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TUGAS KEPANITERAAN ILMU KESEHATAN ANAK

Nama : Grace Elizabeth Claudia


NIM : 11.2015.161
Pembimbing : dr. Melani, SpA

1. Perbedaan Oto Acoustic Emission (OAE) dan Brainstem Evoked Response Audiometri
(BERA)
OAE BERA
Peralatan Sumbat liang telinga (probe) Elektroda dipasang pada dahi
dari bahan karet (di bayi dan pada bagian
dalamnya terdapat suara dan belakang telinga bayi.
mikrofon mini) yang Kemudian dipasangkan
terhubung dengan kabel ke headphones pada bayi.
alat perekam. Elektroda disambungkan ke
alat EEG
(elektroensefalogram)

Cara Kerja Alat diletakkan di liang Melalui headphone akan


telinga, bunyi klik dihantarkan suara ke telinga
dikeluarkan, sel rambut halus bayi. Kemudian elektroda
berespon dengan bergetar yang terpasang akan
di mana getaran ini mengukur apakah otak
dihantarkan kembali dari mendengar suara ini dalam
telinga dalam hingga telinga bentuk gelombang otak EEG
luar. Kemudian OAE yang
dibentuk oleh cochlea diukur
dengan microphone.
Yang Mengetahui respon sel Reaksi sistem saraf
dinilai rambut terluar terhadap pendengaran dan batak otak
stimulus suara dan rumah (brainstem) pada saat dilalui
siput / gendang telinga rangsangan bunyi.
(koklea) balita berfungsi
dengan baik.

2. ROP (Retinopathy of Prematurity)


ROP adalah penyakit vasoproliferatif pada retina yang dihubungkan dengan kelahiran
prematur. Telah diketahui bahwa ROP merupakan penyebab gangguan penglihatan utama
pada bayi premature yang sangat mungkin untuk dihindari. Gangguan penglihatan ini
bersifat permanen dan mempunyai pengaruh besar terhadap kualitas hidup pasien.
Patofisiologi:
Normal embryology of the eye: In the normally developing retina, there are no
retinal vessels until about 16 weeks gestation. Until then, oxygen diffuses from
the underlying choroidal circulation. At 16 weeks, in response to a stimulus
(experimental evidence suggests relative hypoxia stimulating the release of
angiogenic factors as the retina thickens), cells derived from mesenchyme
traveling in the nerve fiber layer emanate from the optic nerve head. These cells
are the precursors of the retinal vascular system. A fine capillary network
advances through the retina to the ora serrata, or retinal edge. More mature
vessels form behind this advancing network. Vascularization on the nasal side of
the ora serrata is complete at ~8 months gestation, whereas that on the temporal
side is ordinarily complete at term. Regulation of this process involves various
factors including vascular endo- thelial growth factor (VEGF) and insulin-like
growth factor 1 (IGF-1) working in combination. Once the retinal vasculature is
completely vascularized, it is no longer susceptible to insults of the type that lead
to ROP.
Gejala Klinis:
Several methods of classification of ROP have been used. With development of
the International Classification of ROP, there is general agreement on the staging
of active disease.
o Stage I. A thin demarcation line develops between the vascularized region
of the retina and the avascular zone.
o Stage II. This line develops into a ridge protruding into the vitreous.
o Stage III. Extraretinal fibrovascular proliferation occurs with the ridge.
Neovascu- lar tufts may be found just posterior to the ridge (Figure
1261).
o Stage IV. Fibrosis and scarring occur as the neovascularization extends
into the vitreous. Traction occurs on the retina, resulting in partial
retinal detachment.
o Stage V. Complete retinal detachment.
o Plus disease (eg, stage III+). This may occur when vessels posterior to the
ridge become dilated and tortuous. Plus disease has become a primary
factor in treat- ment decisions.
o Pre-plus disease. Dilation and tortuosity of posterior pole vessels in zone
1; less severe than plus disease.
o Aggressive posterior ROP (AP-ROP). Rapidly progressive ROP primarily
zone I. Requires immediate treatment.

The retina is divided into circumferential zones I, II, and III to designate how far
from the back of the retina (the posterior pole) disease is present. e most severe
disease is any stage with plus disease close to the posterior pole, in zone I. e least
severe is disease in the peripheral retina, zone III. No treatment is necessary for
peripheral zone III disease, as it regresses spontaneously.
3. Komplikasi dari bayi premature?
Respiratory distress syndrome; electrolyte and metabolic problems; infection; necrotizing
enterocolitis; patent ductus arteriosus; apnea and bradycardia; anemia; and
intraventricular hemorrhage and other signs of brain injury.

Daftar Pustaka
1. Soepardi EA, Iskandar N, editor. Buku Ajar Ilmu Kesehatan Telinga Hidung Tenggorok
Kepala Leher. Edisi ke-6. Jakarta: Balai Penerbit FKUI; 2007.
2. Gomella LT. Neonatology. 7th Edition. New York: Mc Graw Hill Education; 2013.