Peningkatan functional oral intake scale dan kualitas hidup pada miastenia gravis pasca rehabilitasi menelan

Abstract

Latar belakang: Miastenia gravis (MG) merupakan penyakit autoimun yang mengganggu transmisineuromuskular karena berkurangnya reseptor asetilkolin di tautan saraf otot sehingga dapat menyebabkandisfagia orofaring. Disfagia pada MG dapat menyebabkan aspirasi yang meningkatkan morbiditas,mortalitas, dan menurunnya kualitas hidup.Tujuan: Menganalisis perbaikan disfagia orofaring padapasien MG dengan melihat peningkatan functional oral intake scale (FOIS) pada pemeriksaan fiberopticendoscopic evaluation of swallowing (FEES) dan untuk mengetahui perbaikan kualitas hidup denganmenggunakan swallowing quality of life (SWAL-QoL) pasca program rehabilitasi menelan.Metode:Penelitian ini merupakan quasi experimental open label pre and post-test design dan data dianalisisdengan menggunakan uji Wilcoxon. Penelitian berlangsung di Poliklinik Ilmu Kesehatan Telinga HidungTenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung sejak Januari − April 2013 pada10 subjek penelitian. Diagnosis dibuat berdasarkan anamnesis, pemeriksaan fisik, penilaian FOIS denganmelihat konsistensi makanan yang aman ditelan berdasarkan temuan pemeriksaan FEES sebelum dansesudah mengikuti program rehabilitasi menelan selama 6 minggu dan penilaian kualitas hidup dengankuesioner SWAL-QoL.Hasil: Didapatkan perbedaan bermakna (p=0,002) pada hasil FOIS dan perbedaanbermakna pada seluruh domain kuesioner SWAL-QoL setelah program rehabilitasi menelan (p<0,05).Kesimpulan: Terdapat peningkatan FOIS sebagai perbaikan disfagia orofaring, serta peningkatan kualitashidup pada pasien MG sesudah program rehabilitasi menelan. Kata kunci: Disfagia, miastenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopicevaluation of swallowing (FEES), kualitas hidup ABSTRACTBackground: Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmissionassociated with acetylcholine receptor deficiency at the neuromuscular junction which may causeoropharyngeal dysphagia. Oropharyngeal dysphagia in MG patients can cause aspiration which result inmorbidity, mortality, and decreased quality of life. Objective: To analyze the improvement of oropharyngealdysphagia in MG patients by evaluating the functional oral intake scale (FOIS) on fiberoptic endoscopicevaluation of swallowing (FEES) examination and to determine the improvement of quality of life byswallowing quality of life (SWAL-QoL). Method: This study was an open label quasi experimental pre andpost-test design and the data was analyzed using the Wilcoxon statistical test. This study was conductedin Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin General Hospital duringJanuary until April 2013 towards 10 subjects. Diagnosis based on anamnesis, physical examination,FOIS assessment in order to describe the consistency of safe food ingested during FEES examinationand SWAL-QoL questionnaire assessment before and after swallowing rehabilitation programme for 6weeks. Results: There were significant differences (p=0.002) in FOIS result and significant differencesin all domains SWAL-QoL questionnaire after swallowing rehabilitation program (p<0.05). Conclusion:There was an improvement of oropharyngeal dysphagia as seen in increased FOIS score and improvementof quality of life after swallowing rehabilitation program. Keywords: Dysphagia, myasthenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopyevaluation of swallowing (FEES), quality of life Alamat korespondensi: Dr. Erlina Julianti, Sp.THT-KL.,M.Kes. RSUD Kabupaten Bekasi, CibitungBekasi. Email: erlina.julianti@gmail.com.

Endoscopic Evaluation of Swallowing in Patient with Tetanus Followed by Myasthenia Gravis as Its Complication

“…One of the muscles affected is the chewing and swallowing muscles which cause dysphagia. 11 This paper aims to report a case of the role of FEES in patients with dysphagia, which is an early symptom of tetanus followed by myasthenia gravis complications.…”