Infeksi TelingaKristianto Yusi AdiputraSiti MasitohSMF THT RSUD. Dr. Soedarso

DefinisiInfeksi-infeksi telinga adalah kondisi-kondisi yang melibatkan dan seringkali peradangan dari area-area berbeda dari telinga. Mereka paling sering berasal dari infeksi virus, jamur dan bakteri. Pada kebanyakan kasus-kasus, infeksi-infeksi telinga adalah tidak serius dan hilang dengan sendirinya.

Pada kebanyakan kasus-kasus, infeksi-infeksi telinga adalah tidak serius dan hilang dengan sendirinyaInfeksi-infeksi telinga dapat terjadi pada telinga luar, tengah dan dalam

Kebanyakan infeksi-infeksi telinga terjadi pada telinga luar atau tengah infeksi-infeksi telinga dalam adalah jarangInfeksi-infeksi telinga adalah lebih umum pada anak-anak daripada orang-orang dewasa karena saluran-saluran mereka lebih pendek dan sempit, membuat mereka lebih sulit untuk mengalir

OTITIS EXTERNA

Otitis ExternaOtitis externa is an inflammatory process of the external auditory canal. In one recent study,1 otitis externa was found to be disabling enough to cause 36 percent of patients to interrupt their daily activities for a median duration of four days, with 21 percent requiring bed rest

The two most characteristic presenting symptoms of otitis externa are otalgia (ear discomfort) and otorrhea (discharge in or coming from the external auditory canal).The ear discomfort can range from pruritus to severe pain that is exacerbated by motion of the ear, including chewing. If inflammation causes sufficient swelling to occlude the external auditory canal, the patient may also complain of aural fullness and loss of hearing.Otorrhea is also quite variable

Etiology of Bacterial Otitis Externa The most common cause of otitis externa is a bacterial infection, although fungal overgrowth is a principal cause in 10 percent of cases.Otitis externa can also result from any of a broad range of noninfectious dermatologic processes.

ComplicationsNecrotizing or malignant otitis externa is a life-threatening extension of external otitis into the mastoid or temporal bone. Most commonly caused by P. aeruginosa, it is an osteomyelitis that occurs most often in elderly patients with diabetes mellitus. However, all immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection, are at risk

Etiology and Presentation of Fungal Otitis Externa Fungi are identified in about 10 percent of cases of otitis externa.The most common pathogen is Aspergillus (80 to 90 percent of cases), followed by Candida. Classically, fungal infection is the result of prolonged treatment of bacterial otitis externa that alters the flora of the ear canal. Mixed bacterial and fungal infections are thus common.However, fungus is occasionally the primary pathogen in otitis externa, especially in the presence of excessive moisture or heat.

TreatmentCleansing of the ear canal by suctioning is a principal treatment. Acidifying drops, given three or four times daily for five to seven days, are usually adequate to complete treatment

Noninfectious Dermatologic Causes of Otitis Externa

OTITIS MEDIA

Otitis MediaDefinisi :Otitis media adalah peradangan sebagian atau seluruh mukosa telinga tengah, tuba Eustachius, antrum mastoid, dan sel-sel mastoid

EpidemiologiEnam puluh hingga delapan puluh persen bayi memiliki paling sedikit satu episode OMA dan 90% terjadi pada usia 2-3 tahun. Di Amerika Serikat angka kejadian tertinggi dari OMA terjadi pada usia 6-24 bulan, frekwensi OMA terjadi pada masa anak-anak, remaja dan dewasa, biasanya anak laki-laki lebih sedikit dibandingkan dengan anak perempuan.

EtiologiSumbatan pada tuba eustachius merupakan penyebab utama dari otitis mediaKuman penyebab OMA adalah bakteri piogenik, seperti Streptococcus hemoliticus, Haemophilus Influenzae (27%), Staphylococcus aureus (2%), Streptococcus pneumoniae (38%), Pneumococcus.

Patogenesis

Stadium Otitis Media Akutstadium oklusi tuba Eustachius, stadiumhiperemis, stadium supurasi, stadium perforasi dan stadium resolusi

Penatalaksanaan

OTITIS INTERNA

DefinitionOtitis interna (Internal otitis) is an inflammation of the inner ear and is usually considered synonymous with labyrinthitis

A prominent and debilitating symptom of labyrinthitis is chronic vertigo (medical). The vestibular system is a set of sensory inputs consisting of three semicircular canals, sensing changes in rotational motion, and the otoliths, sensing changes in linear motion

The brain combines visual cues with sensory input from the vestibular system to determine adjustments required to retain balance. When working properly, the vestibular system also relays information on head movement to the eye muscle, forming the vestibulo-ocular reflex, in order to retain continuous visual focus during motion.

When the vestibular system is affected by labyrinthitis, rapid, undesired eye motion (nystagmus), often results from the improper indication of rotational motion. Nausea, anxiety, and a general ill feeling are common due to the distorted balance signals that the brain receives from the inner ear

TreatmentProchlorperazine is commonly prescribed to help alleviate the symptoms of vertigo and nauseaEvidence suggests that selective serotonin-reuptake inhibitors may be more effective in treating labyrinthitisSome evidence suggests that viral labyrinthitis should be treated in its early stages with corticosteroids such as prednisone, and possibly antiviral medication such as Valtrex and that this treatment should be undertaken as soon as possible to prevent permanent damage to the inner ear

Vestibular rehabilitation therapy (VRT) is a highly effective way to substantially reduce or eliminate residual dizziness from labyrinthitis. VRT works by causing the brain to use already existing neural mechanisms for adaptation, plasticity, and compensation

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