Electronic Theses and Dissertation

Latar Belakang: Disfagia merupakan gangguan menelan yang timbul akibat kelainan struktural atau fungsional pada organ-organ yang terlibat dalam fase menelan. Disfagia terjadi pada 10-89% pasien setelah laringektomi total. Neofaring yang terbentuk setelah laringektomi total memengaruhi tahap menelan akibat perubahan anatomi dan fisiologi laring setelah operasi. Evaluasi kemampuan menelan pada pasien pasca laringektomi total dapat menggunakan pemeriksaan instrumental dengan Fiberoptic Endoscopic Evaluation of Swallowing (FEES) dan pemeriksaan noninstrumental dengan kuisioner Swallowing Outcome After Laryngectomy (SOAL) yang merupakan alat ukur sensitif dan tervalidasi untuk mengevaluasi perubahan yang terjadi pada proses menelan pasca laringektomi total. Tujuan: Mengetahui akurasi kuesioner SOAL terhadap hasil pemeriksaan FEES pada pasien pasca laringektomi total. Metode: Jenis penelitian ini merupakan studi uji diagnostik dengan desain cross sectional. Penelitian dilakukan di Poliklinik T.H.T.B.K.L RSUDZA sejak bulan Juni-September 2025 pada pasien pasca laringektomi total yang sudah lebih dari 3 bulan. Tahapan yang dilakukan berupa anamnesis, pemeriksaan fisik THT, penilaian skor kuisioner SOAL dan pemeriksaan FEES. Hasil: Didapatkan 17 pasien pasca laringektomi total dengan kelompok usia terbanyak 41-60 tahun (58,8%) dan jenis kelamin seluruhnya laki-laki. Mayoritas responden mengalami disfagia (82,4%) dan hanya 3 (17,6%) responden tidak mengalami disfagia. Didapatkan nilai 100% pada uji sensitivitas dan spesifisitas kuisioner SOAL terhadap hasil pemeriksaan FEES. Berdasarkan uji Cohen’s Kappa didapatkan kesepakatan atau akurasi yang signifikan antara kuisioner SOAL dengan hasil pemeriksaan FEES (p-value= 0,000). Kesimpulan: Penilaian kuesioner SOAL dan pemeriksaan FEES memiliki akurasi yang baik sebagai alat skrining klinis untuk mendeteksi disfagia pada pasien pasca laringektomi total.

Kata kunci: Disfagia, Pasca Laringektomi Total, Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Swallowing Outcome After Laryngectomy (SOAL)

Background: Dysphagia is a swallowing disorder that arises due to structural or functional abnormalities in the organs involved in the swallowing phase. Dysphagia occurs in 10-89% of patients after total laryngectomy. The neopharynx formed after total laryngectomy affects the swallowing phase due to changes in the anatomy and physiology of the larynx after surgery. Evaluation of swallowing ability in patients after total laryngectomy can use instrumental examination with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and non-instrumental examination with the Swallowing Outcome After Laryngectomy (SOAL) questionnaire which is a sensitive and validated measurement tool to evaluate changes that occur in the swallowing process after total laryngectomy. Objective: To determine the accuracy of the SOAL questionnaire against the results of the FEES examination in patients after total laryngectomy. Methods: This type of research is a diagnostic test study with a cross-sectional design. The study was conducted at the ENT Clinic of RSUDZA from June to September 2025 in patients after total laryngectomy who had been more than 3 months old. The stages carried out were anamnesis, ENT physical examination, assessment of the SOAL questionnaire score and FEES examination. Results: There were 17 patients after total laryngectomy with the largest age group being 41-60 years (58.8%) and all male. The majority of respondents experienced dysphagia (82.4%) and only 3 (17.6%) respondents did not experience dysphagia. A value of 100% was obtained in the sensitivity and specificity test of the SOAL questionnaire against the results of the FEES examination. Based on the Cohen’s Kappa test, a significant agreement or accuracy was found between the SOAL questionnaire and the results of the FEES examination (p-value = 0.000). Conclusion: The SOAL questionnaire assessment and FEES examination have good accuracy as a clinical screening tool to detect dysphagia in patients after total laryngectomy Keywords: Dysphagia, Post Total Laryngectomy, Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Swallowing Outcome After Laryngectomy (SOAL)