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DAFTAR ISI

Kata Pengantar .................................................................................................................... i


Daftar Isi ............................................................................................................................. ii
Daftar Gambar .................................................................................................................... iii
BAB I

: PENDAHULUAN
A. Latar Belakang ........................................................................................ 1
B. Tujuan ..................................................................................................... 2

BAB II

: HIDUNG DAN SINUS PARANASAL


A. Anatomi .................................................................................................. 3
1. Anatomi hidung bagian luar ............................................................. 3
2. Anatomi hidung bagian dalam .......................................................... 4
a. Septum nasi .......................................................................... 4
b. Nares anterior dan posterior ................................................. 5
c. Vestibulum ........................................................................... 5
d. Struktur dinding kavum nasi ................................................ 5
3. Pendarahan hidung ........................................................................... 8
4. Persarafan hidung ............................................................................. 9
5. Sinus paranasal ................................................................................. 10
a. Embriologi sinus paranasal................................................... 11
b. Sinus maksila ........................................................................ 11
c. Sinus frontal.......................................................................... 13
d. Sinus etmoid ......................................................................... 14
e. Sinus sfenoid ........................................................................ 14
6. Kompleks ostiomeatal ...................................................................... 15
B. Histologi Hidung .................................................................................... 16
1. Mukosa pernapasan .......................................................................... 16
2. Mukosa olfaktorius ........................................................................... 17
C. Sistem Transpor Mukosiliar ................................................................... 19
1. Epitel................................................................................................. 19
2. Silia ................................................................................................... 20
3. Palut lendir........................................................................................ 21

4. Membrana basalis ............................................................................. 21


5. Lamina propria ................................................................................. 22
6. Transportasi mukosilier .................................................................... 22
7. Pemeriksaan fungsi mukosilier......................................................... 23
D. Fisiologi .................................................................................................. 24
1. Fisiologi penghiduan ........................................................................ 24
2. Fungsi hidung ................................................................................... 26
a. Fungsi respirasi ..................................................................... 26
b. Indera penghidu .................................................................... 26
c. Penyesuaian udara (air conditioning) ................................... 26
d. Resonansi suara .................................................................... 25
e. Proses bicara ......................................................................... 27
f. Purifikasi udara ..................................................................... 27
g. Refleks nasal ......................................................................... 27
3. Fungsi sinus paranasal ...................................................................... 27
a. Sebagai pengatur kondisi udara (air conditioning) ............. 28
b. Sebagai penahan suhu (thermal insulators) ........................ 28
c. Membantu keseimbangan kepala.......................................... 28
d. Membantu resonansi suara .................................................. 29
e. Sebagai peredam perubahan tekanan udara .......................... 29
f. Membantu produksi mukus .................................................. 29
E. Pemeriksaan ............................................................................................ 29
1. Pemeriksaan hidung.......................................................................... 29
a. Pemeriksaan hidung luar ...................................................... 29
b. Rinoskopi anterior ............................................................... 30
c. Rinoskopi posterior ............................................................. 30
d. Nasoendoskopi ..................................................................... 30
e. Tes penghidu ........................................................................ 31
2. Pemeriksaan sinus paranasal ............................................................ 32
a. Inspeksi ................................................................................. 32
b. Palpasi................................................................................... 33

c. Transiluminasi ...................................................................... 33
d. Pemeriksaan radiologi .......................................................... 34
e. Sinoskopi .............................................................................. 34
F.

Gangguan Penghiduan ............................................................................ 35


a. Macam macam kelainan penghidu ...................................... 35
b. Disfungsi penghiduan ............................................................ 36
c. Defek konduktif ..................................................................... 36
d. Defek sentral/sensorineural .................................................... 37
e. Tanda dan gejala .................................................................... 38
f. Temuan fisik .......................................................................... 38
g. Diagnosis gangguan penghiduan ........................................... 39
h. Laboratorium.......................................................................... 39
i. Pencitraan ............................................................................... 39
j. Pemeriksaan sensorik ............................................................. 40
k. Terapi .................................................................................... 41
l. Prognosis ................................................................................ 42

BAB III

: SINUSITIS
1.

Definisi ................................................................................................... 44

2.

Etiologi dan Faktor Predisposisi ............................................................ 45

3.

Klasifikasi ............................................................................................... 45

4.

Patogenesis ............................................................................................. 45

5.

Diagnosis ................................................................................................ 46

6.

Pemeriksaan Penunjang .......................................................................... 47


a. Sinoskopi sinus maksilaris .............................................................. 47
b. Laboratorium................................................................................... 48
c. Imaging ........................................................................................... 48

7.

Diagnosis sinusitis menurut waktu dan klasifikasinya ........................... 49


a. Sinusitis Akut ................................................................................. 49
i. Sinusitis Maksilaris ............................................................ 51
ii. Sinusitis Etmoidalis ............................................................ 52
iii. Sinusitis Frontalis................................................................ 52

iv. Sinusitis Sfenoidalis ............................................................ 52


b. Sinusitis subakut ............................................................................. 52
c. Sinusitis Kronis ............................................................................... 53
8.

Komplikasi Sinusitis............................................................................... 55
a. Komplikasi local ............................................................................. 56
i. Osteomielitis ....................................................................... 56
ii. Mukokel .............................................................................. 56
b. Komplikasi Orbita ........................................................................... 57
c. Komplikasi Intrakranial .................................................................. 58

BAB IV

: CEPHALGIA
A. Definisi ........................................................................................................ 60
B. Patogenesis .................................................................................................. 60
C. Manifestasi klinis ........................................................................................ 61
i. Migraine .......................................................................................... 61
ii. Nyeri kepala tipe tegang ................................................................. 62
iii. Nyeri kepala tipe cluster ................................................................. 63
iv. Sinus Headache ............................................................................... 64

BAB V

: SINUS HEADACHE
A. Definisi ........................................................................................................ 65
B. Etiologi ........................................................................................................ 65
C. Patogenesis .................................................................................................. 65
D. Manifestasi klinis ........................................................................................ 66
E. Penatalaksanaan .......................................................................................... 66
a. Sinusitis akut ................................................................................... 66
b. Sinusitis Subakut............................................................................. 67
c. Sinusitis Kronis ............................................................................... 68

BAB IV

: PENUTUP
A. Kesimpulan .............................................................................................. 69
B. Saran ........................................................................................................ 70

Daftar Pustaka ..................................................................................................................... 71


Lampiran slide .................................................................................................................... 73