resus mastoiditis.docx

7/24/2019 RESUS MASTOIDITIS.docx

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TUTORIAL KLINIK

MASTOIDITIS

Disusun Untuk Memenuhi Sebagian Syarat Mengikuti

Kepaniteraan Klinik Ilmu Kesehatan Telinga Hidung Dan Tenggorok Kepala !eher

"umah Sakit Umum Daerah Temanggung

Dokter #embimbing $

dr% #ramono& Sp% THTK!

Disusun oleh$

Al'a (ardholi )*+,,+-,+,./0

KEPANITERAAN KLINIK ILMU KESEHATAN TELINGA, HIDUNG DAN TENGGOROK

FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN

UNIVERSITAS MUHAMMADIYAH YOGYAKARTA

RUM AH SAKIT UMUM DAERAH TEMANGGUNG

2014


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I% #"O1!2M

Seorang a!"en ere#$an $!"an 4% &a'$n (a&ang (a&ang (engan )e*$'an n+er" )ea*a

!ea) 1 #"ngg$ +ang *a*$-

RPS . Kea*a &era!a )en/ang (an /e)o&/e)o& a(a )ea*a !ee*a' )"r"- Ke*$'an

("!er&a" n+er" &e*"nga !ee*a' )"r", (an #enge*$ar)an /a"ran- N+er" &e*"nga 3, &e*"nga

)"r" er(eng$ng 3, ga&a* a(a &e*"nga , en$r$nan en(engaran 3, a&$) ,

"*e) - Ke*$'an ("ra!a)an !$(a' !ea) !e&a'$n +ang *a*$ na#$n '"*ang &"#$*-

RPD . R"5a+a& &ra$#a a(a &e*"nga !ee*$#n+a ("!ang)a*- R"5a+a& a*erg" ("!ang)a*-

Ke*$'an '"($ng &er!$#a&, )e*$ar /a"ran (an ra!a &"(a) n+a#an a(a '"($ng

("!ang)a*- Ke*$'an n+er" &enggoro)an, )er"ng (an !$*"& #ene*an ("!ang)a*-

RPK . T"(a) a(a anggo&a )e*$arga +ang #en(er"&a )e*$'an !er$a-

II% H3#OTH2SIS

Ma!&o"("&"!

D"agno!"! an("ng .

O&"&"! e)!&erna

Here! 6o!&er o&")$!


3/9

III% M24HA5ISM

Kuman aerob

Gram negative :

proteus,

pseudomonas

spp E colli,

Gram positif :

s pyogenes dan

Bakterioides spp

Timbul Infeksi pada telinga

Eksogen infeksi

dari luar melalui

perforosi

membrane

Endogen

alergi,DM, TB

!inogen dari

penyakit

ronggga "idung

dan sekitarnya

#eradangan pada

Mastoidit

Keluarnya pus"Kemera"an

pada mastoid

Timbul suara

denging$yeri

pus"emasGangguan rasa

nyaman $yeri %iperemi

&tolitisKerusakan

'aringan(dikontinuit

as 'aringan

Gangguan

pendengaran

#enurunan

"arga diriGangguan

Komunikasi


4/9

I6% MO"2 I5(O

Na#a . N+- M

7en"! Ke*a#"n . Pere#$an

U#$r . 4% &a'$n

A*a#a& . Kranggan, Te#angg$ng

Aga#a . I!*a#

Tangga* #a!$) . 18 no9e#er 201:

KU . Le#a'

Ke!a(aran . ;o#o!#en&"!

V"&a* S"gn .

Te)anan Dara' . 1%0


5/9

Me#ran T"#an" . Re&ra)!" 1,:C

o L+#'o!"& . L 1>,%C

o LED 1a# . H %0##

2 a# . H >0 ##

Fo&o ron&gen. Fo&o Ma!&o"( o!"!" S/'$**er &angga* 20 no9e#er 201:


6/9

Ke!an . #a!&o"("&"! "*a&era*

6I% DO59T K5O:

1- aga"#ana)a' enega)an ("agno!"! #a!&o"("&"!

2- aga"#ana Pena&a*a)!anaann+a

6II% !2A"5I58 ISSU2S

#enegakan diagnosis mastoiditis

D"agno!"! (ar" #a!&o"("&"! ("(aa&)an er(a!ar)an 'a!"* ana#ne!"!, e#er")!aan B"!") (an

e#er")!aan en$nang-

a- Ana#ne!"!

Ana#ne!"! "n" #er$a)an 'a* +ang !anga& en&"ng, )arena 'a#"r :0C ("agno!"!

(aa& ("&ega))an (ar" ana#ne!a !aa- Ke*$'an +ang a*"ng !er"ng a(a*a' a(an+a

n+er", o&orea &er$! #ener$! a&a$ )a(ang )a#$' *e"' (ar" %? #"ngg$ (an

en(engaran #en$r$n &$*"-Per*$ ("er(a*a# $n&$) #enge&a'$" r"5a+a& en+a)"&

!ee*$#n+a a(a a!"en &er)a"& (engan Ba)&or re!")o #a!&o"("&"!- Ya"&$ a(an+a

"nBe)!" &e*"nga &enga' +ang a)$& #a$$n )ron"! (an a(e)$a& a&a$ &"(a)n+a

engoa&an $n&$) "nBe)!" &e*"nga &er!e$&-

- Pe#er")!aan F"!")

Pa(a e#er")!aan B"!") #a!&o"("&"! (aa& ("&e#$)an.

a- Fer"!

/- H"*angn+a !en!a!" en(engaran(- a')an )a(ang &"#$* !$ara er(eng"ng a(a !a&$ !"!" &e*"nga (aa& $ga a(a

!"!" &e*"nga +ang *a"nn+a

e- Ke#era'an a(a )o#*e)! #a!&o"(

B- Ke*$arn+a /a"ran a") en"ng #a$$n er$a *en("r-

g- Ma&"n+a ar"ngan )era! T$*ang, T$*ang Ra5an-


7/9

'- A(an+a a!e! K$#$*an ar"ngan #a&" (an nana'

/- Pe#er")!aan Pen$nang

Un&$) #en$nang &ega)n+a ("agno!"! (aa& ("*a)$)an e#er")!aan )$*&$r

#")ro"o*og", eng$)$ran !e* (ara' #era' (an !e* (ara' $&"' +ang #enan(a)an

a(an+a "nBe)!", e#er")!aan /a"ran !$#!$# $n&$) #en+"ng)"r)an a(an+a en+earan

)e (a*a# r$angan (" (a*a# )ea*a- Pe#er")!aan *a"nnn+a a(a*a' Bo&o #a!&o"(, ;T

!/an )ea*a ("(aa&)an !e*!e* $(ara (a*a# ro!e!$! #a!&o"(e$! &er"!" o*e' /a"ran

(an #e*ear, MRI)ea*a (an Bo&o o*o! )ea*a-

Pa(a #a!&o"("&"! a)$& &a#a) er!e*$$ngan r$ang &e*"nga &enga' (an !e* $(ara

#a!&o"(, "*a ro!e! "nB*a#a!" &er$! er*an$& a)an &era(" er!e*$$ngan +ang ("B$!

a(a )e($a (aera' &er!e$&- Pa(a #a!a er#$*aan "nBe)!" "a!an+a !&r$)r$r &rae)$*a

(an (an !e* $(ara #a!&o"( #a!"' $&$', &a" )a(ang)a(ang (engan a(an+a e(e#a

#$)o!a (an en$#$)an /a"ran !ero$r$*en, #a)a &era(" )e)a$ran ena#a)an

&rae)$*a!" !e* $(ara #a!&o"(- Pro!e! "nB*a#a!" a(a #a!&o"( +ang )ron") a)an

#en+ea)an enea*an !&r$)&$r &rae)$*a!" ("")$&" (e#"nera*"!a!" &rae)$*a, a(a

!aa& "n" +ang &a#a) a(a Bo&o #a!&o"( a(a*a' er!e*$$ngan !e* $(ara #a!&o"( (an

$#*a' !e* $(ara +ang er)$rang !er&a !&r$)&$r &rae)$*a +ang &er!"!a &a#a)

#enea*-

#enatalaksanaan )Terapi0 Mastoiditis

Men$r$& H"g*er 188> ena&a*a)!anaan #e("! a(a #a!&o"("&"! an&ara *a"n.

1- Pe#er"an an&""o&"/ !"!&e#") D"er")an eeraa #"ngg$ !ee*$# oera!" (aa&

#eng$rang" a&a$ #eng'en&")an !$$ra!" a)&"B (an #e#era")" 'a!"*

e#e(a'an- Pengoa&an (engan oa&oa&an !eer&" an&""o&"), an&" n+er", an&"

era(angan (an *a"n*a"nn+a a(a*a' *"n" er&a#a (a*a# engoa&an #a!&o"("&"!-

Te&a" e#"*"'an an&" a)&er" 'ar$! &ea& !e!$a" (engan 'a!"* &e!& )$*&$r (an 'a!"*

re!"!&en!"

2- Pe#e(a'an a(a &$*ang #a!&o"(- Pengoa&an "n" #er$a)an engoa&an +ang

*e"' "n9a!"B e(a' +ang ("*a)$)an er$a e(a' &er$)a, 'a* "n" ("*a)$)an ")a

(engan engoa&an &"(a) (aa& #e#an&$ #enge#a*")an )e B$ng!" +ang nor#a*-


8/9

A(a eeraa en"! e#e(a'an a&a$ &e)n") oera!" +ang (aa& ("*a)$)an a(a

OMSK (engan #a!&o"("&"! )ron"!, a") &"e en"gna a&a$ #a*"gna, an&ara *a"n.

1- Ma!&o"(e)&o#" !e(er'ana !"#*e #a!&o"(e/&o#+

Oera!" "n" ("*a)$)an a(a OMSK &"e a#an +ang (engan engoa&an &"(a)

!e#$', Oera!" "n" ("*a)$)an (engan e#er!"'an (" r$ang #a!&o"( (ar"

ar"ngan a&o*og") agar "nBe)!" #ena(" &enang (an &e*"nga &"(a) era"r *ag"- Pa(a

oera!" "n" B$ng!" en(engaran &"(a) ("era")"-

2- Ma!&o"(e)&o#" ra(")a*

Pa(a oera!" "n" rongga #a!&o"( ("er!"')an (ar" !e#$a ar"ngan a&o*og")-

D"n("ng a&a! an&ara *"ang &e*"nga *$ar (an &e*"nga &enga' (engan rongga #a!&o"(

("r$n&$')an, !e'"ngga )e&"ga (aera' ana&o#" &er!e$& #ena(" !a&$ r$angan-

T$$an oera!" "n" a(a*a' #e#$ang !e#$a ar"ngan a&o*og") (an #en/ega'

)o#*")a!" )e "n&ra)ran"a*- F$ng!" en(engaran &"(a) ("era")"- Ker$g"an oera!"

"n" a(a*a' a!"en &"(a) ("ero*e')an erenang !e$#$r '"($-

=- Ma!&o"(e)&o#" ra(")a* (engan #o("B")a!"

Se*$r$' rongga #a!&o"( ("er!"')an (an ("n("ng o!&er"or *"ang &e*"nga

("ren(a')an- T$$an oera!" "n" a(a*a' $n&$) #e#$ang !e#$a ar"ngan

a&o*og") (ar" rongga #a!&o"( (an #e#er&a'an)an en(engaran +ang #a!"' a(a-

4- M"r"ngo*a!&"

Oera!" "n" #er$a)an en"! &"#ano*a!&" +ang a*"ng r"ngan, re)on!&r$)!"

'an+a (" *a)$)an (" #e#ran &"#an"- T$$an oera!" "n" a(a*a' $n&$) #en/ega'

er$*angn+a "nBe)!" &e*"nga &enga' a(a OMSK &"e a#an (engan erBora!" +ang

#ene&a-

:- T"#ano*a!&"

Pe#e(a'ana-T"#ano*a!&" A(a*a' re)on!&r$)!" e(a' a(a #e)an"!#e

en(engaran (" &e*"nga &enga', (engan #e#era")" #e#rana &+#an"/a

#e*"n($ng" Bene!&ra/o/'*ea!e (ar" &e)anan !$ara- T$$an (ar" &"n(a)an "n" a(a*a'

$n&$) #en+e*a#a&)an (an #e#$*"')an en(engaran, (engan /ang)o) #e#rane

&"#an" (an re)on!&r$)!" &e*"nga &enga'- Se(ang)an &$$an !e)$n(ern+a a(a*a'

$n&$) #e#er&a'an)an a&a$ #e#era")" en(engaran &"#ano*a!&" "*a#ana

#$ng)"n- Ter(aa& eraga" &e)n") &"#ano*a!&" +ang ere(a, +a"&$


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en/ang)o)an )$*"&, Ba!"a, #e#ran&"#an" 'o#o*og (an re)on!&r$)!" o!")$*a

'o#o*og, )ar&"*ago (an a*o*a!&")-

%- Pen(e)a&an gan(a &"#ano*a!&" ;o#"ne( aroa/' &+#ano*a!&+

T$$an oera!" "n" $n&$) #en+e#$')an an+a)"& !er&a #e#era")"

en(engaran &ana #e*a)$)an &e)n") #a!&o"(e)&o#" ra(")a*-Me#er!"')an

)o*e!&ea&o#a (an ar"ngan gran$*a!" (" )a9$# &"#an" (")era)an #e*a*$" 2 a*an

+a"&$ *"ang &e*"nga (an rongga #a!&o"( (engan #e*a)$)an &"#ano&o#" o!&er"or-

6III% #"O1!2M SO!6I58

a- De/"!"on Ma)"ng . ana#ne!"!, e#er")!aan B"!"), e#er")!aan en$nang,

("agno!"!, (an &era" !e!$a" ("agno!"!

- D"agno!"! . Ma!&o"("&"!

/- Treaen& . a(a a!"en "n" ("*a)$)an #a!&o"(e)&o#", (an

(" er")an &era" #e(")a#en&o!a er$a .

InB$!e a!er"ng 20

In- ;eB&r"a@on 1 gr< 12 a#

In- Me&ron"(a6o*e 100 #g < ? a#

In- Ke&oro*a/ =0 #g< 12 a#

In- A!a# &ra#e@ :00 #g < ? a#

In- De@a#e&'a!on 1 a# < ? a#

resus mastoiditis.docx

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