17. Dr. Hertati - Karsinoma Nasofaring

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    KARSINOMA NASOFARING

    BLOK . XX

    OLEH

    Dr.B.R.HERTATI.SIAHAAN.,MPd

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    Karsinoma Nasofaring

    T!mor ganas dida"ra# $"%a&a dan &"#"r 'ang

    ("r)an'a$ di Indon"sia

    *+ (!mor ganas nasofaring

    - (!mor ganas #id!ng / sin!s %aranasa&

    -* (!mor ganas &aring

    T!mor ganas rongga m!&!(, (onsi&, #i%ofaring

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    Ras mongo&oid m"r!%a$an fa$(or dominan(im)!&n'a $an$"r nasofaring

    0!$!% (inggi %ada 0ina s"&a(an, Hong$ong,

    1i"(nam, T#ai&and, Ma&a'sia, Singa%!ra,Indon"sia

    P"n'")a)n'a 1ir!s E%s("in Barr

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    G"2a&a dan Tanda

    Da%a( di)agi 3 $"&om%o$ 4

    -. G"2a&a Nasofaring

    5. G"2a&a T"&inga

    6. G"2a&a Ma(a3. G"2a&a Saraf

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    -. G"2a&a Nasofaring 4

    "%is(a$sis

    5. G"2a&a T"&inga 7

    (ini(!s, o(a&gia6. G"2a&a Ma(a 4

    di%&o%ia

    3. G"2a&a saraf 4

    gangg!an saraf o(a$ $" IX, X, XI, XII

    M"(as(as" $" K"&.L"#"r da&am )"n(!$ B"n2o&an di&"#"r

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    Diagnosis Pas(i

    Bio%si Nasofaring

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    HISTOPATOLOGI

    T"&a# dis"(!2!i o&"# 8HO ada 6 )"n(!$ 4

    $arsinoma s"& s$!amosa 9 )"r$"ra(inisasi:

    $arsinoma (ida$ )"r$"ra(inisasi

    $arsinoma (ida$ )"rdiff"rinsisasi

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    TERAPI

    RADIOTERAPI

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    ANGIOFIBROMA NASOFARING

    T!mor 2ina$ %"m)!&!# dara# di Nasofaring

    S";ara His(o&ogis

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    ETIOLOGI

    )"&!m 2"&as di$"(a#!i

    !m!mn'a ("r2adi %ada &a$i &a$i d"$ad" 5

    an(ara = > -? (a#!n, 2arang ("r2adi %ada!sia @ 5 (a#!n

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    PATOGENESIS

    T!mor %"r(ama $a&i (!m)!# di)aa# m!$osa

    di("%i %os("rior / &a("ra& $oana dia(a% nasofaring

    T!mor a$an (!m)!# )"sar dan m"&!as di)aa#

    m!$osa, s"%an2ang a(a% nasofaring, m"n;a%ai("%i %os("rior s"%(!m dan m"&!as $"ara# )aa#

    m"m)"n(!$ (on2o&an masa $"a(a% rongga

    #id!ng %os("rior

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    P"r&!asan $"ara# an("rior a$an m"ngisi rongga

    #id!ng, m"ndorong s"%(!m $"sisi $on(ra &a("ra&

    dan m"mi%i#$an $on$a

    P"r&!asan $"ara# &a("ra&, (!mor m"&")ar $"ara#foram"n s%#"no%a&a(ina, mas!$ $" fosa

    in(ra("m%ora& 'ang a$an m"nim)!&$an )"n2o&an

    di%i%i, dan rasa %"n!# dia2a#.

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    A%a)i&a (!mor ("&a# m"ndorong sa&a# sa(!

    a(a! $"d!a )o&a ma(a ma$a (am%a$

    g"2a&a 'ang $#as %ada a2a#

    'ang dis")!( C a2a# $odo$ C

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    P"r&!asan $" in(ra$rania& da%a( ("r2adi

    m"&a&!i fosa infra ("m%ora& dan

    %("rigoma$si&a mas!$ $" fosa ;"r")ri

    m"dia.

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    Dari sin!s "(moid mas!$ $" fosa ;"r")ri

    an("rior

    A(a! dari sin!s sf"noid $" sin!s

    ;a"rnos!m dan fosa #i%ofis"

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    G"2a&a 4

    #id!ng ("rs!m)a( 'ang %rogr"sif

    "%is(a$sis )"r!&ang 'ang masif

    o)s(r!$si #id!ng m"m!da#$an ("r2adin'a%"nim)!nan s"$r"( s"#ingga (im)!&

    rinor"a $ronis 'ang dii$!(i o&"# gangg!an

    %"n;i!man

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    (!)a "!s(a;#i!s a$an m"nim)!&$an

    $"(!&ian a(a! o(a&gia

    s"fa&gia #")a( m"n!n2!$$an )a#a (!mor

    s!da# m"&!as $" in(ra$rania&

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    TMOR LARING

    T!mor 2ina$ Laring (ida$ )an'a$ di("m!$an

    #an'a $!rang &")i# dari s"m!a 2"nis

    (!mor &aring.

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    TMOR

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    PAPILOMA LARING

    T!mor ini da%a( digo&ong$an da&am 5 2"nis 4

    -.Pa%i&oma Laring

    )"r)"n(!$ m!&(i%"& m"nga&ami r"gr"si %ada a$(! d"asa

    5.Pada orang d"asa

    )iasan'a )"r)"n(!$ (!ngga& (ida$ a$an m"nga&ami r"so&!si

    m"r!%a$an %r"$an$"r

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    GE

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    Diagnosa

    B"rdasar$an 4

    Anamn"sis G"2a&a $&inis

    Bio%si %"m"ri$saan P.Ana(omi

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    TMOR GANAS LARING

    B!$an&a# #a& 'ang 2arang di("m!$an dan masi#

    m"r!%a$an masa&a#

    RS.0i%(o Karsinoma Laring m"nd!d!$i !r!(an$" 6 s"("&a# 0a.Nasofaring dan (!mor ganas

    #id!ng dan sin!s %aranasa&

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    E(io&ogi

    )"&!m di$"(a#!i d"ngan %as(i

    orang 'ang )"risi$o (inggi 4

    %"ro$o$

    a&$o#o&

    sinar radioa$(if

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    HISTOPATOLOGI

    0ar;inoma S"& S$!amosa 9? > ? :

    di)agi 6 (ing$a( diff"r"nsiasi 4

    a. Grad" - 4 diff"r"nsiasi )ai$). Grad" 5 4 diff"r"nsiasi s"dang

    ;. Grad" 6 4 diff"r"nsiasi

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    G"2a&a 4

    s!ara s"ra$ 9 !(ama :

    dis%n"a dan s(ridor

    n'"ri ("nggoro$

    disfagia

    rasa n'"ri $"(i$a m"n"&an

    )a(!$ dan #"mo%(isis

    )"ra( )adan (!r!n

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    DIAGNOSA

    anamn"sis

    %"m"ri$saan $&inis

    %"m"ri$saan &a).dara#

    %"m"ri$saan Radio&ogi

    %"m"ri$saan 0T.S;an

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    DIAGNOSA PASTI

    Bio%si Laring

    Bio%si 2ar!m #a&!s

    Kirim $" La).Pa(o&ogi Ana(omi

    Hasi& 'ang ("r)an'a$ 4

    C KARSINOMA SEL SKAMOSA