Gambaran Karakteristik Penderita, Prosedur dan Temuan Operasi pada Penderita Rinosinusitis Kronis yang Menjalani Bedah Sinus Endoskopik Fungsional (BSEF) di RSUP H. Adam Malik, Medan

ABSTRAK

Pendahuluan: Bedah sinus endoskopik fungsional (BSEF) telah menjadi
standar tindakan bedah dalam penatalaksanaan rinosinusitis kronis
(RSK), khususnya bagi penderita yang gagal dengan pengobatan
medikamentosa. Di RSUP H. Adam Malik, Medan, penderita RSK cukup
banyak begitu juga dengan penderita RSK yang ditangani dengan BSEF.
Diharapkan penelitian ini dapat memberikan informasi mengenai
gambaran karakteristik penderita RSK dan tindakan BSEF di RSUP H.
Adam Malik, Medan.
Tujuan Penelitian: Untuk mengetahui gambaran karakteristik penderita,
prosedur dan temuan operasi pada penderita RSK yang menjalani BSEF
di RSUP H. Adam Malik, Medan.
Metode Penelitian: Penelitian deskriptif dengan desain case-series
dilakukan di RSUP H. Adam Malik, Medan. Data dikumpulkan
berdasarkan formula kuesioner, pencatatan hasil pemeriksaan
endoskopik, tomografi komputer sinus paranasalis dengan potongan
koronal, prosedur dan temuan operasi pada tindakan BSEF.
Hasil: Penderita RSK yang menjalani BSEF terbanyak adalah penderita
RSK dengan polip (62,50%). Kategori penyakit berdasarkan SNOT-20
terbanyak adalah kategori penyakit sedang (81,25%). Jumlah penderita

RSK dengan riwayat pengobatan antibiotik sama banyak dengan
penderita RSK dengan riwayat pengobatan medikamentosa lainnya, yaitu
37,50%. Temuan endoskopik pre-operatif terbanyak adalah edema
mukosa konka inferior (100%). Gambaran tomografi komputer terbanyak
menunjukkan obstruksi kompleks ostiomeatal sebanyak 87,50% dan
keterlibatan sinus maksilaris 100%. Derajat keparahan penyakit
berdasarkan Harvard staging system terbanyak adalah derajat III
(46,88%). Tindakan BSEF terbanyak dilakukan adalah unsinektomi dan
antrostomi meatus media bilateral, masing-masing 68,75%. Temuan intraoperatif terbanyak dijumpai adalah mukosa etmoid polipoid yaitu
(84,39%).
Kesimpulan: Penderita RSK yang menjalani BSEF paling banyak
dijumpai di RSUP H. Adam Malik, Medan adalah penderita RSK dengan
polip. Penderita RSK terbanyak berada pada kategori penyakit sedang.
Pengobatan penderita RSK sebelum dilakukan tindakan BSEF harus
dilakukan evaluasi kembali. Tindakan prosedur BSEF paling banyak
dilakukan adalah unsinektomi dan antrostomi meatus media. Temuan
intra-operatif terbanyak adalah mukosa etmoid polipoid.
Kata Kunci: bedah sinus endoskopik fungsional, rinosinusitis kronis,
karakteristik RSK, prosedur BSEF, temuan intraoperatif

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ABSTRACT

Introduction: Functional endoscopic sinus surgery (FESS) has become
the standard surgical treatment for patients with chronic rhinosinusitis
(CRS), particularly those who have failed medical treatment. There are
many CRS cases in General Hospital of H. Adam Malik, Medan, as well as
CRS patients treated with FESS. This research is expected to provide
information on characteristics of CRS patients, FESS procedure and
operative findings in General Hospital of H. Adam Malik, Medan.
Aim: To determine the characteristic of patients, procedures and operative
findings in patients who underwent FESS in General Hospital of H. Adam
Malik, Medan.
Methods: A case-series descriptive study conducted in General Hospital
of H. Adam Malik, Medan. Data collected from patients using a
questionnaire formula. Results of endoscopic examination, paranasal
sinus coronal computed tomography, procedures and operative findings
were recorded.
Results: CRS with polyps were the commonest group found in patients

who underwent FESS (62.50%). Mostly were in moderate disease
category based on SNOT-20 (81.25%). Patients given antibiotics as
primary treatment and patients with other history of medical treatment
were 37.50% respectively. Inferior turbinate mucosal edema was the
commonest pre-operative endoscopic findings (100%). The commonest
computer tomography findings are ostiomeatal complex obstruction (87,
50%) and maxillary sinus involvement (100%). The commonest stage in
severity of the disease based on Harvard staging system was stage III
(46.88%). Uncinectomy and bilateral middle meatal antrostomy were the
commonest
procedure
performed
(68.75%).
The
commonest
intraoperative finding was ethmoid polypoid mucosal (84,39%).
Conclusion: CRS with polyp were the commonest type of CRS treated
with FESS in General Hospital of H. Adam Malik, Medan. Treatment of
CRS patients before FESS should be re-evaluated. Most performed
procedures were uncinectomy and middle meatal antrostomy. The

commonest intraoperative finding was ethmoid polypoid mucosal.
Keywords: functional endoscopic sinus surgery, chronic rhinosinusitis,
characteristics of CRS, FESS procedure, intraoperative findings

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