for nasal obstruction assessment in patients with chronic rhinosinusitis. Rhinology. 2015;53(1). p.66-74.
10. Hsu DW, Suh JD. Anatomy and Physiology of Nasal Obstruction. Otolaryngol Clin N Am. 2018. p.2-18
11. Berger G, Gass S, Ophir D. The Histopathology of the hypertrophic inferior turbinate. Arch Otolaryngol Head Neck Surg. 2006;132: p.588-594.
Additional Files
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2020 Medica Hospitalia : Journal of Clinical Medicine
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyrights Notice
Copyrights:
Researchers publishing manuscrips at Medica Hospitalis: Journal of Clinical Medicine agree with regulations as follow:
Copyrights of each article belong to researchers, and it is likewise the patent rights
Researchers admit that Medica Hospitalia: Journal of Clinical Medicine has the right of first publication
Researchers may submit manuscripts separately, manage non exclusive distribution of published manuscripts into other versions (such as: being sent to researchers’ institutional repository, publication in the books, etc), admitting that manuscripts have been firstly published at Medica Hospitalia: Journal of Clinical Medicine
License:
Medica Hospitalia: Journal of Clinical Medicine is disseminated based on provisions of Creative Common Attribution-Share Alike 4.0 Internasional It allows individuals to duplicate and disseminate manuscripts in any formats, to alter, compose and make derivatives of manuscripts for any purpose. You are not allowed to use manuscripts for commercial purposes. You should properly acknowledge, reference links, and state that alterations have been made. You can do so in proper ways, but it does not hint that the licensors support you or your usage.