Patients with Laryngeal Disorders Who Undergone Microlaryngeal Surgery at The Dr. Soetomo General Hospital Surabaya

Objective: To describe laryngeal abnormalities undergoing microlaryngeal surgery (MLS).  Material and Methods: A retrospective analytical study by examining the central medical record and electronic medical record of patients with laryngeal disorders in the otorhinolaryngology head and neck surgery (ORL-HNS) Outpatient Unit and the Teratai ORL-HNS Surgery Inpatient Care Unit at Dr. Soetomo General Hospital, Surabaya, from January 1 until December 31, 2019, utilizing the chi-square test followed by the Wald test.  Results: The number of patient visits from January 1 until December 31, 2019, amounted to 80 patients, most of whom were male and belonged to the 19-60 age group. The histopathology results of patients with neoplasms indicated moderately differentiated squamous cell carcinoma, while the same procedure applied to patients without neoplasms mainly indicated vocal nodules. In this case, the most used technique was a biopsy. Patients with smoking risk factors amounted to 38, while those without smoking risk factors amounted to 42.  Conclusion: MLS is used as a means of diagnosis and therapy, including cases of benign and malignant neoplasms.  

Differences in the length of postoperative care of endoscopic endonasal surgery in simple and complex surgical procedure groups

Background: The rapid development of endoscopic endonasal surgery has made the procedure widely used in nasal and sinus surgery. Endoscopic endonasal surgery is a minimally invasive procedure, but the possibility of postoperative damage to the sinonasal mucosa cannot be ruled out. The aim of this study was to analyze the difference in the length of postoperative care between complex and simple endoscopic endonasal surgeries which can be used as a reference in planning postoperative care.   Methods: This was a retrospective cross-sectional observational study. The participants were divided into two groups, i.e., simple, and complex surgical procedures groups. The simple procedure group consisted of middle meatal anstrostomy, frontal sinusotomy, sphenoidectomy, uncinectomy, endoscopic septoplasty, and endoscopic turbinoplasty. The complex procedure group included pansinus surgery and or at least total ethmoidectomy. The length of postoperative care between the two groups were measured and analyzed using the Chi-square test.   Results: The median length of care in the complex procedure group was significantly longer than that in the simple procedure group (p = 0.028), 12 weeks and 9 weeks, respectively. The number of postoperative outpatient visits was significantly less in the simple procedure group compared with the complex procedure group (Median 4 vs. 5; p=0.015). There was a significant correlation between length of care and the endonasal endoscopic surgical procedure group (p = 0.023).   Conclusions: The complex endoscopic endonasal surgery group required a longer length of care and more postoperative outpatient visit than the simple procedure group.

Changes in Plasma Beta-Endorphin Levels in Stage III–IV Nasopharyngeal Carcinoma Patients Post World Health Organization 3-Step Analgesic Ladder Therapy

Introduction Nasopharyngeal carcinoma (NPC) is the most common malignancy in the field of otorhinolaryngology, and chronic pain is identical with this malignancy. Pain therapy according to World Health Organization (WHO) recommendations is WHO 3-step analgesic ladder. Pain is subjective and related to the function of beta-endorphin hormone.

Objective Analyzing the relationship between the degree of pain and plasma endorphin levels in stage III–IV NPC patients before and after the administration of WHO 3-step analgesic ladder.

Materials and Methods The study design used pretest and posttest without control design. Participants were given WHO 3-step analgesic ladder therapy for 3 days. The participants then rated the pain scale using the visual analog scale (VAS) and plasma beta-endorphin levels in venous blood. The statistical test used the dependent t-test, Wilcoxon test, and Spearman test with p < 0.05, confidence interval: 95%.

Results There were 14 stage-III NPC patients with moderate pain (78.57%) and 31 stage-IV NPC participants had moderate pain (83.87%; p = 0.071). The VAS value in the moderate pain group before and after therapy was 82.22 and 66.67%, respectively (p < 0.001). The values of plasma beta-endorphin levels before and after therapy were 74.89 ± 69.12 and 72.49 ± 75.53 pg/mL, respectively (p = 0.647). Plasma beta-endorphin levels were −19.20 ± 37.72 pg/mL (mild pain), −4.76 ± 35.30 pg/mL (moderate pain), and −21.67 ± 6.27 pg/mL (severe pain; p = 0.717).

Conclusion Pain levels in advanced NPC patients have decreased after the therapy, but plasma beta-endorphin levels have no significant difference.