Nyilo Purnami, Nyilo
Department of Otorhinolaryngology Head and Neck Surgery Medical Faculty Airlangga University

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RECCURENT LARYNGEAL PAPILLOMA Purnami, Nyilo; Fathoni, Rizka
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 1 (2012)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (963.253 KB)

Abstract

A case of respiratory papillomatosis was reported. The patient suffered from the disease since eight months old with chief complaint progressive hoarseness and dyspnea. It was diagnosed with respiratory papillomatosis and scheduled for performing tracheotomy and continued with the first microlaryngeal surgery (MLS). Decanulation was taken after 2nd surgery of removing papillomas. Finally was reported she got serial of surgery for 22 times during 18 years of age. It was costly and deteriorating quality of life. The problem remains persisted because of frequent recurrences and need for repetitive surgeries. Specimen biopsy for histologic examination was shown the signs of HPV infection, papilomatic coated squamous epithel with mild dysplasia and coilocytosis. The threatening of upper airway obstruction is the main important reason for patients coming. The patency of airway assessed by Direct Laryngoscopy then the next treatment was decided with schedule of Micro Laryngeal Surgery (MLS). Finally the MLS treatment is just only for temporarilyrecovery. A further research to define the proper treatment in the future is required, especially for prevention of the diseases related to the viral causes of infection.
BIOFILM BACTERIA PLAYS A ROLE IN CSOM PATHOGENESIS AND HAS SIGNIFICANT CORRELATION WITH UNSAFE TYPE CSOM Artono, Artono; Purnami, Nyilo; Rahmawati, Rosydiah
Folia Medica Indonesiana Vol 51, No 4 (2015): Oktober - December 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (65.176 KB) | DOI: 10.20473/fmi.v51i4.2846

Abstract

Chronic suppurative otitis media (CSOM) may cause severe morbidity and mortality and remains a major health problem worldwide. The incidence of CSOM in Indonesia (1994-1996) is estimated at about 8.36 million people and CSOM general prevalence is 3.8% (Helmi 2005). This study aims to prove the existence of bacterial biofilm in patients with safe type and hazard type CSOM from mastoidectomy. The design was observational analytic with cross sectional approach. This study was conducted at the Teratai Wards, IBP Dr. Soetomo Hospital, and Electron Microscopy Unit, Faculty of Medicine, Airlangga University Surabaya, from November 2013 to June 2014. Samples of pathological tissues were taken by consecutive sampling and bacterial biofilms examination was done by SEM. SEM results categorized the biofilm bacteria as positive or negative. Biofilm bacteria tested positive when it shows three-dimensional representation of bacteria with clear shapes and sizes and clusters, the formation of amorphous material consisting of glycocalyx material surrounding the bacteria, and surface attachment. Biofilm bacteria was regarded as negative when there is no bacterial cluster, glycocalyx and surface attachment. This study was performed on 33 CSOM patients.  Samples were divided into unsafe type CSOM (17 patients) and safe type CSOM (16 patients). Positive biofilm bacteria was found in 12 patients with unsafe type (75%) and 6 patients with safe type (35.35%). Negative biofilm bacteria was found in 4 patients with the unsafe type (25%) and 11 patients with safe type (67.9%). Logistic regression analysis revealed p value = 0.027, indicating the biofilm bacteria have a significant correlation with unsafe type CSOM (p <0.05). In conclusion, biofilm bacteria plays a role in CSOM pathogenesis of biofilm bacteria has significant correlation with unsafe type CSOM.
RECCURENT LARYNGEAL PAPILLOMA Purnami, Nyilo; Fathoni, Rizka
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 1 (2012)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (963.253 KB) | DOI: 10.20473/ijtid.v3i1.196

Abstract

A case of respiratory papillomatosis was reported. The patient suffered from the disease since eight months old with chief complaint progressive hoarseness and dyspnea. It was diagnosed with respiratory papillomatosis and scheduled for performing tracheotomy and continued with the first microlaryngeal surgery (MLS). Decanulation was taken after 2nd surgery of removing papillomas. Finally was reported she got serial of surgery for 22 times during 18 years of age. It was costly and deteriorating quality of life. The problem remains persisted because of frequent recurrences and need for repetitive surgeries. Specimen biopsy for histologic examination was shown the signs of HPV infection, papilomatic coated squamous epithel with mild dysplasia and coilocytosis. The threatening of upper airway obstruction is the main important reason for patients coming. The patency of airway assessed by Direct Laryngoscopy then the next treatment was decided with schedule of Micro Laryngeal Surgery (MLS). Finally the MLS treatment is just only for temporarilyrecovery. A further research to define the proper treatment in the future is required, especially for prevention of the diseases related to the viral causes of infection.
CORRELATION OF HEARING IMPAIRMENT AND COMMUNICATION DISORDER AMONG GERIATRIC IN GERIATRIC CLINIC, DR. SOETOMO HOSPITAL SURABAYA Kartika M, A Ratna; Purnami, Nyilo; Liben, Paulus
Folia Medica Indonesiana Vol 51, No 4 (2015): Oktober - December 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (46.439 KB) | DOI: 10.20473/fmi.v51i4.2859

Abstract

The objective of this study was to analyze correlation between hearing impairment and communication disorder among geriatrics in Geriatric Clinic, Dr. Soetomo Hospital. A randomized cross-sectional study design has been used in this study. Analysis was done by filling in some questionnaire and interview to some patients who were randomly selected according to predetermined condition. The data were collected and reviewed for the factors, which were assumed as risk factors of hearing disorder and life’s quality deterioration. Statistical analysis was performed using Fisher’s Exact Test using SPSS program version 17. Results showed correlation between hearing impairment and the quality of life and social communication (p=0.033, OR=6.11). However, there was no correlation between hearing impairment with diabetes mellitus (p=0.255), with hypertension (p=0.565), and noisy environment (p=0.689). In conclusion, the study showed that there is correlation between hearing impairment and communication disorder.
Characteristics of infants and young children with sensorineural hearing loss in Dr. Soetomo Hospital Purnami, Nyilo; Dipta, Cintya; Rahman, Mahrus Ahmad
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.855 KB) | DOI: 10.32637/orli.v48i1.251

Abstract

Background: Hearing loss is one of the congenital abnormalities frequently found in children, which is followed by delayed speech and language development. The majority of cases have unknown causes of hearing loss resulting in late diagnosis. Newborn Hearing Screening Program (NHSP) recommended Otoacoustic Emissions (OAE) and Brainstem Evoked Response Audiometry (BERA) as detection of hearing loss in infants and children. Objective: To obtain the prevalence and description of sensorineural hearing loss in infants and children. Method: A retrospective descriptive study of infants underwent OAE and BERA between 2011-2013 at Dr Soetomo Hospital. The degree of hearing loss was according to the International Standard Organization (ISO). Result: A total number of 552 infant and children were examined, and 377 (68%) were detected with sensorineural hearing loss (SNHL). This group of SNHL consisted of 199 males (52.79%) and 178 females (47.21%). The largest age group was 12 to 36 months, revealed 237 patients (62.86%) with SNHL. The majority degree of hearing loss was profound hearing loss in 329 patients (87.27%). The risk factors of SNHL mostly were not found, in 310 patients (82.23%). The majority number of SNHL was bilateral, in 357 patients (94.69%). Conclusion: SNHL was found in majority of infant and children in the Audiology Clinic of Dr.Soetomo Hospital. The hearing loss found were mostly profound and bilateral, with unknown risk factors, which might contribute to speech and language developmental delay. This is relevance with the Universal NHSP recommendation that early detection should be implemented to all newborn. ABSTRAK Latar belakang: Gangguan pendengaran adalah salah satu kelainan kongenital yang sering ditemukan, dan berpengaruh pada perkembangan bicara dan bahasa anak. Sebagian besar gangguan pendengaran tidak jelas ada faktor risikonya, sehingga tidak segera terdeteksi. Bila tidak dilakukan deteksi dini, akan menyebabkan keterlambatan diagnosis dan intervensi. Telah direkomendasikan oleh Newborn Hearing Screening Program (NHSP) pemeriksaan Otoacoustic Emissions (OAE) dan Brainstem Evoked Rresponse Audiometry (BERA) sebagai alat deteksi dini gangguan pendengaran pada bayi dan anak. Tujuan: Mendapatkan prevalensi dan deskripsi gangguan pendengaran sensorineural pada bayi dan anak. Metode: Penelitian deskriptif retrospektif dengan mengumpulkan data subjek periode 2011- 2013 di Rumah Sakit Dr.Soetomo. Pemeriksaan OAE menggunakan Distortion Product Otoacoustic Emissions. Pemeriksaan BERA berdasarkan International Standard Organization (ISO). Hasil: Terdapat sebanyak 377 pasien (68%) dengan gangguan pendengaran sensorineural dari total 552 bayi dan anak. Pada kelompok umur 12 sampai 36 bulan didapati gangguan pendengaran sensorineural tertinggi sebanyak 237 (62,86%) pasien. Sebagian besar pasien laki-laki sebanyak 199 (52,79%). Mayoritas pasien mengalami gangguan pendengaraan derajat sangat berat sebanyak 329 (87,287%) dari total 377 penderita. Mayoritas faktor risiko dari gangguan pendengaran yang tidak diketahui sebanyak 310 kasus (82,23%), dan mayoritas penderita mengalami gangguan pendengaran sensorineural bilateral sebanyak 357 (94,69%). Kesimpulan: gangguan pendengaran sensorineural ditemukan terbanyak pada bayi dan anak di Klinik Audiologi RSUD Dr. Soetomo. Derajat keparahan terbanyak adalah profound, dan ditemukan terbanyak bilateral. Faktor risiko yang tidak diketahui terbanyak ditemukan, dan bisa merupakan faktor yang berpengaruh pada kejadian lambat bicara dan berbahasa. Temuan ini sesuai dengan rekomendasi program skrining pendengaran yang seharusnya diterapkan pada semua bayi baru lahir.
The correlation between plasma reactive oxygen species and hearing threshold levels in presbycusis patients Purnami, Nyilo; Nuraini, Anita; Surarso, Bakti
Oto Rhino Laryngologica Indonesiana Vol 49, No 1 (2019): Volume 49, No. 1 January-June 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (331.38 KB) | DOI: 10.32637/orli.v49i1.291

Abstract

Background: Presbycusis is a hearing loss due to the degeneration process in elderly people of 65 years old and beyond, characterized by a decrease in hearing sensitivity in both ears. Reactive oxygen species (ROS) are assumed to have an important role in the pathogenesis of presbycusis. Purpose: To find out the correlation between ROS levels in plasma and hearing threshold levels in presbycusis patients. Method: The design was cross sectional and conducted at the Outpatient Clinic of Neurotology Division, Geriatric Clinic, Clinical Pathology Installation, and Central Installation of Biomaterials Network Bank of Dr. Soetomo Hospital. Samples were taken by consecutive sampling for audiometric examination and measurement of ROS levels in plasma. Results: Fifty samples were collected, ROS levels in plasma were found with mean (SD) of 2.46 ng/ml (0.84). The mean hearing threshold level was 47.70 dB (12.42). The Pearson statistical test revealed a significant correlation between ROS levels in plasma and hearing threshold levels, with p=0.003 (p<0.05), and the correlation coefficient (r) 0.41. Conclusion: There was a correlation between ROS in plasma and hearing threshold levels in presbycusis patients, with a significant moderate-positive correlation pattern. It indicated that the higher the ROS levels in plasma, the higher the hearing threshold levels in presbycusis patients. Latar belakang: Presbikusis adalah gangguan pendengaran akibat proses degenerasi yang dijumpai pada usia 65 tahun atau lebih, ditandai oleh penurunan kepekaan pendengaran pada kedua telinga. Reactive oxygen species (ROS) diduga mempunyai peran penting pada patogenesis  presbikusis. Tujuan: Untuk mengetahui hubungan antara kadar ROS dalam plasma dengan nilai ambang dengar pada penderita presbikusis. Metode: Penelitian ini adalah cross sectional, dilakukan di Unit Rawat Jalan (URJ) THT-KL Divisi Neurotologi, URJ Geriatri, Instalasi Patologi Klinik, dan Instalasi Pusat Biomaterial Bank Jaringan RSUD Dr. Soetomo. Sampel diambil secara consecutive sampling. Diperoleh 50 sampel untuk dilakukan pemeriksaan audiometri dan pengukuran kadar ROS dalam plasma. Hasil: Kadar ROS dalam plasma didapatkan hasil rerata (SD) 2,46 ng/ml (0,84). Nilai ambang dengar didapatkan hasil rerata (SD) 47,70 dB (12,42). Hasil uji statistik dengan korelasi Pearson terhadap kadar ROS dalam plasma dan nilai ambang dengar didapatkan hasil koefisien korelasi (r) sebesar 0,41 dan p=0,003 (p<0,05). Kesimpulan: Terdapat hubungan antara kadar ROS dalam plasma dengan nilai ambang dengar pada penderita presbikusis dengan pola hubungan bersifat positif-sedang yang signifikan, yang berarti semakin tinggi kadar ROS dalam plasma, semakin tinggi nilai ambang dengar.
SEROPOSITIVITY OF ANTI-RUBELLA ANTIBODIES AS A MARKER FOR RUBELLA INFECTION IN INFANTS AT HIGH RISK OF CONGENITAL DEAFNESS Purnami, Nyilo; Etika, Risa; Martono, Martono; Wardhani, Puspa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1479

Abstract

Hearing loss in newborns or congenital deafness can be caused by the development of several parts of the auditorysystem. Congenital deafness is often associated with infections, such as Toxoplasmosis, Rubella, Cytomegalovirus (CMV),and Herpes (TORCH). Deafness is very difficult to be early detected. Therefore, simple but fast methods are needed. Earlydetection is based on the Newborn Hearing Screening (NHS) program. Otoacoustic Emission (OAE) and AutomatedAuditory Brainstem Response (AABR) checks are raw materials for early detection. Congenital deafness often occurs withpregnancy infections with viruses such as Rubella. Rubella infection during pregnancy, especially during the first trimester,often causes Congenital Rubella Syndrome (CRS). Rubella infection often occurs with other causes, such as Toxoplasma,CMV, and Herpes. A Serological test can be used as one of the diagnostics of this infection. This study used single RubellaIgG and IgM antibodies and double antibodies test as a marker for the infection. The authors wanted to correlate theserological examination of this infection with the auditory function. Rubella infection was detected with single serologicalanti-Rubella IgG and IgM and double multiple Rubella and TORCH serological tests. Also, the auditory function wasassessed using the OAE and AABR test in this research. The result showed 35 (77.7%) patients with positive Rubellaserological tests among 45 NICU patients at Dr. Soetomo Hospital. There were number of patients was 12 (34.2%) patientswith a single positive serological test and 23 (65.7%) patients with positive multiple TORCH serological tests. The number ofpatients with Rubella negative infection was 10 (22.2%). There were 11 (31.4%) patients of positive Rubella infections withpositive hearing loss and 24 (68.6%) patients with negative hearing loss. From the results of the study, 35 patients were athigh risk of disturbance and the statistical analysis showed that there were no significant serological differences in Rubellapositive with hearing loss (p=0.087). Hearing loss in NICU infants has a high risk of factors causing Rubella infection andother related causes. In most Rubella positive serological tests IgG was found, which can be due to maternal factors.Serology tests need to be repeated for confirmation under the surveillance program. How to follow-up the patients anddefine the next laboratory test after six months remain a great challenge. The efforts need to be strengthened in surveillanceprograms.
POLYMERASE CHAIN REACTION AND SEROLOGY TEST TO DETECT RUBELLA VIRUS IN CONGENITAL RUBELLA SYNDROME PATIENTS WITH HEARING LOSS Izzattisselim, Sabrina; Purnami, Nyilo
Indonesian Journal of Tropical and Infectious Disease Vol 8, No 1 (2020)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i1.8735

Abstract

Rubella infections in pregnant women, especially during the first trimester, often lead to manifest as congenital rubella syndrome (CRS). This syndrome consists of several inherited disorders such as deafness, cataracts, and cardiac abnormalities. Deafness is the most common manifestation of CRS, 70-90% of all cases with deafness type are sensory neural deafness. The mechanism of hearing loss due to rubella virus is caused by hypoxia resulting from endothelial vascular damage in cochlea, followed by cell death in the organ of Corti and stria vascularis.Cochlea?s stria damage makes alterations in the composition of endolymph. This study aimed to confirm rubella infection using PCR and serological tests in patients with CRS who were clinically deaf. A suspected CRS reported was a 2-month-old patient with an unclear response to surround sound. The patient had been already diagnosed with congenital cataracts before. Prenatal, perinatal and postnatal history was evaluated. Hearing screening was done by OAE (Biological), and AABR (Beraphone). Anti-rubella IgM and IgG was obtained from blood serum. PCR was carried out from a throat swab and the eye-lens specimen. OAE and AABR results ?refer? to both sides of the ear indicated a sensorineural hearing loss. The serological examination of IgM was positive with an index of 15.00 and IgG rubella positive with a titer> 500 IU / ml. Positive results from the rubella virus were identified from the throat swab and lens specimens using the PCR method. Detection of rubella virus in CRS sufferers with clinical deafness of both ears gives positive results using PCR and serology methods. In the future PCR can be potential for prenatal diagnosis of rubella virus aimed at the provision of early prevention.
CORRELATION OF MALONDIALDEHYDE AND HEARING THRESHOLD LEVEL AT FREQUENCY 4000 HZ POST GUNSHOT EXPOSURE Purnami, Nyilo; Helmi, Fauzi; Herawati, Sri
Oto Rhino Laryngologica Indonesiana Vol 50 (2020): Volume 50, No. 1 January - June 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i1.283

Abstract

Background: The incidence of acoustic trauma after gunshot exposure in students of the SekolahPolisi Negara (SPN) is quite high. Malondialdehyde (MDA) is a compound that can portray oxidativestress due to free radicals. The correlation between the levels of MDA and the hearing threshold frequencypost gunshot exposure could be used as the base for administering antioxidants to prevent acoustictrauma. Objective: To find out the correlation between the levels of MDA and the hearing thresholdfrequency post gunshot exposure, in East Java SPN students. Method: An observational analytic studywith a retrospective cross sectional approach using secondary data of medical records of the East JavaSPN students batch 2017/2018. The samples were selected by simple random sampling. Result: Out of50 students, the mean of age was 19.62 years. All samples were male with mean 559.17 and standarddeviation (SD) 959.86. The calculation of the 4000 Hz frequency threshold value obtained an averagevalue of 31.52 and SD of 13.4. Hearing loss complaint was found in 1 student (2%). No complaints oftinnitus and vertigo were found. Statistical tests with Pearson correlation between serum MDA levels and4000 Hz frequency threshold values showed a correlation coefficient (r) of 0.74 and p = 0.00 (p<0.05).Conclusion: There was a significant correlation between MDA levels and the hearing threshold at 4000Hz frequency after gunshot exposure in East Java SPN students.Keywords: acoustic trauma, malondialdehyde, hearing threshold level at frequency 4000 HzABSTRAKLatar belakang: Insiden trauma akustik pasca pajanan letusan senjata api pada siswa Sekolah PolisiNegara (SPN) cukup tinggi. Malondialdehid (MDA) merupakan senyawa yang dapat menggambarkanstres oksidatif akibat radikal bebas. Adanya hubungan antara kadar MDA dengan nilai ambang dengarfrekuensi 4000 Hertz (Hz) dapat menjadi dasar pemberian antioksidan untuk pencegahan traumaakustik. Tujuan: Membuktikan hubungan antara kadar MDA dengan nilai ambang dengar frekuensi4000 Hz pasca pajanan letusan senjata api pada siswa SPN Jawa Timur. Metode: Penelitian ini adalahobservasional analitik dengan pendekatan retrospektif cross sectional menggunakan data sekunderberupa rekam medik siswa SPN Jawa Timur angkatan 2017/2018. Sampel dipilih secara simple random sampling. Hasil: Dari 50 siswa, usia rerata adalah 19,62 tahun. Seluruh sampel penelitian adalah laki-laki, rerata=559,17 dan standar deviasi (SD)=959,86. Penghitungan nilai ambang dengar frekuensi 4000 Hz didapatkan hasil nilai rerata=31,52 dan SD=13,4 Keluhan penurunan pendengaran hanya dijumpai pada 1 siswa (2%). Uji statistik dengan korelasi Pearson antara kadar MDA dalam serum dengan nilai ambang dengar frekuensi 4000 Hz didapatkan hasil koefisien korelasi (r) sebesar 0,74 dan p = 0,00 (p<0,05). Kesimpulan: Terdapat hubungan yang signifikan antara kadar MDA dengan nilai ambang dengar frekuensi 4000 Hz pasca pajanan letusan senjata api pada siswa SPN Jawa Timur.Kata kunci: trauma akustik, malondialdehid, nilai ambang dengar frekuensi 4000 Hz