Sinekia Palatum Molle dan Pilar Tonsil ke Dinding Faring Posterior pada Pasien Tuberkulosis Paru

Desno Marbun, Sinta Sari Ratunanda, Nur Akbar Aroeman, Agung Dinasti Permana

Abstract


Tuberkulosis paru masih merupakan penyakit infeksi yang sering dijumpai dan masalah kesehatan di dunia. Sinekia yang disebabkan oleh infeksi kronik tuberkulosis pada daerah faring merupakan kasus yang jarang terjadi. Pembentukan sinekia ini menyebabkan obstruksi saluran napas bagian atas dan dapat menyebabkan gangguan menelan. Laporan kasus ini dimaksudkan untuk memaparkan penatalaksanaan pasien tuberkulosis paru disertai kelainan sinekia palatum molle dan pilar tonsil ke dinding faring posterior. Seorang pasien laki-laki usia 40 tahun terdiagnosis tuberkulosis milier yang telah mendapatkan pengobatan antituberkulosis 4 bulan datang dengan keluhan hidung tersumbat, suara sengau, dan gangguan menelan sejak 2 bulan sebelum masuk rumah sakit. Dilakukan pelepasan sinekia dengan cara reseksi dan insisi palatum molle pendekatan intraoral dengan panduan endoskopi, didapatkan massa jaringan granuloma pada tepi sinekia tersebut. Hasil pemeriksaan histopatologi berupa jaringan granuloma tuberkulosis. Pascaoperasi pasien dapat bernapas lancar melalui hidung dan gangguan menelan menghilang. Simpulan, operasi pelepasan sinekia diputuskan mengingat gangguan obstruksi saluran napas atas. Penatalaksanaan sinekia palatum molle dan pilar tonsil ke dinding faring posterior dengan operasi memberikan hasil yang baik untuk patensi jalan napas dan fungsi menelan.

 

SINECHIA OF SOFT PALATE AND TONSILLAR PILLAR TO THE POSTERIOR PHARYNGEAL WALL AT PATIENT WITH PULMONARY TUBERCULOSIS

Pulmonary tuberculosis is still a common infection and world health problem. Sinechia at the pharyngeal region due to chronic infection of tuberculosis is a rare case. The sinechial formation causes upper airway obstruction and difficulty of swallowing. This case report was ment to present management of pulmonary tuberculosis with sinechia of soft palate and tonsilar pillar to the posterior pharyngeal wall. A 40-year-old man was diagnosed with milliary tuberculosis that had been undergone four months antituberculosis therapy complained nasal obstruction, hot potato voice and difficulty of swallowing since 2 months ago. Sinechia release had been performed with ressection and incission of soft palate transoral approach guiding endoscopy. We founded masses of granuloma at the edge of sinechia with histopatology result as tuberculosis granuloma. After the procedure, patient can breathed and swallowed normally. In conclusion, operational procedure had been decided due to upper airway obstruction. Operatif management for sinechia of soft palate and tonsillar pillar to the posterior pharyngeal wall brings a good result for upper airway pattency and swallow function.


Keywords


Palatum molle; pilar tonsil; pulmonary tuberculosis; sinechia; sinekia; soft palate; tonsillar pillar; tuberkulosis paru

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DOI: https://doi.org/10.29313/gmhc.v4i2.1802


pISSN 2301-9123 | eISSN 2460-5441

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