BAB 6 KESIMPULAN DAN SARAN
6.2. Saran
1. Mempersiapkan sebaik mungkin pasien yang hendak dikemoterapi untuk menghindari faktor resiko terjadinya ototoksik.
2. Perlu penelitian lebih lanjut dengan jumlah sampel yang lebih banyak untuk mendapatkan suatu kesimpulan yang lebih representatif.
KEPUSTAKAAN
Austin FD.1997, Anatomi dan Embriologi. Dalam Ballenger JJ. Penyakit Telinga, Hidung, Tenggorok, Kepala dan Leher. Edisi 13. Jilid Dua. Binarupa Aksara.pp.101-32.
Anson BJ et al, 1991, Embryology of the Ear , in Otolaryngology, Vol I, Third Edition, WB Saunders Company USA, pp.3-20
Averdi R, 1989, Penggunaan Sitostatika pada Tumor Ganas, Telinga Hidung dan Tenggorok , dalam Tumor, Telinga, Hidung, Tenggorok. Diagnosis dan Penatalaksanaan, FK UI, Jakarta, pp 95-106.
Brockstein BE,1998, Vokes EE. Principles of Chemotherapy in Treating Head and Neck Cancer. In Bailey BJ, Head & Neck Surgery Otolaryngology. Second Edition. Philadelphia. Lippincott Raven. pp. 1377-79.
Cavallini C. Cisplatin Ototoxicity and OAES. Available at :
http://www.otoemissions.org/biophysics/ototoxicity.html.
Chen WC et al, January 2006 Sensorineural Hearing Loss in Combined Modality Treatment of Nasopharyngeal Carcinoma in American Cancer Society
Coebergh WWJ, Vandenbroucke PJ, 1999, Aspek Epidemiologi Kanker , dalm Van De Velde CJH, Bosman FT, Wagener DJTH, Onkologi, Edisi ke 5 Gadjah Mada University Press, pp. 37-50.
Crist WM, 2000, Penyakit Neoplasma dan Tumor , dalam Nelson Ilmu Kesehatan Anak, Edisi 15, Vol 3, Penerbit Buku Kedokteran EGC, pp1758-68
Dehne at al, 2001, Cisplatin Ototoxicity : Involvement of Iron and Enhanced Formation of Superoxide Anion Radicals, in Toxicology and Applied Pharmacology, pp. 27-34
Dhingra PL, 2004, Anatomy of The Ear ,in Diseases of Ear ,Nose and Throat, Third Edition, Elsevier New Delhi, pp. 3-15
Domenech J, Carulla M, 1990, High- Frequency Audiometric Assessment Of Cisplatin-Induced Hearing Loss, Departement of ORL, Faculty of Medicine, University of Barcelona., pp. 1367-68.
Donaldson AJ, Duckert LG, 1991, Anatomy of The Ear, in Paparella MM, Otolaryngology, Vol.I, Third Edition WB Saunders Company USA,pp.39-56
Dutta A, Venkatesh MD, Kashyap RC, 2005, Study of The Effects of Chemotherapy on Auditory Function, Indian Journal of Otolaryngology and Head Neck Surgery, Vol. 57, No.3, pp 226-8
Edmunds AL. Inner Ear. Ototoxicity. Available at :
http://www/emedicine.com/emedicine_specialities.html.
Ekborn A, 2003, Cisplatin Induced Ototoxicity, Pharmacokinetics, Predietion and Prevention. Department of Otorhinolaryngology and Head & Neck Surgery Karolinska Hospital. Stockholm. Pp.13-16.
Feldman AS, Grimes CT, 1997, Audiologi, Dalam Ballenger JJ. Penyakit Telinga, Hidung, Tenggorok, Kepala dan Leher. Edisi 13. Jilid Dua. Binarupa Aksara, pp. 273-80.
Funk E, 2005, Ototoxicity, in Bobby R Alford Department of Otolaryngology-Head and Neck Surgery, June 23.
Franzmann E at al, 2006, Oncology of Head and Neck Tumors, in Otolaryngology Basic Science and Clinical Review, Thieme New York , pp. 137-48
Gulya AJ, 2003, Development Anatomy of The Temporal bone and Skull Base , in Glasscock and Shambought Surgery of The Ear, Fifth Edition, BC Decker Inc, pp. 3-31
Grau JJ. 1996, Calcium Supplementation and Ototoxicity in Patients Receiving Cisplatin. In J. Clin. Pharmacol. Vol. 42.pp. 233-235.
Hamers FPT at al, 2003, Cisplatin Ototoxicity Involves Organ of Corti, Stria Vascularis and Spiral Ganglion: Modulation by Msh and ORG 2766, in Audiology and Neurootology, Dec, pp. 305-315.
Harsal A, 2003, Kemoterapi Pada Keganasan Kepala dan Leher , dalam Makalah Lengkap Simposium Bedah Kepala dan Leher , Jakarta,pp. 1-4
Hutagalung M, Cakra IGM, Dhaeng Y, 1996, Tinjauann Lima Besar Tumor Ganas THT di RSUP Dr. Sardjito Selama Lima Tahun(1991-1995) dalam Kumpulan Naskah Ilmiah Tahunan Perhati Malang , pp 952-962.
Jacob LCB at al, 2006, Auditory Monitoring in Ototoxicity, in Rev Bras Otorinolaringolgy, pp.836-44.
Khandekar JD, 1994, Kemoterapi pada Kanker Kepala Leher. Dalam Ballenger JJ. Penyakit Telinga Hidung Tenggorok, Kepala dan Leher. Jilid I. Edisi 13. Binarupa Aksara. pp. 839-42.
Li Y, Womer RB, Silber JH, 2003, Predicting Cisplatin Ototoxicity in Children: the Influence of Age and the Cumulative Dose, European Journal of Cancer, October, pp. 2445-2451.
Liston SL, Duvall AJ, 1994, Embriology,Anatomy dan Fisiology Telinga, dalam Boies Buku Ajar Penyakit THT, Edisi 6, Penerbit Buku Kedokteran EGC, pp. 27-37
Lim DJ, 2006, Ultrastructure Anatomy of The Cochlea, in Otolaryngology Basic Science and Review Thieme New York ,pp. 315-30
Lukmantya H, 1996, Pola Tumor Ganas , dalam Kumpulan Naskah Ilmiah Tahunan Perhati, Malang, pp.1067-73
Lundberg BW, 2003, Chemotherapy of Head and Neck Cancer. In Lee KJ. Essensial Otolaryngology Head & Neck Surgery. Eight Ed. Int Ed. McGraw-Hill. Pp. 371-376.
Mattox DE, Nager GT, Levin LS, 1991, Congenital Aural Atresia :Embriology Patology, Classification Genetics and Surgical Management, in Paparella MM ,Otolaryngology, Third Edition Vol.3 WB Saunders Company , pp.1991-3
Monfardini at al, 1987, Head and Neck Tumor, in Mannual of Adult and Pediatric Medical Oncology , Springer Verlay. Berlin, pp. 274-8
Munir M, 2001, Tumor Leher dan Kepala. Dalam Buku Ajar Ilmu Kesehatan Telinga Hidung Tenggorok, Kepala Leher. Edisi Kelima. Jakarta. FKUI. Pp. 132-37.
Nagar YS, Singh S, Datta NR, 2004, Chemo-reiradiation in Present / Recurrent Head and Neck Cancer, in Japanese Journal of Clinical Oncology, pp. 61-8
Primose WJ, 1997, The Principles of Chemotherapy. In. Scott-Brown’s Otolaryngology. Sixth Ed. Butterworth Henemann. Great Britain. pp. 1/22/1-1/22/6.
Rademaker JM, et al, 2006, Relationship Between Cisplatin Administration and the Development of Ototoxicity. In Journal of Clinical Oncology. Vol. 24. No. 6. pp. 918-924.
Reksodiputro HA, 2002, Konsep Multimodalitas Dalam Penanganan Kanker Nasofaring, dalam Simposium Perkembangan Multimodalitas Penatalaksanaan Kanker Nasofaring dan Pengobatan Suportif, Jakarta.
Riggs LC, 1998, Ototoxicity. In Bailey BJ. Head & Neck Surgery-Otolaryngology. Second Edition. Philadelphia. Lippincott Raven. pp. 2165-2168.
Rybak LP, Toulitas JS,Campbell, 2006, Ototoxicity, in Otolaryngology Basic Science and Clinical Review, Thieme New York, pp. 129-36.
Saini A, et al, 2003, Chemotherapy for Head and Neck Cancer. In : Principles and Practice of Head and Neck Oncology. New York. Martin Dunitz. Pp. 79-83.
Salmon SE, et al, 1995 Kemoterapi Kanker. Dalam Katzung BG. Farmakologi Dasar dan Klinik. Edisi 3. Penerbit Buku Kedokteran EGC.pp. 794-804
Siahaan KDM, Wiratno, 1996, Distribusi Tumor Ganas THT dan Kepala Leher di RSUP Dr. Kariadi Semarang tahun 1991-1995, dalam Kumpulan Naskah Ilmiah Tahunan Perhati, Malanag, pp.964-70
Smets LA, et al, 1999, Prinsip-prinsip Kemoterapi. Dalam : Onkologi. Edisi 5. Gajah Mada University Press. Pp. 217-221.
Stupp R, Vokes EE, 1996 Head and Neck Cancer , in Current Cancer Therapeutics, Second Edition ,Churchil Livingstone, pp. 154-8
Sudarwi A, Amriyatun, 1996 Faktor-Faktor resiko terjadinya 3 keganasan di kepala dan leher , dalam Kumpulan Naskah Ilmiah Tahunan Perhati, Malang, pp. 989-96
Sutirto I, et al. 2001 Gangguan Pendengaran dan Kelainan Telinga. Dalam : Buku Ajar Ilmu Kesehatan Telinga, Hidung, Tenggorok Kepala Leher. Edisi Lima. Jakarta. FKUI, pp. 9-19
Toure J. Head and Neck Cancer : Squamous Cell Carcinoma. Available at :
http://www.emedicine.com/specialities.htm.
Tuper G, Ahmad N, Seidman M, 2005 Mechanisme of Ototoxicity, in Hearing and Hearing Disoders; Research and Diagnostic, Departement of Otolaryngology , Head and Neck Surgery , Henry Ford Health System, Vol 9, No. 1 pp. 2-10
Vermey at al, 1999, Tumor Kepala Leher, dalam Van DE Velde CJH, Bosman FT, Wagener DJTH, Onkologi, Edisi ke 5 Gadjah Mada University Press, pp. 249-54
Walters FLC, et al, 2002, Co Treatment with Melanotan-II Apoten Melanocortin, Does Not Protect Against Cisplatin Ototoxicity. In : Hearing Research. No. 172. pp. 110-111.
Whitworth CA at al, 2004, Protecion Againts Ototoxicity by Adenosin Agonist, in Biochemical Pharmacology, pp. 1801-07
Wright A , 1997, Anatomy and Ultrastructure of The Human Ear , Basic Science, in Scott Brown,s Otolaryngology, Sixth Edition, Vol. 1, Buterworth, pp. 1/1/1- 1/1/49.
Wright A, 1997, Ototoxicity. In : Scott-Brown’s Otolaryngology. Sixth Edition. Butterworth Heinemann. Great Britain. pp. 3/20/1-10.
Yellin MW, 1991, Hearing Measurement in Adult, in Paparella MM, Otolaryngology , Vol. II, Third Edition , WB Saundres Company, Philadelphia , pp. 961-9
Lampiran 1
STATUS PENELITIAN
Identitas Penderita
− No. Urut Penelitian : ...
− Tanggal Berobat : ... − No. MR. : ... − Nama : ... − Umur : ... − Jenis Kelamin : ... − Suku : ... − Pekerjaan : ... − Alamat : ... − No. Telp./HP. : ... Anamnesis Keluhan : Riwayat penyakit :
Riwayat gangguan pendengaran = + / – Riwayat penggunaan obat ototoksik = + / – Riwayat trauma kepala = + / – Riwayat gangguan pendengaran pada keluarga = + / –
Pemeriksaan Fisik
Telinga Kanan Kiri
− Daun telinga − Liang telinga − Membran timpani Normal / Abnormal Normal / Abnormal Utuh / Perforasi Bulging + / – Hiperemis + / – Normal / Abnormal Normal / Abnormal Utuh / Perforasi Bulging + / – Hiperemis + / –
Hidung Kanan Kiri
Rhinoskopi anterior − Kavum nasi − Konka inferior − Septum − Mukosa Lapang / Sempit Normal/Edema/Hipertropi Normal / Deviasi Hiperemis + / – Lapang / Sempit Normal/Edema/Hipertropi Normal / Deviasi Hiperemis + / – Orofaring : Diagnosa :
Pemeriksaan Audiometri Nada Murni (Sebelum Kemoterapi)
Telinga kanan
Hantaran udara = ……… dB Hantaran tulang = ……… dB
Telinga kiri
Hantaran udara = ……… dB Hantaran tulang = ……… dB
Pemeriksaan Laboratorium Darah (Sebelum Kemoterapi)
Hb Ureum Kreatinin KGD Kemoterapi I = Gejala tinitus = +/-
- Audiometri Nada Murni (Pasca Kemoterapi I)
Telinga kanan Hantaran udara = ……… dB Hantaran tulang = ……… dB Telinga kiri Hantaran udara = ……… dB Hantaran tulang = ……… dB
–Pemeriksaan Laboratorium Darah : − Hb − Ureum − Kreatinin − KGD Kemoterapi Siklus II Gejala tinitus = +/-
- Audiometri Nada Murni (Pasca Kemoterapi II)
.1. Telinga kanan Hantaran udara = ……… dB Hantaran tulang = ……… dB Telinga kiri Hantaran udara = ……… dB Hantaran tulang = ……… dB –Pemeriksaan Laboratorium Darah :
− Hb − Ureum − Kreatinin − KGD
Kemoterapi Siklus III
Gejala tinitus = +/-
- Audiometri Nada Murni (Pasca Kemoterapi II)
1. Telinga kanan Hantaran udara = ……… dB Hantaran tulang = ……… dB Telinga kiri Hantaran udara = ……… dB Hantaran tulang = ……… dB –Pemeriksaan Laboratorium Darah :
− Hb − Ureum − Kreatinin − KGD
