Ariel Valentino – 1606900064

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Definisi,Etiologi,Epidemiologi,FaktorRisiko,Klasifikasi,
PrognosisTuliKonduktifdanPerforasiMembranTimpani.
Definisi
• Tuli konduktif  tuli akibat abnormalitas/kerusakan struktur
telinga luar dan/atau telinga tengah.
• Perforasi membran timpani  rusaknya integritas membran
timpani akibat berbagai macam etiologi  menyebabkan tuli
konduktif

Etiologi Tuli Konduktif

• Telinga luar: serumen, malformasi •

Perforasi Membran Timpani

kongenital, atresia kanal, tumor,
inflamasi  eksudat
• Telinga tengah: malformasi
ossicles, disfungsi tuba Eustachius,
otitis media, otosklerosis,
kolesteatoma
Trauma  tamparan/pukulan
• Infeksi  otitis media
• Barotrauma
• Suara intensitas tinggi
• Iatrogenik
 Epidemiologi Tuli Konduktif (WHO)
• 2008  360 juta
• 2018  466 juta
• Perkiraan 2030  630 juta
• Perkiraan 2050  >900 juta

Addressing the rising prevalence of hearing loss [Internet].

• Indonesia  11,5 juta Geneva: World Health Organization; 2018 [updated 2018 Feb;
cited 2019 Apr 07]. Available from:
• Gangguan pendengaran (16,8%), penyakit telinga (18,5%), tuli berat (0,4%) https://apps.who.int/iris/bitstream/handle/10665/260336/97892
41550260-
• Tuli kongenital (0,1%), otitis media supuratif kronik (3,7%) eng.pdf;jsessionid=FD7CC6CBB84864D0117785FD6517381F
Epidemiologi Perforasi Membran Timpani Faktor Risiko
Perforasi Membran
Tuli Konduktif
Timpani
Lou • Prevalensi terbesar  trauma • Penggunaan alat • Suara intensitas
(2012) perkelahian suami-istri (52%) ventilasi mekanik
• Anomali
tinggi
• Trauma
kongenital  cleft • Serumen dan
lip, maxilla, palate benda asing
Rasool • Prevalensi terbesar  trauma (70%)
• Dari angka tersebut, 70% sampel
• Infeksi kongenital • Cotton swab
 CMV, Rubella,
(2016) wanita karena pukulan dari suami
Toxoplasma, dll
• High diving 
barotrauma
• Otitis media • Rhinorrhea dan
• Sindrom Down, otorrhea
Ahluwalia • Etiologi trauma  138/291 (46,9%)
• 99/138 (60.8%) pasien tsb 
Turner • Polip aural
(2018) perkelahian suami-istri
 Stevens G, Flaxman S, Brunskill E, Mascarenhas M,

Klasifikasi Tuli Konduktif Mathers CD, Finucane M. Global and regional hearing
impairment prevalence: an analysis of 42 studies in 29

dan Perforasi Membran

countries. Eur J Public Health. 2011 Dec 24;23(1):146–
52.

Lokasi
• Anterior, inferior, superior, posterior
• Pars tensa dan pars flaccida

Ukuran
• Kecil  perforasi <50% diameter
• Besar  perforasi ≥50% diameter

• Kering  tidak ada cairan: karena trauma,

Berdasarkan durasi:
Cairan otitis media kronik tipe mucosal inaktif
• Basah  ada cairan seperti otitis media
kronik tipe mucosal aktif
• Transient  telinga luar (obstruksi)
• Permanen  telinga tengah (otitis
media kronik)
 Prognosis Tuli Konduktif
• Dipengaruhi berbagai faktor prognostic
• Komplikasi kronik  degenerasi koklea  tuli sensorineural
Early
Derajat tuli
Vertigo/tidak treatment (7
(<50 dB)
hari pertama)

Prognosis Perforasi Membran Timpani

Letak terhadap
Lokasi Ukuran Tipe injury Kalsifikasi annulus
fibrosus
Referensi
1. Shearer AE, Hildebrand MS, Smith RJH. Hereditary hearing loss and deafness overview. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University
of Washington, Seattle; 1999 Feb 14 [updated 2017 Jul 27; cited 2019 Apr 07]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1434/
2. Sinkkonen ST, Jero J, Aarnisalo AA. Tympanic membrane perforation. Duodecim. 2014;130(8):810-8
3. Pereira LV, Bahmad F Jr. Up to date on etiology and epidemiology of hearing loss. In: Update On Hearing Loss. InTech; 2015.
4. Kirtane MV, de Souza CE, Sanna M, Devaiah AK. Otology and neurology: otorhinolaryngology – head and neck surgery series. Uttar Pradesh: Thieme Medical and Scientific Publishers; 2013.
5. Lou Z-C, Lou Z-H, Zhang Q-P. Traumatic tympanic membrane perforations: a study of etiology and factors affecting outcome. Am J Otolaryngol. 2012 Sep;33(5):549–55.
6. Rasool S, Ahmad F, Ahmad R. Traumatic tympanic membrane perforations: an overview in a politically disturbed region of Indian-occupied Kashmir. Egypt J Otolaryngol. 2016;32(3):187.
7. Ahluwalia H, Narain P, Ahluwalia A, Singh J, Singh A. Determinants of holistic outcome in traumatic tympanic membrane perforation. Indian J Otol. 2018;24:83-7
8. Gleeson M, Browning GG, Burton MJ, Clarke R, Hibbert J, Jones NS, et al, editors. Scott-Brown’s otorhinolaryngology, head and neck surgery. 7th ed. London: Edward Arnold; 2008.
9. Addressing the rising prevalence of hearing loss [Internet]. Geneva: World Health Organization; 2018 [updated 2018 Feb; cited 2019 Apr 07]. Available from:
https://apps.who.int/iris/bitstream/handle/10665/260336/9789241550260-eng.pdf;jsessionid=FD7CC6CBB84864D0117785FD6517381F?sequence=1
10. Suwento R. Hearing Health Infrastructure in Indonesia. In: Hearing Impairment [Internet]. Springer Japan; 2004. p. 45–8.
11. Biswas AK, Goswami SC, Baruah DK, Tripathy R. The potential risk factors and the identification of hearing loss in infants. Indian J Otolaryngol Head Neck Surg. 2011;64(3):214–217.
12. Blazer DG, Domnitz S, Liverman CT, editors. Hearing health care for adults: priorities for improving access and affordability [Internet]. Washington (DC): National Academies Press (US); 2016
Sep 6 [cited 2019 Apr 07]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK385309/
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Otorhinolaryngology. 2016 Feb;81:29–32
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2011 Dec 24;23(1):146–52.
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17. Carpenter DJ, Tucci DL, Kaylie DM, Frank-Ito DO. The anatomic determinants of conductive hearing loss secondary to tympanic membrane perforation. J Otol. 2017;12(3):125–131.
18. Sogebi OA, Oyewole EA, Mabifah TO. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome. Ghana Med J. 2018;52(1):34–40.
19. Hakuba N, Hato N, Okada M, Mise K, Gyo K. Preoperative factors affecting tympanic membrane regeneration therapy using an atelocollagen and basic fibroblast growth factor. JAMA
Otolaryngol Head Neck Surg. 2015 Jan 1;141(1):60
20. Enache R, Sarafoleanu C. Prognostic factors in sudden hearing loss. J Med Life. 2008;1(3):343–347.
21. Liberman MC, Liberman LD, Maison SF. Chronic conductive hearing loss leads to cochlear degeneration. PLoS One. 2015;10(11):e0142341.