Laryngopharyngeal reflux (LPR) can contribute to chronic rhinosinusitis (CRS). Pepsin is believed to be one of the causes of CRS. Pepsin can be a promising biomarker because it is only produced by gastric parietal cells, so it can explain the correlation of CRS with LPR. This study aims to determine the relationship between CRS and LPR based on nasal pepsin examination. The design in this study is a cross-sectional prospective with statistical analysis using the Chi-square method. The research sample were patients with complaints of runny nose and nasal congestion within 12 weeks and met the inclusion and exclusion criteria. All samples were subjected to nasal endoscopy and fiber optic laryngoscope and have Reflux Symptoms Index (RSI) > 13. Specimens from the samples were obtained through the nasal washing method, and pepsin was evaluated using the PepTest lateral flow device. A total of 35 samples in this study consisted of 13 men (37.14%) and 22 women (62.85%). The highest age in the CRS group was the 18-40-year-old group with 16 (64%). A total of 20 (83.3%) CRS patients were positive for pepsin p=0.04 (p<0.05).

Antrochoanal polyp (ACP) are benign lesions that originate from the mucosa of the maxillary sinus, and extend into the nasal cavity to reach the choana and nasopharynx. The treatment of ACP is surgical, endoscopic medial maxillectomy (EMM) is one of the options for surgical therapy. ACP generally affects adolescents but in this case by adults. To report and analyze ACP in adult patient with EMM technique. A 45-year-old man with an ACP completely removed by EMM technique. The evidence-based literature regarding the ACP, their management, and its complications were conducted on the Pubmed Medline, PMC and Google Scholar database. Based on the inclusion and exclusion criteria, two studies were found relevant to our case. From sources in two journals, both are retrospective studies with the ACP completely removed with endoscopic medial maxillectomy technique and the other is a retrospective descriptive study. Complete ACP removal with the EMM technique. There was no complications during and after surgery and we had no recurrences during the control period.

Introduction: Nasopharyngeal carcinoma (NPC) is one of the common head and neck malignancies found in Indonesia. Diagnosis was based on histopathological result of tumor tissues taken from the nasopharynx. Histopathological from nasopharyngeal blind biopsy remains a golden standard of NPC diagnosis. Blind biopsy causes many problems for patients including pain sensation, risk of bleeding and traumatic effect. Another technique for obtaining specimen for evaluation malignant cells of nasopharynx was by cytological investigation. Cytology evaluation could detect malignant cells from smear specimen. Cytological specimen could be obtained from nasopharynx by brushing method. Cells are collected by brushing then processed with liquid-based technique; specimens were smeared and stained for cytology evaluation. Since nasopharynx location is invisible, then nasopharyngoscopy guidance was used to obtain a brushing specimen. Objective: To analyze an agreement between cytological results from nasopharyngeal brushing under nasopharyngoscopy and histopathological results from blind biopsy as a golden standard for the detection of malignant cells in NPC patients. Method: Diagnostic test with the cross-sectional comparative study. Population of this study was NPC patients who came to outpatient Department of Otorhinolaryngology Head and Neck Surgery Dr. Soetomo Hospital Surabaya. Samples were collected with consecutive sampling method during February until May 2011. During that period we obtained 36 patients as study samples. First we performed brushing method under nasopharyngoscopy guidance and then blind biopsy of nasopharynx on each patient. Cytology preparation processed with liquid-based technique liquiPREP and Papanicolaou stain. Histopathologic preparation used hematoxylin and eosin (H&E) stain. Sample data was tested by McNemar test and Kappa association test. Result: 36 samples were obtained consisted of 27 male (75%) and 9 female (25%). The result for cytological evaluation in detecting malignant cells of NPC patients was sensitivity 87.10%, specificity 80%, positive predictive value 96.43%, negative predictive value 50% and accuracy 86.11%. Statistically, analysis result with McNemar test was no significant difference and from Kappa association test there was a significant association between brushing method under nasopharyngoscopy guidance and blind biopsy. Conclusion: There was an agreement between brushing method under nasopharyngoscopy guidance and blind biopsy in detecting malignant cells of NPC.

Background: Nasal polyps are benign chronic inflammatory masses with epithelial tissues of the nasal mucosa and paranasal sinuses. The clinical diagnosis is made based on sinonasal symptoms for more than three months and the presence of polyps in the nasal cavity. The classification of nasal polyps based on the histopathological structure is divided into three types, i.e., oedematous, eosinophilic polyps, inflammatory polyps, and chronic seromucous inflammatory polyps. This study aims to describe the profile of patients with nasal polyps at Dr. Soetomo Public Hospital Surabaya. Methods: This study applied a descriptive method with a retrospective approach by obtaining data from the medical records of the outpatient unit in the Ear, Nose, Throat, and Head-Neck (ENT-HN) Department of Dr. Soetomo Public Hospital Surabaya for the period January 2017-December 2018 based on age, gender, clinical symptoms, symptoms duration, polyp types, location of nasal polyp, and comorbidities. Results: The number of patients with nasal polyps was slightly more in women, as many as 13 patients or 52%, mostly aged 51-60 years old, amounting to 11 patients or 44%. The most common clinical symptom experienced by patients was nasal obstruction, as many as 24 patients or 96%. Patients who experienced symptom duration for one to three years before treatment amounted to 13 patients or 52%. Patients with histopathology of inflammatory nasal polyps were 19 patients or 76%, while patients of nasal eosinophil polyps were six patients or 24%. Additionally, patients with comorbidity in nasal polyps of allergic rhinitis medical history were 11 patients or 44%. Also, bilateral nasal polyps were mostly experienced by patients, reaching 14 patients or 56%. Conclusion: This study reveals nasal polyps in women aged 51-60 years with clinical symptoms of nasal obstruction with the results of a histopathological examination of the inflammation type at bilateral polyps.

Introduction: Rhinosinusitis and allergic rhinitis are common health problems. Allergic rhinitis patients tend to have edema on their nasal mucosa, disrupted cilia, and excessive secrete production that clogged paranasal sinuses’ ostiums and lead to inflammation and infection of the paranasal sinuses. There is still a contradiction of allergic rhinitis as predisposing factor of rhinosinusitis. Those correlation is not yet clear, thus we aim to analyze the correlation between allergic rhinitis and rhinosinusitis.Methods: This study was a cross-sectional design. The samples were obtained by consecutive sampling. Adult patients above 19 years old with nasal discharge were examined by the doctors on duty and interviewed. Medical data obtained was recorded and analyzed using chi square test.Results: From 98 patients, 17 patients (17.35%) had both rhinosinusitis and allergic rhinitis, 48 patients (48.98%) only had rhinosinusitis, and 13 patients (13.26%) only had allergic rhinitis. Patients who had neither rhinosinusitis nor allergic rhinitis reported to be 20 patients (20.41%). Chi square test showed that allergic rhinitis had no significant correlation with rhinosinusitis (p=0.266).Conclusion: There is no significant correlation between allergic rhinitis and rhinosinusitis. Rhinosinusitis is a multifactorial disease.