17. Dr. Hertati - Karsinoma Nasofaring
-
Upload
sjane-tadjang -
Category
Documents
-
view
219 -
download
0
Transcript of 17. Dr. Hertati - Karsinoma Nasofaring
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
1/29
KARSINOMA NASOFARING
BLOK . XX
OLEH
Dr.B.R.HERTATI.SIAHAAN.,MPd
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
2/29
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 å
T!mor ganas rongga m!&!(, (onsi&, #i%ofaring
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
3/29
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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
4/29
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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
5/29
-. 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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
6/29
Diagnosis Pas(i
Bio%si Nasofaring
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
7/29
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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
8/29
TERAPI
RADIOTERAPI
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
9/29
ANGIOFIBROMA NASOFARING
T!mor 2ina$ %"m)!&!# dara# di Nasofaring
S";ara His(o&ogis
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
10/29
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
11/29
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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
12/29
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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
13/29
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#.
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
14/29
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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
15/29
P"r&!asan $" in(ra$rania& da%a( ("r2adi
m"&a&!i fosa infra ("m%ora& dan
%("rigoma$si&a mas!$ $" fosa ;"r")ri
m"dia.
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
16/29
Dari sin!s "(moid mas!$ $" fosa ;"r")ri
an("rior
A(a! dari sin!s sf"noid $" sin!s
;a"rnos!m dan fosa #i%ofis"
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
17/29
G"2a&a 4
#id!ng ("rs!m)a( 'ang %rogr"sif
"%is(a$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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
18/29
(!)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&
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
19/29
TMOR LARING
T!mor 2ina$ Laring (ida$ )an'a$ di("m!$an
#an'a $!rang &")i# dari s"m!a 2"nis
(!mor å.
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
20/29
TMOR
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
21/29
PAPILOMA LARING
T!mor ini da%a( digo&ong$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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
22/29
GE
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
23/29
Diagnosa
B"rdasar$an 4
Anamn"sis G"2a&a $&inis
Bio%si %"m"ri$saan P.Ana(omi
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
24/29
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$" 6 s"("&a# 0a.Nasofaring dan (!mor ganas
#id!ng dan sin!s %aranasa&
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
25/29
E(io&ogi
)"&!m di$"(a#!i d"ngan %as(i
orang 'ang )"risi$o (inggi 4
%"ro$o$
a&$o#o&
sinar radioa$(if
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
26/29
HISTOPATOLOGI
0ar;inoma S"& S$!amosa 9? > ? :
di)agi 6 (ing$a( diff"r"nsiasi 4
a. Grad" - 4 diff"r"nsiasi )ai$). Grad" 5 4 diff"r"nsiasi s"dang
;. Grad" 6 4 diff"r"nsiasi
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
27/29
G"2a&a 4
s!ara s"ra$ 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
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
28/29
DIAGNOSA
anamn"sis
%"m"ri$saan $&inis
%"m"ri$saan &a).dara#
%"m"ri$saan Radio&ogi
%"m"ri$saan 0T.S;an
-
7/24/2019 17. Dr. Hertati - Karsinoma Nasofaring
29/29
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