DYSFAGIA PASCA STROKE

Penemuan endoskopi laring dan esofagoskopi:
1.Oral/laryngeal candidiasis
2.Parese palatum molle
3.Parese (adduktor) N.recurrens(pita suara kiri)
4.Tidak ditemukan penyempitan /sumbatan/tumor intra/ekstra luminal esofagus

ORAL CANDIDIASIS

These pictures showed oral candidiasis as viewed by flexible endoscope (fiberscope) passed through nasal cavity in a male person with diabetes mellitus and chronic sore throat and dysphonia.

ARGON BEAM COAGULATION TO CONTROL POST BIOPSY BLEEDING

Biopsy for suspected malignant lesions pose a post-biopsy bleeding risk.
One of the techniques to control this situation is by giving prae-biopsy "bleed- reduction medication" and/or doing coagulation using electrical discharges("electrocoagulation").
Using laser as a technique to control  bleedings might be an option,however we have  to be aware of possible "rebleedings"  due to the broken/abnormal walls of the neovascularisation of the tumor ("neoangiogenesis") or of the "feeding vessels".
Using cryo-techniques might be another possibility to counter bleeding with a special treatment for the biopsy specimen.
One should mention the possibility of reducing distant metastasis by this technique(by blood-born or lymph- vessels).
Tumor debulking by laser and/or cryosurgery may help conventional tumor surgery.(by "down- staging")
Endoscopic photo of this case of nasopharyngeal cancer biopsy was completed by argon beam coagulation to control post-biopsy bleeding.

KENAPA HIDUNG DITUTUP BALON MERAH?

Hidung adalah bagian tubuh  yang memiliki peran penting baik dari  segi anatomi,fungsional dan lokasi yang begitu sentral di wilayah muka atau wajah seseorang.
Gambar pertama diatas menunjukkan betapa penting peran hidung dalam proses berkomunikasi bahkan bisa dikatakan sebagai " landmark" seseorang yang mempunyai nilai estetika yang tinggi.
Orang akan segera tertarik perhatiannya  pada seseorang yang memiliki bentuk hidung yang aneh atau kurang sempurna sehingga penderita  besar kemungkinan akan  rela menjalani operasi plastik atau estetik untuk membuat bentuk hidungnya menjadi sempurna dan  indah.
Foto  kedua  menggambarkan peran fungsional hidung sebagai alat  yang bisa mengalami gangguan penciuman ("anosmia") yang  disebabkan (antara lain) oleh adanya polip hidung. Pada kasus ini adanya polip pada rongga hidung (hanya) dapat diketahui dan dipastikan melalui pemeriksaan endoskopi lubang hidung.(endoskopi nasal atau rhinoskopi,baik dengan endoskop lentur ("fiberscope") ataupun endoskop kaku ("rigid endoscope").
Selanjutnya polip dapat ditanggulangi dengan pembedahan minimal invasif melalui "endoscope".

NASOPHARYNGITIS:INFLAMMATORY AND/OR PRE-MALIGNANT CONDITION?

From our daily experiences of nasopharyngoscopy, we may be confused of the endoscopy results of patients with clinical symptoms of upper respiratory infections or allergies/inflammatory conditions.
As our working place is in the South East Asia,we are aware of the possibility of malignant lesions of the upper airways.(i.a. nasopharyngeal cancer and/or malignant lymphoma.)
The possibility of viral infections is our highest awareness to refer of the high incidences of Epstein- Barr virus infections with its implication in nasopharyngeal (epithelial) cancers.
If we look into our daily works,we can say that most of the cases were infections/inflammatory.Some of the cases showed granulomatous lesions/polypoid lesions as shown in these endoscopic pictures.

NASOGASTRIC INTUBATION UNDER VISUAL CONTROL

Nasogastric intubation (for feeding in indicated patient) might be done under visual control.
The procedure is best done in endoscopy room with the adequate resources for the procedure.
Topical anaesthesia of the nasopharyngeal and oral cavity is preferred for the convenience of the patient before the procedure.
The patient is asked to make  swallowing movements while the operator passing  the tip of the tube into the esophagus.
The visual control is done to prevent the tube from false passing into the  respiratory tract(laryngeal inlet).The picture shows the procedure in awake patient with no sedation.

ENDOSKOPI PASCA CHEMORADIASI CA LARING

Gambar menunjukkan tampilan endoskopi penderita Ca laring pada seorang pria berusia 56 tahun yang telah setahun sebelumnya menjalani pembedahan dan kemoradiasi.Meskipun fungsi pita suara membaik dan suara penderita tidak serak lagi,masih nampak selaput lendir (mukosa) laring  kemerahan dan pembengkakan /fibrosis laring pasca radiasi yang  memerlukan observasi lebih lanjut.