Telinga luar:
Sumbatan serumen
Benda asing
Otitis eksterna
Ruptur membran timpani
Telinga tengah
Otitis media
Telinga dalam
Labirintitis
Vertigo
Sumbatan Serumen
Serumen: diproduksi oleh kele
njar minyak di liang telinga
Liang telinga separuh bagian
luar
Mencegah tumbuhnya
bakteri dan jamur
Mencegah kerusakan kulit di
liang telinga
Penumpukan terjadi karena
kebiasaan buruk sering
mengorek kotoran telinga
Diperburuk bila kemasukan
air pada saat mandi/
berenang
Air membuat serumen
bertambah besar
Kapan perlu
dikeluarkan?
Tuli
Otalgia
Serumen mengganggu pemeriksaan
Anak < 1 tahun
Tata Laksana
Obat pelunak serumen
Pencegahan
Jangan bersihkan liang telinga
dengan cotton buds membuat
serumen semakin menumpuk di
bagian dalam.
Anamnesis dan
Pemeriksaan Fisik:
Serangga
Hook
Suction
Syringing
Surgery
Hook
Ear syringe
Contraindications of
syringing
1- Organic foreign body: it will enlarge with
water and cause more pain and become
more difficult to remove.
2-Tympanic membrane perforation
3- Alive insect, water will irritate it and it will
move more and more and so will be more
painful, so here we should kill it first either
by putting oil in the ear, paraffin or
anesthetic agent then remove it by any
available method.
Otitis Eksterna
Peradangan pada
telinga luar:
Cuping telinga
Liang telinga
Tanda:
Otorrhea: keluar cairan dari
telinga
Robek gendang telinga
Prognosis
Biasanya sembuh spontan
dalam 4-6 minggu
Patofisiologi
Sumbatan tuba eustakius + invasi
kuman peradangan telinga tengah
( OMA)
Anak sering mengalamiinfeksi sal
nafas sering OMA
Bayi plg sering OMA krn : tuba
eustakius pendek, lebar, lebih
horizontal
Stadium :
stadium oklusi tuba : Mt retraksi
Stadium hiperemis : Mt hiperemis, oedem
Stadium supurasi : Mt bulging, anak
tampak sangat sakit
4. Stadium perforasi : Mt ruptur, anak tenang
5. Stadium resolusi : Mt normal kembali
1.
2.
3.
gejala :
nyeri telinga
suhu tubuh tinggi
Ada riwayat batuk pilek sebelumnya
Ggn pendengaran / rasa penuh
Pada bayi / anak : gelisah, diare,
kejang
Bila Mt ruptur sekret (+) anak
tenang
terapi :
tergantung stadium
AB
nasal decongestan
analgetik
miringotomi ( stad supurasi )
aural toilet ( stad perforasi )
jenis OMSK
OMSK
intrakranial
Mastoiditis
- abses ekstradural
Petrositis
- trombosis sinus lateralis
Paresis fasialis
- abses subdural
Labirinitis
- meningitis
Abses subperiosteal / abses
retroaurikular
- abses otak
Abses bezold
- hydrosefalus otitis
1.
2.
3.
4.
gejala / tanda :
Kurang pendengaran
Telinga rasa tersumbat
Diplakusis binauralis
(suara sendiri terdengar
lebih nyaring pada telinga
yg sakit)
Spt ada cairan pd telinga
Nyeri
tinitus
Vertigo
Otoskopi : Mt retraksi,
tampak permukaan
cairan dlm kavum timpani
Test penala : tuli
konduktiv
Terapi :
Medikamentosa:
Nasal dekongestan
Antihistamin ( jika disebabkan oleh
alergi )
Perasat valsalva
Jika 1- 2 minggu gejala menetap
myringotomy k/p pasang gromet
( pipa ventilasi
Vertigo
Mahmoud Aldari
Vertigo Overview
Vertigo is the feeling that you or your
environment is moving or spinning.
It differs from dizziness in that vertigo
describes an illusion of movement.
When you feel as if you yourself are
moving, it's called subjective
vertigo, and the perception that your
surroundings are moving is called
objective vertigo.
Vertigo Causes
Vertigo can be caused by problems in
the brain or the inner ear.
Vertigo can be Central or
Peripheral.
Vertigo Causes
cont
Vertigo Causes
cont
Vertigo Causes
III. Meniere's disease
triad of symptoms:
a.
b.
c.
Episodes of vertigo.
Ringing in the ears (tinnitis).
Hearing loss.
a.
b.
c.
Vertigo.
One-sided ringing.
Hearing loss.
cont
Vertigo Causes
cont
Clinical Presentation
Vertigo implies that there is a sensation of motion
either of the person or the environment.
This should not be confused with symptoms of
lightheadedness or fainting.
symptoms include a sensation of disorientation or
motion.
In Addition:
nausea or vomiting.
Sweating.
abnormal eye movements.
Clinical Presentation
cont.
The duration of symptoms can be from minutes to
hours.
Symptoms can be constant or episodic.
Onset may be due to a movement or change in position.
History of recent head trauma.
any new medications the patient is taking.
The person may have hearing loss and a ringing
sensation in the ears.
The person might have visual disturbances, weakness,
difficulty speaking, a decreased level of consciousness,
and difficulty walking,
Vertigo Diagnosis
Important Points in History:
if the patient feels any sensation of motion, which may indicate
that true vertigo exists. Report any nausea, vomiting,
sweating, and abnormal eye movements.
how long the patient has symptoms and whether they are
constant or come and go. Do the symptoms occur when
moving or changing positions? Is the patient currently taking
any new medications? Has there been any recent head trauma.
Are there any other hearing symptoms? Specifically, report any
ringing in the ears or hearing loss.
Does the patient have other neurological symptoms such as
weakness, visual disturbances, altered level of consciousness,
difficulty walking, abnormal eye movements, or difficulty
speaking?
Vertigo Diagnosis
Cont.
Investigation:
CT scan if a brain injury is suspected to be the cause of
vertigo.
Blood tests to check blood sugar levels.
use of an electrocardiogram (ECG) to look at heart
rhythm may also be helpful.
Peripheral
Vertigo
Onset
Gradual
Usually Sudden
Tinnitus, hearing
loss
Absent
Present
Neighborhood signs
(Diplopia, cortical
blindness,
dysarthria,)
Present
Absent
Nystagmus
Pure, vertical,
suppress with
fixation, &
multidirectional
Mixed, horizontal,
suppress with
fixation, &
unidirectional
Vertigo Treatment
The choice of treatment will depend on the
diagnosis.
Identifying and eliminating the underlying cause.
Bacterial infection of the middle ear requires antibiotics.
For Meniere's disease, in addition to symptomatic
treatment, people might be placed on a low salt diet and
may require medication used to increase urine output.
Vertigo Medications
Commonly prescribed medications
for vertigo include the following:
Meclizine hydrochloride (Anticholinergic )
Diphenhydramine (Antihistamine)
Scopolamine transdermal
(Anticholinergics/Antispasmodics)
Promethazine hydrochloride (Antihistamine)
Diazepam
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