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Tamin S, Shabrina F, Hutauruk SM, Rachmawati EZK, Fardizza F, Koento T, Prihartono J. Tracheostomy decannulation readiness: A cross sectional study comparing standardised evaluation for tacheostomy decannulation to flexible endoscopic evaluation of swallowing examination. Med J Malaysia 2024; 79:119-123. [PMID: 38553913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Tracheostomy is a procedure commonly performed in neurocritical and mechanically ventilated patients in the intensive care unit. Dysphagia and impaired airway protection are the main causes for a delay in tracheostomy decannulation in patients with neurological disorders. Endoscopic evaluation is an objective examination of readiness for tracheostomy decannulation with flexible endoscopic evaluation of swallowing (FEES) as the most commonly used method, yet it requires special expertise and is heavily dependent on its operator in assessing the parameters. A relatively new method for assessing decannulation readiness in neurologic disorder, the Standardized Endoscopic Swallowing Evaluation for Tracheostomy Decannulation (SESETD) was introduced in 2013 by Warnecke, et al. This method includes stepwise evaluation of secretion management, spontaneous swallowing and laryngeal sensitivity. This study aims to find conformity between the SESETD and FEES in assessing readiness for tracheostomy decannulation in patients with neurologic disorders. MATERIALS AND METHODS This study is a cross-sectional study conducted on 36 neurologic patients at Cipto Mangunkusumo General Hospital which was aimed to find the agreement between two modalities for tracheostomy decannulation readiness, FEES and SESETD based on parameters, standing secretion, spontaneous swallowing and laryngeal sensitivity. RESULT A total of 36 subjects were examined and 22 of them underwent successful tracheostomy decannulation. The agreement between FEES and SESETD showed significant results with p-value <0.0001 and Kappa value = 0.47. CONCLUSION There was conformity between FEES and SESETD in evaluating tracheostomy decannulation readiness based on three parameters: standing secretion, spontaneous swallowing and laryngeal sensitivity.
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Affiliation(s)
- S Tamin
- Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Jakarta, Indonesia.
| | - F Shabrina
- Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Jakarta, Indonesia
| | - S M Hutauruk
- Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Jakarta, Indonesia
| | - E Z K Rachmawati
- Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Jakarta, Indonesia
| | - F Fardizza
- Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Jakarta, Indonesia
| | - T Koento
- Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Jakarta, Indonesia
| | - J Prihartono
- Universitas Indonesia, Faculty of Medicine, Department of Community Medicine, Jakarta, Indonesia
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Fardizza F, Reksodiputro MH, Hermani B, Koento T, Marsinta Hutauruk S, Widiarni Widodo D, Cahyono A, Ayu Anatriera R, Anam K. Promising perioperative outcomes of supraclavicular flap in the reconstruction of head and neck complex defects: An evidence-based case report. Acta Oto-Laryngologica Case Reports 2022. [DOI: 10.1080/23772484.2022.2150931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Fauziah Fardizza
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Mirta Hediyati Reksodiputro
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Bambang Hermani
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Trimartani Koento
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Syahrial Marsinta Hutauruk
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Dini Widiarni Widodo
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Arie Cahyono
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Raden Ayu Anatriera
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Khoirul Anam
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
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Restuti RD, Tamin S, Nugroho DA, Hutauruk SM, Mansyur M. Factors affecting the occurrence of otitis media with effusion in preschool and elementary school children: a comparative cross-sectional study. BMJ Open 2022; 12:e065291. [PMID: 36171035 PMCID: PMC9528613 DOI: 10.1136/bmjopen-2022-065291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Identify the risk factors for otitis media with effusion (OME), especially laryngopharyngeal reflux (LPR), adenoid hypertrophy and allergic rhinitis, that could be used to develop prevention strategies in children. DESIGN A comparative cross-sectional study was conducted to make sure the adequacy of proportions of OME and non-OME cases in finding the related factors. SETTING History taking, ear/nose/throat (ENT) examination, and tympanometry were performed in preschool and elementary schools. Flexible fibreoptic nasopharyngolaryngoscopy was performed in a bronchoesophagology outpatient clinic in a tertiary referral hospital in Jakarta, Indonesia. PARTICIPANTS Preschool and elementary children in East Jakarta, Indonesia were recruited for this study. A total of 2016 participants underwent history taking, ENT examination and tympanometry. The case group was 46 children with OME, and the control group was 46 children without OME. The number of subjects fulfilled the minimum sample size for two proportions comparison. MAIN OUTCOME MEASURES A type B tympanogram indicated OME. A Reflux Finding Score of more than 7 indicated LPR. Adenoid hypertrophy was diagnosed using flexible fibreoptic nasopharyngolaryngoscopy. Allergic rhinitis was diagnosed using a questionnaire based on the International Study of Asthma and Allergies in Childhood phase III that has been validated for Indonesians. RESULTS The proportion of LPR in the OME group was significantly higher than in the non-OME group, at 78.3% and 52.2%. The probability of OME occurrence in patients with LPR was 3.3 times higher than in patients without LPR (OR 3.3; 95% CI 1.33 to 8.189; p=0.01). There was no significant relationship between adenoid hypertrophy and OME (p=0.211; 95% CI 0.71 to 3.97), and also between allergic rhinitis and OME (p=0.463; 95% CI 0.61 to 4.28). CONCLUSION The probability of OME occurrence in patients with LPR was 3.3 times higher than in patients without LPR. LPR should be considered in patients with OME and vice versa.
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Affiliation(s)
- Ratna Dwi Restuti
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Susyana Tamin
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dwi Agustawan Nugroho
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Syahrial Marsinta Hutauruk
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Muchtaruddin Mansyur
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Tamin S, Siregar D, Hutauruk SM, Restuti RD, Rachmawati EZK, Bardosono S. Association between laryngopharyngeal reflux and obstructive sleep apnea in adults. PeerJ 2022; 10:e13303. [PMID: 35497179 PMCID: PMC9053297 DOI: 10.7717/peerj.13303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/29/2022] [Indexed: 01/13/2023] Open
Abstract
Background Obstructive sleep apnea syndrome (OSAS) and laryngopharyngeal reflux (LPR) have been found to coexist in the population. OSAS and LPR also share obesity as an important risk factor. However, the relationship between LPR and OSAS remains unclear. This study aimed to correlate LPR as measured by the Reflux Symptom Index (RSI) and the Reflux Finding Score (RFS) with OSAS. Methods This cross-sectional study included sixty-four subjects who underwent anamnesis to complete the RSI and the Epworth Sleeping Scale (ESS). The subjects were then divided into the OSAS and non-OSAS groups based on the Apnea-Hypopnea Index (AHI) obtained through a polysomnography examination. Both groups underwent a flexible fiberoptic nasopharyngolaryngoscopy examination to determine the RFS. LPR was identified based on the RSI and RFS. Results The mean BMI of the OSAS group significantly was higher than the non-OSAS group (p < 0.05). Most of the subjects in the OSAS group exhibited mild-moderate OSAS (AHI 10-29), and severe OSAS occurred in only seven subjects. The mean RSI and RFS values in the OSAS group did not differ significantly from the non-OSAS group (p = 0.34 and p = 0.36, respectively). The proportion of LPR between the mild-moderate OSAS group, the severe OSAS group, and the non-OSAS group did not differ significantly (p = 1.00). RSI and RFS did not significantly correlate with AHI. Based on RSI, the proportion of LPR between the ESS (+) and ESS (-) groups did not significantly differ (adjusted p = 0.062). The proportion of LPR based on RFS was almost equal between the ESS (+) and ESS (-) groups (p = 0.817). Conclusions The BMI of the OSAS group was significantly higher than the non-OSAS group. There was no significant difference in RSI and RFS between the OSAS and non-OSAS groups. There was no significant correlation between RSI and AHI, or between RFS and AHI. There was no significant difference in the proportion of RSI between the ESS (+) and the ESS (-) groups.
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Affiliation(s)
- Susyana Tamin
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dumasari Siregar
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Syahrial Marsinta Hutauruk
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ratna Dwi Restuti
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Saptawati Bardosono
- Department of Nutrition Science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Reksodiputro MH, Hutauruk SM, Koento T, Fardizza F, Hakim RYR, Audindra S, Yosia M. Randomised clinical trial: Effect of administering platelet-rich fibrin to autologous fat tissue in injection laryngoplasty for vocal cord paralysis. Ann Med Surg (Lond) 2021; 68:102564. [PMID: 34367634 PMCID: PMC8326719 DOI: 10.1016/j.amsu.2021.102564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 12/03/2022] Open
Abstract
The vocal cord in humans is essential in producing voice used in communication and interaction between us. Vocal cord paralysis causes dysphonia, which interferes with communication, causing disruptions towards social activity and daily activities. One of the managements for vocal cord paralysis is medialization and augmentation of the vocal cord through injection laryngoplasty. Autologous fat is one of the best fillers used in this procedure, but it is highly absorbable and can be reabsorbed very quickly when injected into body tissues. Platelet Rich Fibrin (PRF) is a biomaterial consisting of growth factors that are thought to improve fat tissue viability by increasing adipogenesis and angiogenesis. Improvement in fat viability will improve clinical outcomes after the laryngoplasty procedure, potentially reducing the number of repeated injections needed to achieve a satisfactory resolution to vocal cord paralysis. The study evaluates a combination of PRF and autologous microlobular fat compared with autologous microlobular fat alone on laryngoplasty. This single-blinded randomised control trial recruit a total of 18 patients, which are then randomised into the treatment and control groups. The evaluation was done via computerized acoustic analysis/Multidimensional Voice Program (MDVP) parameters and maximum phonation time. The MDVP results and maximum phonation time in both groups showed clinical improvement after the operation with no statistically significant differences. PRF and PRP are platelet-derived products commonly used tissue engineering procedure. PRF is an enhanced version of PRP believed to have superior growth factor release quality. Microlobular fat containing adipose stem cell is used as filler in injection laryngoplasty for medialization of vocal cord. This study observed combination of PRF and autologous microlobular fat filler for injection laryngoplasty. The MDVP results and maximum phonation time showed clinical improvement after the injection laryngoplasty.
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Affiliation(s)
- M H Reksodiputro
- Facial Plastic Reconstructive Division, Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
| | - S M Hutauruk
- Larynx Pharynx Division, Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
| | - T Koento
- Facial Plastic Reconstructive Division, Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
| | - F Fardizza
- Larynx Pharynx Division, Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
| | - R Y R Hakim
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
| | - S Audindra
- Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
| | - M Yosia
- Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia
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Hutauruk SM, Hermani B, Monasari P. Role of chlorhexidine on tracheostomy cannula decontamination in relation to the growth of Biofilm-Forming Bacteria Colony- a randomized controlled trial study. Ann Med Surg (Lond) 2021; 67:102491. [PMID: 34194732 PMCID: PMC8234354 DOI: 10.1016/j.amsu.2021.102491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 11/29/2022] Open
Abstract
Background Regular cleaning of the cannula in the trachea is very important for infection prevention. How to wash the tracheal cannula which is good to reduce the possibility of colonies of biofilm-forming bacteria and the growth of bacterial and the pattern of bacterial on the tracheal cannula is still unknown. This study aims to evaluate the efficacy of decontamination of the tracheal cannula using chlorhexidine and NaCl 0.9% in patients using the tracheal cannula to decrease biofilm-forming bacterial colony. Methods 40 subjects were grouped into 20 subjects in the control group washing the cannula using 0.9% NaCl and the interventional group washing cannula using and with 2.5% chlorhexidine solution and 0.9% NaCl. This study used a parallel randomized controlled trial of 2 groups with a single blinded. Results 40 subjects studied, 17 subjects (85%) each group produced biofilm-forming bacteria prior to intervention. After intervention in the study group, 15 subjects were biofilm negative and 5 biofilm positive subjects p = 0.001. The most common bacteria found in the control group is Pseudomonas aeruginosa, while in the study group some bacteria such as Acinetobacter sp. and Proteus mirabilis. Amoxicilin-Clavulanate had the highest resistance to biofilm forming bacteria in both groups. Piperacillin, ceftazidime, ciprofloxacin and meropenem have the highest sensitivity to biofilm-forming bacteria. Conclusion There was a significant decrease in the number of colonies that produced biofilm in the tracheal cannula in the study group compared to the control group in tracheal cannula washing. Biofilm-Forming Bacteria Colony. Tracheostomy Cannula. Decontamination. Chlorhexidine. Chlorhexidine with NaCl versus NaCl only. Randomized control trial.
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Affiliation(s)
- Syahrial Marsinta Hutauruk
- ENT-Head and Neck Department, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo National Hospital, Jalan Diponegoro No. 71, Jakarta Pusat, Jakarta, 10430, Indonesia
| | - Bambang Hermani
- ENT-Head and Neck Department, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo National Hospital, Jalan Diponegoro No. 71, Jakarta Pusat, Jakarta, 10430, Indonesia
| | - Putri Monasari
- ENT-Head and Neck Department, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo National Hospital, Jalan Diponegoro No. 71, Jakarta Pusat, Jakarta, 10430, Indonesia
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