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LIDAH

Macroglossia
Dapat terjadi pd: congenital hypothyroidism, Downs syndrome, acromegaly
Fissured tongue/ scrotal tongue
Terapi
sugesti kondisi N disertai simptom
obat kumur chorhexidine
Sindrom Melkersson Rosenthal
Hairy Tongue (Black hairy Tongue)
Abnormal coating
terjadi gangguan deskuamasi sel dan penumpukan keratin sehingga papila filiformis memanjang.
Letak
depan sulkus terminal daerah dorsum lidah papilla filliformis memanjang (15-20 mm) & o : 2mm
Predileksi
midline posterior di sebelah anterior papila circumvalata.(dpn sulkus terminal)
Terapi
tata laksana faktor predisposisi, jaga OH, bersihkan lidah, keratolytic agent
(contoh: Podophylin resin solution 1%, topical tretinoin)
Geographic tongue/ Erythema Migrans
Bila simptomatik lakukan pemeriksaan untuk melihat defisiensi haematinic
Simptomatik: obat kumur analgesic, hindari makanan yang mengiritasi lidah, suplemen Zinc
Atrofi Lidah
Lidah tampak merah, mengkilat, terasa sakit.
Bila terjadi pemeriksaan penunjang penyakit yang melatar belakangi seperti defisiensi besi, anemia megaloblastik, defisiensi nutrisi,
diabetes mellitus Pemeriksaan lab kadar ferritin, B12 , asam folat dan kadar glukosa darah.
Tambahan: dapat terjadi: keluhan sakit pada lidah
tanpa adanya gambaran klinis yang nyata burning mouth
syndrome/glossodynia/glossopyrosis
Klasifikasi BMS
Faktor lokal (50%): tongue-thrusting, space untuk lidah terbatas karena pemakaian gigi tiruan
Faktor sistemik (30%): defisiensi hematologis, diabetes, penyakit mukosa mulut
Faktor psikogenik (20%): kecemasan, depresi, cancerophobia.
Sering terjadi pada wanita menopause
Tata laksana
terapi faktor sistemik, perbaiki gigi tiruan, yakinkan pasien, vitamin B1 300mg B6 50mg sebagai placebo, hormon replacement
Bila tidak ada respons obat psychoactive
EXTERNAL EAR
Non-inflammatory diseases and injuries of external ear
Deformities & Malformations

Prominent ears

Hyperostoses and Exostoses

Auricular Appendages

Congenital Pre-auricula fistula & cyst

Opening at preauricular sites on the helical rim.

can be retro &/ infra auricular site.

Can be bilateral & familial

Recurrent infections need surgical excision.

Malformation of auricle

Stenosis and atresia EAC

DD : EAC cholesteatoma,tumours, FB, clotted blood

Complication : OE
Injuries and Physical Damage

Auricular Hematoma, Auricular Seroma

Elicit injuries to:


Temporal bone
EAC
Middle ear
TMJ

Surgical evacuation w/ reattachment perichondrium and cartilage

Sharp auricular injuries and auricular avulsion

Burn and Frost bite injuries

DD : caustic chemical injuries, electrical injuries

Complication : cartilage deformity and permanent necrosis

Injuries to EAC
Inflammatory diseases and injuries of external ear
Inflammation Auricle
Excema & Dermatitis

Symptoms : itchy & burning sensation w/ little pain. The skin is erythematous, may be dry and scaly, moist and weeping.

DD : pyoderma, perichondritis, cellulitis, dermatitis seborrheic, psoriasis

Tx : eliminate allergic causative agent, treatment based on dermatologic principle, AB for bacterial infection.
Perichondritis
Symptom :

Severe pain on rapid onset

Feeling of tension

Auricular contour might be change


Swelling and tenderness of concha
Enlarged cervical lymph nodes and painful
Fever
Symptoms if reccurence

local pain, oedema, erythema, articular pain

Fever

Sensorineural hearing loss

Iritis, conjunctivitis

Elevated sedimentation rate

Respiratory problems.
Auricular Cellulitis/ Ersypelas

Acute streptococcal infection of the subcutaneous tissue auricle and surroundings

Symptoms :

Redness, swelling, warmth

Malaise, fever, otalgia

DD : dermatitis, perichondritis, herpes zoster oticus.

Complication : necrotizing fasciitis, systemic complications.

Tx : AB penicillin high dose (IV), analgetic (NSAID),


Herpes Zoster Oticus
Inflammation EAC
Otitis Externa
Necrotizing Otitis Externa
Otomycosis
Tumours of External Ear
Tumours of Auricle
Tumours of EAC