Serumen Prop

Defenisi Serumen
Serumen adalah hasil produksi kelenjar sebasea, kelenjar seruminosa, epitel kulit yang
terlepas dan partikel debu.
Dalam Keadaan normal serumen terdapat di sepertiga luar linag telinga karena
kelenjar tersebut banyak terdapat pada daerah ini.
Konsistensinya biasa ludang tetapi terkadang kering dan dipengaruhi oleh faktor
keturunan, iklim, usia, dan keadaan lingkungan.
Serumen dapat keluar sendiri dari liang telinga akibat migrasi epitel kulit yang
bergerak dari arah membran timpani menuju ke luar serta dibantu oleh gerakan rahang
sewaktu mengunyah.
Fungsi Serumen :
Sebagai proteksi yaitu dengan mengikat kotoran, menyebarkan aroma yang
tidak disenangi serangga sehingga serangga tidak masuk ke liang telinga.
sarana pengangkut debris epitel dan komtaminan untuk dikelurkan dari
membran timpani.
Pelumas dan mencegah kekeringan dan pembentukan fisura pada epidermis.
Faktor-faktor yang dapat menyebabkan serumen terkumpul dan mengeras
diliang telinga :
1. Dermatitis kronik liang telinga luar
!. "iang telinga sempit
#. Produksi serumen banyak dan kental
$. %danya benda asing di liang telinga
&. %danya eksostosis liang telinga
'. Serumen terdorong oleh jari tangan atau ujung handuk setelah mandi atau
kebiasaan mengorek telinga
Serumen dapat dibersihkan dengan konsistensinya.
Serumen "embek dapat menggunakan kapas yang dililitkan pada pelilit kapas.
Serumen yang keras dapat dikeluarkan dengan pengait atau kuret.
%pabila kedua cara ini tidak dapat mengeluarkan serumen maka dapat
dilunakkan lebih dahulu menggunakan tetes karbolgliserin 1() selama # hari.
Serumen yang sudah terlalu jauh terdorong ke dalam liang telinga dapat
dikeluarkan dengan mengalirkan air hangat sesuai suhu tubuh.
Indications
*erumen in the e+ternal ear canal is physiological. ,ndications to address the cerumen
include the following-$. :
Difficulty in e+amining the full tympanic membrane
/titis e+terna
0a+ occlusion of the e+ternal ear canal
%s part of the workup for conducti1e hearing loss
Prior to taking the impression for hearing aid fitting
Suspected e+ternal ear canal or middle ear cholesteatoma
Suspected e+ternal ear canal pathology such as s2uamous cell carcinoma or
ec3ema
%s part of the follow4up to canal wall down mastoidectomy
%s part of grommet insertion or middle ear surgery 5preoperati1ely or
perioperati1ely
Patient re2uest
Contraindications
Specific contraindications e+ist for each specific procedure. ,ndi1idual assessment
should dictate which techni2ue is the most appropriate.
*ontraindications to irrigation include the presence or history of a perforated
tympanic membrane, pre1ious pain on irrigation, or pre1ious surgery to the
middle ear.
% relati1e contraindication to probing is the inability to 1isuali3e the ear canal.
6elati1e contraindications to microsuction are se1ere pre1ious e+acerbation of
tinnitus, 1ery hard cerumen, and an uncooperati1e patient.
7+ceptional caution has to be used when clearing cerumen in patients who
ha1e undergone a mastoidectomy in the past, during which sensiti1e
anatomical structures like the facial ner1e and semicircular canals may ha1e
been e+posed.
Preparation and visual assessment
%ssemble and prepare all necessary e2uipment.
8ake time to e+plain the procedure to the patient and obtain consent.
*onnect suction tip and turn on the suction machine and microscope light.
Position the patient9s head facing away from the operator, the neck fle+ed
laterally and the shoulder pulled down.
7+amine the pinna, outer portions of the e+ternal canal, and the adjacent scalp
for any e1idence of pre1ious surgery incision scars, signs of infection, or
discharge.
,nspect the outer ear canal opening, using the appropriate aural

o 8he speculum should be the largest si3e that fits. ,t should be placed
deep enough to clear the hair4bearing skin but not deeper, as
unnecessary pain may result.
o 8he speculum should be held with the first and second fingers. :se the
other fingers to retract the pinna up and backward in an adult 5retract
the pinna up and downward in a child.
%ssess the cerumen. ;ently probe with a blunt instrument such as <obson
=orne curette to determine whether the cerumen is soft, hard, or bony hard.
%ssess whether tympanic membrane is 1isible. "ook for any air spaces around
the cerumen.
>efore beginning the cerumen remo1al, ensure that the microscope and
operator are optimally positioned. 8he microscope should be positioned to
pro1ide the optimal 1iew of the ear canal, and the operator should be sitting
comfortably and with a straight back.