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Abstrak :
Latar Belakang: Pekerja mebel di Kelurahan Pondok Bambu adalah pekerja informal yang dalam pekerjaannya terpajan dengan pelarut organik seperti toluen. Telah terbukti adanya pengaruh pajanan toluen terhadap kejadian gangguan penghidu. Belum ditemukan prevalensi gangguan penghidu akibat pajanan kimia di tempat kerja di Indonesia. Gangguan penghidu ini sering kali tidak dikeluhkan oleh penderita. Menurunnya fungsi penghidu dapat mempengaruhi kesehatan dan keselamatan pekerja karena akan terus menginhalasi zat kimia berbahaya. Metode: Penelitian ini menggunakan desain potong lintang. Subjek adalah pekerja mebel di RW 01, Kelurahan Pondok Bambu yang berjumlah 44 orang. Pengumpulan data dilakukan melalui wawancara, pemeriksaan fisik, pemeriksaan fungsi penghidu dengan Sniffin Sticks dan pemeriksaan kadar lingkungan toluen dengan personal sampling. Hasil: Dari 44 subjek, 37 (84,1%) dari mereka mengalami gangguan penghidu, yang termasuk kategori risiko pajanan tinggi adalah 14 (31,8%) orang dan yang berisiko pajanan rendah 30 (68,2%) orang. Sebanyak 13 (92,9%) subjek yang berisiko tinggi mengalami gangguan penghidu, sedangkan yang berisiko rendah 24 (80%). Tidak didapatkan perbedaan yang bermakna antara kedua kelompok dengan terjadinya gangguan penghidu. Median Kadar toluen rata-rata adalah 0,48 ppm (0,002 – 7,72). Didapatkan hubungan yang bermakna antara kebiasaan merokok dengan gangguan penghidu, p = 0,02, OR = 26,4 ( IK 95% 1,59 - 453,77). Variabel lain seperti kebiasaan minum alkohol, gejala rinitis kronik dan riwayat atopi tidak ada yang secara signifikan berhubungan dengan gangguan penghidu. Kesimpulan: Kejadian gangguan penghidu pada subjek penelitian ini tidak berhubungan dengan besar risiko pajanan toluen di tempat kerjanya tetapi berhubungan dengan kebiasaan merokok. ...... Background: Workers at the furniture industry of Pondok Bambu village are informal workers who may be occupationally exposed to organic solvents such as toluene. The influence of toluene exposure on smell disorders has been proven. The prevalence of smell disorders due to chemical exposure in the workplace in Indonesia is not yet been found. Occupational- related smell disorder is rarely complained by the patient. Decreasing of smelling function can affect the health and safety of workers as he will continue to inhale harmful chemicals. Methods: This study used a cross-sectional design. 44 subjects recruited from the furniture industry in RW 01, Pondok Bambu village were studied. Data were collected through interviews, physical examination, quantitative smell function test with Sniffin Sticks and personal sampling airborne toluene levels measurement. Results: Among the fourty-four studied subjects, 37 (84.1%) subjects had smell disorder. Fourteen (31.8%) of them were categorized as high-risk exposure group and 30 (68.2%) as low-risk exposure group. Thirteen (92.9%) subjects from the high-risk exposure group had smell disorder, whereas from the low-risk group were 24 (80%) subjects. Exposure risk status was not statistically significant with smell disorder. The median score of airborne toluene levels is 0.48 ppm (range from 0.002 to 7.72). Smoking habit was the only variable that statistically significant with smell disorder, p = 0.02, OR = 26.4, (95% CI 1.59 to 453.77). Other variables such as alcohol consumption, chronic rhinitis symptoms and atopic history were not statistically significant. Conclusion: The smell disorders on the studied subjects is not associated with the exposure risk to toluene in the workplace but related to smoking habit.

Abstrak :
Latar belakang : Gangguan penghidu saat ini lebih disadari oleh masyarakat akibat terjadinya pandemi COVID-19. Tatalaksana gangguan penghidu pasca-virus belum disepakati secara universal meskipun beberapa obat telah diuji coba. Tujuan: Penelitian ini bertujuan mengetahui gambaran jenis dan derajat gangguan penghidu pasca-virus serta efektifitas kombinasi latihan penghidu ortonasal (LPO) dan protokol terapi penghidu terhadap perbaikan fungsi penghidu pasca-virus. Metode: Penelitian dilakukan bulan Februari – Mei 2022 di poliklinik THT-KL RSCM. Desain penelitian yang digunakan uji kuasi eksperimental 1 grup pre dan post test dengan 12 subjek gangguan penghidu yang terjadi mendadak pasca infeksi virus. Subjek penelitian dilakukan penilaian fungsi penghidu dengan uji penghidu alkohol (UPA), uji penghidu intravena (UPI) dan sniffin stick test (SST). Subjek penelitian diberikan kombinasi LPO dan protokol terapi hidung yang terdiri dari irigasi hidung, steroid intranasal, dekongestan topikal, omega-3 dan oles balsam aromatik selama 6 minggu kemudian dilakukan penilaian statistik. Hasil: Didapatkan hiposmia 8 subjek dan ansomia 4 subjek. Pada subjek hiposmia terdapat 2 subjek pantosmia dan 3 subjek parosmia, sedangkan pada subjek anosmia didapatkan 1 subjek pantosmia. Pada penelitian ini didapatkan 9 subjek jenis sensorineural dan 3 subjek jenis konduksi. Setelah dilakukan terapi didapatkan hasil siginifikan berdasarkan pemeriksaan UPA, UPI, diskriminasi, identifikasi dan total ADI (p<0,05). Kesimpulan: Karakteristik gangguan penghidu pada penelitian ini sesuai dengan jenis gangguan penghidu sensorineural dan konduksi serta derajat anosmia dan hiposmia. Kombinasi LPO dan protokol terapi hidung selama 6 minggu terbukti efektif pada gangguan penghidu pasca-virus. ......Background: Postviral olfactory dysfunction is becoming more aware of the public due to the COVID-19 pandemic. The management of chronic postviral olfactory dysfunction is still unknown, although several drugs have been tried, but the treatment is not universally agreed yet. Objective: This study was conducted to describe the types and degrees of postviral olfactory dysfunction and the effectiveness of the combination of orthonasal olfactory training and nasal protocols therapy on the improvement of postviral olfactory function. Methode: The research was conducted from February to May 2022 at ENT outpatient clinic Dr. Cipto Mangunkusumo hospital. The research design used was a quasi-experimental test with 1 pre and post-test group with 12 subjects with olfactory dysfunction that occurred suddenly after viral infection. The research subjects will be assessed for olfactory function using the alcohol sniff test (AST), the intravenous olfactory test (IOT) and the sniffin stick test (SST). Subjects will be given a combination of orthonasal olfactory training and a nasal protocol therapy consisting of nasal irrigation, intranasal steroids, topical decongestants, omega-3 and aromatic balsam for 6 weeks then statistical analysis was performed. Results: There were 8 subjects with hyposmia and 4 subjects with ansomia. In hyposmic subjects there are 2 phantosmia subjects and 3 parosmia subjects, while in anosmia subjects there are 1 subject with phantosmia. The types of post-viral olfactory disorders in this study were 9 sensorineural subjects and 3 conductive subjects. The results of statistical calculations of olfactory function after therapy were found to be significant based on AST, IOT, discrimination, identification and TDI (p<0.05). Conclusion: The characteristics of the olfactory dysfunction in this study are sensorineural and conduction olfactory dysfunction. The combination of orthonasal olfactory training and nasal protocol therapy for 6 weeks has been shown to be effective in improving olfactory function in postviral olfactory dysfunction.

Abstrak :
Latar belakang: SARS-CoV2, virus yang menyebabkan COVID-19 merupakan masalah kesehatan terbesar yang dihadapi dunia dewasa ini. Gangguan penghidu dan pengecap saat ini telah diakui menjadi suatu entitas gejala pada COVID-19 namun studi terkait evaluasi objektif dan tata laksana gangguan ini masih sangat terbatas. Tujuan penelitian: Mengetahui gambaran klinis gangguan penghidu pada COVID-19 berdasarkan uji penghidu alkohol (UPA) dan uji penghidu intravena (UPI) serta efektifitas terapi hidung sebagai tambahan terapi standar pasien COVID-19 dengan gangguan penghidu. Metode: Penelitian ini merupakan uji klinis acak terkontrol paralel dengan penyamaran tunggal pada 2 kelompok menggunakan 24 pasien terkonfirmasi COVID-19 yang mengalami gangguan penghidu dan dirawat di RS Cipto Mangunkusumo periode Juli-Oktober 2020. Penapisan gangguan penghidu menggunakan UPA dan dilanjutkan dengan UPI. Protokol terapi hidung yang digunakan terdiri dari steroid intranasal, cuci hidung Nacl 0,9%, dekongestan topikal dan balsam aromatik selama 2 minggu kemudian dilakukan analisis statistik perbedaan delta pada hasil pemeriksaan UPA dan UPI menggunakan Uji T independent atau Uji Mann Whitney. Hasil: Terdapat 4 subyek yang keluar dari penelitian dan analisis akhir dilakukan hanya pada 10 subyek per kelompok. Pada pengukuran awal didapatkan rerata nilai pengukuran UPA yang terganggu (kontrol 5,13 ± 3,79; terapi 2,6 ± 2,23). Pada pemeriksaan UPI didapatkan perlambatan onset UPI {kontrol 26 (8-300); terapi :131,5 (20-300)} penurunan nilai durasi {(kontrol:111 (0-182); terapi:44 (0-70)}. Uji perbedaan delta semua variabel pasca terapi didapatkan bahwa terdapat hasil perbedaan signifikan pada onset UPI kelompok terapi (p<0,001) dibandingkan kontrol. Terdapat peningkatan persentase perbaikan semua biomarka: UPA (170,13%), onset UPI (13,45%), dan durasi UPI (32,82%) pada kelompok terapi dibandingkan dengan kelompok kontrol dengan keunggulan persentase >10%. Kesimpulan: Karakteristik gambaran gangguan penghidu pada subyek COVID-19 pada penelitian ini sesuai dengan jenis gangguan penghidu sensorineural. Subyek pada kedua kelompok mengalami perbaikan gangguan penghidu pasca follow up 2 minggu. Pemberian terapi hidung memberikan nilai tambah dengan bukti awal perbaikan pada nilai onset UPI dibanding pemberian terapi standar saja. ......Background: SARS-CoV2, the virus that causes COVID-19, makes the disease biggest health problem the world facing today. Smell and taste disorders are currently recognized as a symptom entity in COVID-19, but studies related to objective evaluation and management of this disorder are still very limited. Aim : To evaluate the clinical presentation of olfactory disorders in COVID-19 based on the alcohol sniff test (AST) and the intravenous olfaction test (IOT) and the effectiveness of the nasal therapy protocol as an adjunct to standard therapy in COVID-19 patients with olfactory disorders. Methods: This study was a two-group single-blind randomized trial of 24 COVID-19 patients with olfactory disorders in Cipto Mangunkusumo General Hospital from July to October 2020. Assestment of olfactory function in this study was performed using AST and IOT. Screening for olfactory disorders performed using AST and followed by IOT. The nasal therapy used consisted of intranasal steroids, Nacl 0,9% nasal washing, topical decongestants and aromatic balms for 2 weeks. Statistical analysis of delta differences was carried based on the results of AST and IOT using independent T test or Mann Whitney test. Results: Four subject were lost to follow up. The final analysis was performed on each 10 subjects per group. The initial measurement showed all subjects included in this study have decreased AST value (control: 5.13 ± 3.79; therapy: 2.6 ± 2.23). Late onset IOT {control: 26 (8-300); therapy: 131.5 (20-300)}, decreased duration {(control: 111 (0-182); therapy: 44 (0-70)}. Statistical tests of delta differences of all post-therapy variabel found that there were significant results on delta IOT latency in the treatment group (p <0.001). There were difference of the percentage improvement of AST (170.13%), IOT onset (13.45%), and duration of IOT (32.82%) in the therapy group compared to the control group. with a percentage advantage >10% Conclusion: The characteristics of the olfactory disorder in COVID-19 subjects in this study were in accordance with the type of sensorineural olfactory disorders. Both subject of two groups have showed improvement in two weeks follow up. The administration of a nasal therapy provides early evidence of improvement in the IOT onset value compared to standard therapy alone.