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REFERAT

DIAGNOSIS DAN PENATALAKSANAAN


ADENOMA PLEIMORFIK PAROTIS

Oleh :

Donny Hendriyanto
S 921608002

Pembimbing :

Dr. dr. Made Setiamika, Sp.T.H.T.K.L(K), FICS

PROGRAM PENDIDIKAN DOKTER SPESIALIS I ILMU KESEHATAN THT.KL

FAKULTAS KEDOKTERAN UNIVERSITAS SEBELAS MARET/

RSUD Dr. MOEWARDI

SURAKARTA

2018
LEMBAR PENGESAHAN

Telah dipresentasikan Referat dengan judul

DIAGNOSIS DAN PENATALAKSANAAN


ADENOMA PLEIMORFIK PAROTIS

Oleh

Donny Hendriyanto

Pada Hari/Tanggal : Selasa, 5 Juni 2018

Tempat : Ruang Perpustakaan SMF/Bag. I K THT-KL


Gedung Wijaya Kusuma Lt.3 RSUD. Dr. Moewardi
Surakarta

Mengetahui

Pembimbing

Dr. dr. Made Setiamika, Sp.T.H.T.K.L(K), FICS (....................)

NIP. 195507271983121002

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Evaluator

1. dr. Imam Prabowo, Sp.T.H.T.K.L (K), FICS (.....................)

NIP. 197005132010011002

2. dr. Dewi Pratiwi, Sp.T.H.T.K.L, M.Kes (.....................)

NIP. 198105152015042002

Penguji

1. dr. Hadi Sudrajad, Msi.Med, Sp.T.H.T.K.L (K) (....................)

NIP. 196604222000121001

2. dr. S. Hendradewi, Msi.Med, Sp.T.H.T.K.L (K) (....................)

NIP. 196511212010012001

3. dr. Vicky Eko N.H., Msc, Sp.T.H.T.K.L (K) (.....................)

NIP. 197709142005011001

4. dr. Novi Primadewi, Sp.T.H.T.K.L, M.Kes (…………….)

NIP. 197511292008122002

5. dr. Putu Wijaya Kandhi, Sp.T.H.T.K.L (K) (.....................)

NIP. 197806202011011004

6. dr. Niken Dyah Aryani, Sp.T.H.T.K.L, M.Kes (.....................)

7. dr. Bayu Aristanto, Sp.T.H.T.K.L, M.Kes (.....................)

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DAFTAR ISI

HALAMAN JUDUL ...................................................................................................... ...

LEMBAR PENGESAHAN ................................................................................................ i

DAFTAR ISI ...................................................................................................................... iii

DAFTAR GAMBAR ....................................................................................................... .. v

ABSTRAK ......................................................................................................................... vi

ABSTRACT ....................................................................................................................... vii

BAB I . PENDAHULUAN ……………...……...…………..…...................................... 1

A. Latar Belakang .............................................................................................. . 1

B. Tujuan ............................................................................................................ 2

BAB II . TINJAUAN PUSTAKA ………...………………….…..................................... 3

A. Definisi .......................................................................................................... 3

B. Anatomi dan Fisiologi Kelenjar Parotis ........................................................ 3

C. Diagnosis ........................................................................................................ 8

1. Anamnesis .................................................................................................. 8

2. Pemeriksaan Fisik ..................................................................................... 9

3. Pemeriksaan Penunjang ............................................................................ 10

D. Diagnosis Banding .......................................................................................... 15

E. Penatalaksanaan ............................................................................................. 15

1. Pembedahan ............................................................................................. 15

2. Radioterapi ............................................................................................... 24

F. Prognosis ....................................................................................................... 25

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BAB III . KESIMPULAN ..........…………..…........……………….................................. 26

DAFTAR PUSTAKA ………………………………………………................................ 27

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DAFTAR GAMBAR

Gambar 2.1. Anatomi kelenjar parotis (Walvekar, 2014) ..........…………….…... 6

Gambar 2.2. Beberapa variasi percabangan nervus facialis (Walvekar, 2014) ...... 7

Gambar 2.3. Adenoma pleimorfik ( Eveson, 2005) .............................................. 9

Gambar 2.4. Pergeseran tonsil (Ferris, Spiro; 2009) .............................................. 10

Gambar 2.5. CT Scan Adenoma pleimorfik ( Eveson, 2005) ............................... 12

Gambar 2.6. MRI Adenoma pleimorfik parotis kanan ( Eveson, 2005) ................ 13

Gambar 2.7. Histopatologi adenoma pleimorfik (Eveson, 2005) .........…….…..... 14

Gambar 2.8. Garis incisi parotidektomi (Yussi, 2013) ........................….....…...... 19

Gambar 2.9. Teknik Parotidektomi (Russell, 2014) ...................……………........ 21

Gambar 2.10. Teknik Parotidektomi (lanjutan) (Russell, 2014) ...…….....…….... 21

Gambar 2.11. Diseksi Microsurgical (Nicoli, 2017) ...…….....……...................... 24

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Diagnosis dan Penatalaksanaan Adenoma Pleimorfik Parotis
Donny Hendriyanto, Made Setiamika
Bagian/ SMF I.K THT-KL Fakultas Kedokteran UNS / RSUD dr. Moewardi
Surakarta

Abstrak

Latar Belakang : Adenoma pleomorfik merupakan tumor kelenjar liur yang paling
banyak ditemukan, dengan sekitar 85% ditemukan pada kelenjar parotis, sebagian
besar asimptomatik, tumbuh lambat, dan berbentuk massa soliter.

Pembahasan : Diagnosis ditegakkan berdasarkan anamnesis, gambaran klinis,


pemeriksaan radiologi dan pemeriksaan histopatologi tumor. Penatalaksanaan
adenoma pleomorfik parotis adalah pembedahan, dengan mengangkat tumor secara
komplit tanpa meninggalkan sisa. Pembedahan yang tidak adekuat untuk
mengangkat seluruh tumor dapat mengakibatkan kekambuhan, metastase dan
keganasan.

Kesimpulan : Adenoma pleimorfik mempunyai prognosis yang baik jika


ditatalaksana dengan baik.

Kata kunci : adenoma pleimorfik, parotis, penatalaksanaan

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Diagnostic and Management of Pleimorphic Adenoma Parotid
Donny Hendriyanto, Made Setiamika
Departement of Otorhinolaryngology Faculty of Medicine Sebelas Maret University
/ dr. Moewardi Hospital Surakarta

Abstract
Background : The pleomorphic adenoma is the most common benign salivary
gland tumour, with approximately 85% of cases are in parotid gland, mainly
asymptomatic, growing slowly, and shaped solitary mass.

Discussion : Diagnose was taken from anamnesis, physical examination, radiologic


finding and histopathology. The management for pleomorphic adenoma is complete
surgical excision. Inadequate surgery can present recurrence, metastazing and
transfrom in to malignancy.

Conclusion : Phleimorphic adenoma has a good prognostic if have been


management properly.

Keywords : phleimorphic adenoma, parotid, management

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