HIPERKES

Laring Faring

Pembimbing :
Dr. Magdalena

Penyusun :
salim
030.11.266
- -
KEPANITERAAN KLINIK ILMU
FAKULTAS KEDOKTERAN UNIVERSITAS TRISAKTI
JAKARTA
PERIODE 2018
 DEFINISI

 Laring: adalah saluran pernapasan yang membawa udara menuju ke trakea

Fungsi utama laring adalah untuk melindungi saluran pernapasan dibawahnya
dengan cara menutup secara cepat pada stimulasi mekanik, sehingga
mencegah masuknya benda asing ke dalam saluran napas. Laring mengandung
pita suara (vocal cord).
 Faring: adalah tabung fibromuskular yang terdapat persis didepan tulang
leher yang berhubungan dengan rongga hidung, rongga telinga tengah, dan
laring.
ANATOMI LARING
ANATOMI FARING
 JOURNALS

Occupational exposure to petroleum-based and oxygenated solvents

and hypopharyngeal and laryngeal cancer in France: the ICARE study

VOICE DISORDERS IN OCCUPATIONS WITH VOCAL LOAD IN

SLOVENIA

Occupational asbestos exposure is associated with pharyngeal

squamous cell carcinoma in men from the greater Boston area
 INTRODUCTION
Journal 1
Several occupational
exposures are also known or
suspected to be associated
with these cancers. Exposure
to strong acid mists. and to
asbestos. are recognized risk
factors for laryngeal cancer,
and there is also some
evidence that exposure to
asbestos increases the risk of
hypopharyngeal cancer.1
Journal 2
Among professional voice
users, not only singers and
actors but also clergy,
teachers, receptionists, sales
personnel, physicians and
anyone else whose ability to
earn a living is impacted
negatively by a loss of vocal
quality and endurance are
included.2
Journal 3
Asbestos has also been
implicated as a risk factor for
squamous cancers of the
upper airway, in particular
laryngeal and pharyngeal
carcinoma, as indicated by
recent meta-analyses
JOURNAL 1
occupational exposure to petroleum-based and oxygenated solvents and
the risk of hypopharyngeal and laryngeal cancer.
 EPIDEMIOLOGIST

walaupun telah terjadi penurunan pada

decade terakhir,akan tetapi insiden
kanker hipofaring dan laring di prancis
tetap menjadi yang paling tinggi di
eropa,dengan angka pertahunnya
mencapai 5/100.000 dan 7/100.000.
 CAUSES

Several occupational exposures are also known or suspected to be associated with these
cancers.

Exposure to strong acid mists and to asbestos are recognized risk factors for
laryngeal cancer.

Other possible occupational risk factors include exposure to polycyclic aromatic

hydrocarbons, engine exhausts, and solvents.

Exposure to solvents in general was found to be associated with an increased risk of

laryngeal or hypopharyngeal cancer in several studies, but the role of specific solvents
was rarely investigated.
 RISK WORKERS

 Factory worker
 PATHOPHYSIOLOGY

Chronic irritation,
inflammation and
EXPOSURE increased cell CARCINOGENICITY
SOLVENTS CANCER
proliferation is a
possible mechanism
 DIAGNOSIS

Those included sociodemographic characteristics, smok- ing

and alcohol consumption histories, and a detailed lifetime
occupational history, with a description of each job held for
at least one month.

Exposures to five petroleum-based solvents (benzene;

gasoline; white spirits and other light aromatic mixtures;
diesel, fuels and kerosene; special petroleum products) and
five oxygenated solvents (alcohols; ketones and es- ters;
ethylene glycol; diethyl ether; tetrahydrofuran) were
assessed by job-exposures matrices (JEMs)
 CONCLUSION

This study provides weak Our findings do not suggest

evidence for an association that the other petroleum-
be- tween hypopharyngeal based or oxygenated
cancer and exposure to solvents cause
white spirits and hypopharyngeal or
tetrahydrofuran. laryngeal cancers.
JOURNAL 2
VOICE DISORDERS IN OCCUPATIONS WITH VOCAL LOAD
 DEFINITION

The term “professional voice users”

• didefinisikan sebagai mereka yang pekerjaannya

membutuhkan suara sebagai alat utama pada pekerjaan
mereka,dan mereka yang jika terkena dysphonia atau
aphonia maka akan mencari pekerjaan yang lain.

professional voice user tidak hanya penyanyi dan actor tetapi

juga termasuk pendeta,guru,resepsionis, salesman,dokter dan
semua pekerjaan yang membutuhkan suara.
 EPIDEMIOLOGIST

In the USA, workers in sales and sales-related occupations (13%)

and teachers (4.2%) represent the largest percentage of
professional voice users.

The identified risk factors for voice disorders were

being a woman, being between 40 and 59 years of
age, having 16 or more years of education and having
a family history of voice disorders
 CAUSES

risk factors • background

for voice noise,
• poor air quality
disorders in (dryness, dust),
other voice • poor posture
professions • and vocal
such as: loading.
 RISK WORKERS

the elite vocal performer (singers, actors),

Koufman
et al. professional voice user (clergy, lecturers,
defined telephone operators),

four levels the non-vocal professional (teachers, doctors,

lawyers, businessmen, receptionists, etc.)
of vocal
and the non-vocal nonprofessional (laborers,
users: clerks)
 DIAGNOSIS

The core of every questionnaire included the

same questions about age, gender, the
prevalence of vo- ice disorders in the current
In some studies, the questions about daily
year, in the entire career and during
vocal load, length of career, instructions
education, the causes of voice disorders
about voice care, typical symptoms of
(vocal load and/or respiratory-tract infection
gastroesophageal reflux (heartburn, acid
or other), vocal habits (speaking loudly,
regurgitation) and allergies were also part of
shouting frequently, fast speaking rate, vocal
the questionnaire.
rest when encountering voice problems),
frequent throat clearing, sufficient hydration
and smoking.
 CONCLUSIONS

The most common causes for dysphonia are

excessive vocal load, misuse of the voice
and respiratory-tract infections
JOURNAL 3
asbestos exposure is associated with pharyngeal squamous cell
carcinoma
 DEFINITION

Asbestos
describes a group of
naturally occurring
fibrous silicate
mineral compounds.
EPIDEMIOLOGIST

Despite the known health

risks, an estimated 125
million people are still
occupationally exposed
worldwide
 CAUSES

Asbestos
has been chronic respiratory diseases,
associated including malignancy,
with a
number of and was first linked to
mesothelioma
and lung cancer
 RISK WORKERS

 Building worker
 PATHOPHYSIOLOGY

ASBESTOS CARCINOGENIC CANCER

 DIAGNOSIS

data on sociodemographics and personal characteristics, alcohol and tobacco use, personal and family
cancer history, occupational history of asbestos exposure, and other relevant dietary, health behavior,
occupational, residential and medical history.

In depth occupational history was collected for each different occupation held by each study subject,
including start and end dates

Duration of work in an asbestos-exposed occupation was calculated for each subject by subtracting the
start from end date for each occupation for which asbestos exposure was reported and summing up the
total duration across all occupations.

Serologic HPV16 testing for L1 viral protein antibodies was performed on study subjects as a measure of past
HPV16 exposure. Sandwich ELISA assays were used for detection of HPV16 antibodies as previously described.
Positive HPV16 L1 serology is considered to be a proxy for past exposure to the virus.
 CONCLUSIONS

These observations are consistent with the

mounting evidence that asbestos is a risk
factor for pharyngeal cancer
THANK YOU 
REFERENCES

1. Barul C, Carton M, Radoi L, Menvielle G, Pilorget C, Bara S, et al.

Occupational exposure to petroleum-based and ocygenated solvents and
hypopharyngeal and laryngeal cancer in France; The ICARE study. BMC
Cancer. 2018;18:388
2. Boltezar L, Bahar M. Voice disorder in occupations with vocal load in
Slovenia. Zdrav Var. 2014;53(4):304-310
3. Langevin S, O’Sullivan M, Valerio J, Pawlita M, Applebaum K, Eliot M, et al.
Occupational asbestos exposure is associated with pharyngeal squamous cell
carcinoma in men from the greater Boston area. Occup Environ Med.
2013;70(12:858-863