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"ABSTRAKLatar belakang: Mikrotia merupakan kelainan perkembangan telinga luar dengan variasi kelainan struktur anatomi daun telinga. Variasi kelainan anatomi telinga tengah pada mikrotia dan angka kejadian kelainan anatomi telinga tengah pada pasien mikrotia telah banyak dilaporkan. Data penelitian variasi anatomi pasien mikrotia tersebut diperlukan untuk memprediksi kelainan anatomi telinga tengah berdasarkan derajat klinis kelainan telinga.Tujuan: Mengetahui hubungan kelainan subunit telinga luar dengan skor Jahrsdoerfer pada pasien mikrotia Metode: Dilakukan penelitian cross sectional menggunakan data retrospektif derajat mikrotia, gambaran CT Scan dan pemeriksaan audiologi (BERA dan audiometri nada murni) di Departemen THT FKUI/RSCM sebanyak 38 pasien mikrotia.Hasil: Subjek penelitian mikrotia didapatkan laki-laki lebih banyak dibandingkan perempuan (65,8%) dengan rerata usia 12,3 ± 8,1 tahun. Kelainan telinga tengah berdasarkan skor Jahrsdoerfer terbanyak adalah kelainan kompleks maleus inkus (72,3%). Gangguan pendengaran terbanyak adalah tuli konduktif (63,1%). Berdasarkan uji korelasi jika jumlah subunit telinga semakin besar maka skor Jahrsdoerfer akan konsisten meningkat menyesuaikan dengan jumlah subunitnya.Kesimpulan: Evaluasi subunit telinga sangat penting dalam evaluasi dan tatalaksana pasien mikrotia.

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ABSTRACT

Background: Microtia is a developmental disorder with a variety of abnormalities of the outer ear anatomical structures. Variations of anatomical abnormalities of the middle ear in microtia and the incidence of middle ear anatomical abnormalities in microtia patients have been reported. The research data is needed to predict the variations in the anatomy of the middle ear abnormalities which are based on the degree of clinical disorders.

Objective: To determine the relationship of auricle subunit with Jahrsdoerfer score on microtia patients Methods: Cross-sectional study using retrospective data of microtia patients, CT Scan and audiological examination (BERA and pure tone audiometry) in the Department of Otolaryngology Faculty of Medicine / RSCM on 38 microtia patients.

Results: Study found male patients more frequent than female (65.8%) with a mean age of 12.3 ± 8.1 years. Most frequent middle ear abnormalities based on Jahrsdoerfer is malleus incus complex disorder (72.3%). Most frequent hearing loss is conductive hearing loss (63.1%). Based on correlation test if the greater auricle subunit value consistently increased with Jahrsdoerfer score.

Conclusion: Evaluation of ear subunit is essential in the evaluation and management of patients with microtia."

"ABSTRACTTotal auricular reconstruction of microtia with autogenous costal cartilage is one of the most demanding challenges in plastic and reconstructive surgery because of the complex three-dimensional shape of the auricle. An ideal result of the constructed ear depends primarily on the fabricated cartilaginous ear framework. As the cartilage framework used for reconstruction is always insufficient for the fabrication of anatomical structures, especially the tragus and the conchal bowl, individualized framework grafting based on different patient age groups and different degrees of strength and thickness of the rib cartilages have been devised accordingly. For a configuration of the concha that is definitely anatomical, we constructed the conchal bowl element in one of three patterns according to the amount of available cartilages: one block, two-pieces, or a cymba bowl element only. The patients were followed up for more than 1 year. The aesthetic results were scored by evaluating characteristics involving the stability of the crus helicis, the conchal definition, and the smoothness of the helical curve.The ears reconstructed early without a conchal bowl element and ears reconstructed later with the concha bowl element showed a definite crus helicis, deep cymba conchal space, and smooth helical curve. The construction of the conchal bowl element is simple dan not time-consuming procedure. It is suggested that the conchal bowl element must be constructed and attached to the main framework for natural configuration of the reconstructed ear. "

"Latar belakang dan tujuan: Mikrotia adalah malformasi kongenital yang seringkali disertai atresia auris dan kelainan telinga tengah. Kelainan ini dikoreksi dengan kanaloplasti dan timpanoplasti. Titik dan arah pengeboran kanaloplasti merupakan hal yang penting. Saat ini belum terdapat panduan yang objektif dalam menentukan arah pengeboran. Volume telinga tengah, berperan penting dalam penentuan keluaran hasil pembedahan, namun saat ini belum pernah dikaitkan dengan sudut α dan β. Penelitian ini bertujuan menilai hubungan sudut α dan β dengan volume telinga tengah tmikrotia dan telinga normal menggunakan HRCT temporal. Metode: Menggunakan desain potong lintang. Subjek penelitian merupakan data sekunder HRCT tulang temporal, kemudian dilakukan pengukuran sudut α dan β dan volume telinga tengah. Hasil: Subjek penelitian berjumlah 34 sampel. Terdapat perbedaan bermakna sudut α dan sudut β telinga mikrotia dibandingkan telinga normal, dengan nilai p<0.001. Rerata volume telinga tengah mikrotia 0.36 cc, normal 0.67 cc. Tidak didapatkan korelasi volume telinga tengah dengan sudut α dan β, pada mikrotia maupun telinga normal. Nilai cut-off sudut α sebesar 15.40, sensitivitas 85.3% dan spesifisitas 82.4%. nilai cut-off sudut β sebesar 270, sensitivitas 73.5% dan spesifisitas 76.5%. Kesimpulan: Perbedaan posisi osikular dengan nilai cut-off yang didapat untuk sudut α dan β dapat menjadi acuan dasar pada operasi kanaloplasti.

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Background and Objectives: Microtia is a congenital malformation with associated auricle atresia and middle ear abnormality, which is treated by canaloplasty and tympanoplasty. Drilling starting point and the direction in canaloplasty operation are no doubt very important things. Nowadays, guideline for determining the drilling direction has not been yet established. Middle ear volume which is one of important variable in determining operation outcome, has not been associated with α and β angle. This study intended to evaluate α and β angle and its relationship with middle ear volume using (HRCT) temporal bone.

Method: Cross-sectional design were used. Data from previous HRCT examination were used to measured α and β angle and middle ear volume.

Results: From 34 subjects, there were significant differences of α and β angle in microtic ear compared to normal ear, with p < 0.001. Middle ear volume average for microtic ear and normal ear were 0.36 cc and 0.67 cc, respectively. No significant correlation between middle ear volume and α and β angle. Cut-off value for α angle is 15.40 with sensitivity 85.3% and specificity 82.4%. Cut-off value for β angle is 270 with sensitivity 73.5% and specificity 76.5%.

Conclusion: Differences in ossicular position with obtained cut-off value for α and β angle could become a base guidance in canaloplasty operation."

"ABSTRAKTesis ini membahas rinosinusitis kronik dan hubungannya dengan kelainan telinga tengah di poliklinik THT RSCM pada pasien dewasa. Penelitian ini bertujuan untuk mengetahui proporsi kelainan telinga tengah pada pasien rinosinusitis kronik dan hubungan antara rinosinusitis kronik dengan kelainan telinga tengah pada percontoh dengan keluhan hidung dan/atau keluhan telinga. Penelitian ini menggunakan metode potong lintang pada pasien usia 18-60 tahun dengan membran timpani intak yang datang ke poliklinik Umum THT RSCM dengan keluhan hidung dan/atau keluhan telinga yang kemudian menjalani rangkaian pemeriksaan nasoendoskopi, otomikroskopi, timpanometri dan uji cukit kulit. Hasil penelitian mendapatkan proporsi kelainan telinga tengah pada pasien rinosinusitis kronik sebanyak 14 percontoh (14/77=18,2%) dan hubungan antara rinosinusitis kronik dengan kelainan telinga tengah secara statistik tidak bermakna (p=0,75).

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ABSTRACTThis study investigates chronic rhinosinusitis and its association with middle ear inflammation in adult patient at ENT oupatient clinic, Cipto Mangunkusumo Hospital. The aim of this study is to determine the proportion of the middle ear inflammation among the chronic rhinosinusitis patients and its association between chronic rhinosinusitis and middle ear inflammation in a population with ear and/or nose complaint. This is a cross sectional study in patients between the age of 18-60 years old with intact tympanic membrane who came to ENT outpatient clinic with ear and/or nose complaints and underwent nasoendoscopic, otomicroscopic, tympanometric examination and skin prick test. The results were proportion of the middle ear inflammation among the chronic rhinosinusitis patients was 14 samples (18,2%) and there was no significant association between chronic rhinosinusitis and middle ear inflammation statistically (p=0,75)."

"ABSTRAKLatar Belakang: Audiometri impedans belum digunakan secara rutin dalam uji tekanan khususnya di Indonesia. Calon penyelam sering langsung menerima pajanan tekanan dalam Ruang Udara Bertekanan Tinggi (RUBT) tanpa diketahui keadaan telinga tengah dan fungsi tuba Eustachius. Pemeriksaan audiometri impedans sangat penting untuk mengetahui fungsi ventilasi tuba Eustachius (TE). Tujuan: Penelitian ini bertujuan untuk mengetahui perubahan nilai tekanan telinga tengah yang berhubungan dengan fungsi ventilasi TE pada calon panyelam. Metode: Penelitian ini melibatkan 29 subjek calon penyelam berusia 20-40 tahun tanpa gangguan pendengaran konduktif. Semua subjek menjalani pemeriksaan audiometri impedans yang dimodifikasi untuk kepentingan penyelaman baik sebelum maupun sesudah uji tekanan dalam RUBT beruang ganda. Hasil: Didapatkan perubahan nilai tekanan di telinga tengah yang bermakna sebelum dan sesudah uji tekanan dengan perasat Toynbee pada telinga kanan dan kiri, masing-masing p < 0,001 dan p = 0,018. Kesimpulan: Pemeriksaan audiometri impedans sangat diperlukan dalam seleksi calon penyelam khususnya dalam uji tekanan dalam RUBT.

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ABSTRACTBackground: Impedance audiometry is not yet used in the pressure test routinely, especially in Indonesia. Prospective divers often receive exposure of pressure in hyperbaric chamber directly without assesment of the middle ear and Eustachian tube (ET) ventilation function. Impedance audiometry examination is very important to asses the ET ventilation function. Objective: This study determined the middle ear pressure value changes associated with ET ventilation function of prospective divers. Method: This study involved 29 prospective diver subjects aged 20-40 years without a conductive hearing loss. All subjects underwent a modified diving impedance audiometry examination both before and after the pressure test in hyperbaric double lok chamber. Result: Obtained value changes of pressure in the middle ear meaningful before and after the pressure test with Toynbee maneuver on the right and left ear, respectively p <0.001 and p = 0.018 Conclution: Impedance audiometry examination is needed in the selection of candidates divers who underwent pressure test within hyperbaric chamber."

"Latar belakang: Atresia aural kongenital dengan mikrotia merupakan gangguan perkembangan daun telinga dan sering dikaitkan dengan malformasi saluran pendengaran eksternal serta telinga tengah. Pembedahan pada atresia aural kongenital dianggap sebagai salah satu yang paling sulit dan membutuhkan penilaian pencalonan yang tepat untuk menentukan operasi. Sistem penilaian Jahrsdoerfer berdasarkan pemeriksaan tomografi komputer (CT scan) masih sering digunakan untuk menentukan kandidat yang tepat untuk operasi namun dirasa terdapat celah dan ketidakcocokan pada skor ini sehingga diperlukan pengukuran lebih detail untuk keperluan kandidasi pembedahan yang lebih baik. Metode: Studi ini merupakan studi potong lintang terhadap pasien mikrotia dengan atresia aural kongenital unilateral di RSUPN Cipto Mangunkusumo menggunakan CT scan. Parameter yang diukur meliputi volume mastoid, volume ruang telinga tengah, diameter tingkap bundar, diameter tingkap lonjong, diameter medial liang telinga, orientasi nervus fasialis, dimensi kompleks maleus inkus, koneksi inkus stapes serta kelengkapan struktur stapes. Hasil: Rerata volume telinga tengah, jarak serta sudut orientasi nervus fasialis, diameter medial liang telinga, dimensi kompleks maleus inkus, volume mastoid, diameter tingkap bundar dan diameter tingkap longkong secara signifikan (p<0,05) berukuran lebih kecil pada telinga mikrotia dibandingkan sisi kontralateral. Kesimpulan: Berdasarkan beberapa parameter telinga tengah mikrotia unilateral yang dilakukan pengukuran dengan CT scan diperoleh seluruh parameter telinga tengah sisi mikrotia memiliki ukuran lebih kecil dibandingkan kontralateral.

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Introduction: Congenital aural atresia with microtia is a developmental disorder of the auricle and is often associated with malformations of the external auditory canal as well as the middle ear. Surgery in congenital aural atresia is considered to be one of the most difficult and requires proper candidature assessment to determine surgery. The Jahrsdoerfer scoring system based on computed tomography (CT) scans is still often used to determine appropriate candidates for surgery, but there are gaps and discrepancies in this score. Detailed measurements requiered for better surgical candidacy.

Methods: This study is a cross-sectional study of microtia patients with unilateral ear canal atresia at Cipto Mangunkusumo Hospital using CT scan. Parameters measured included mastoid volume, middle ear space volume, round window diameter, oval window diameter, medial diameter of the ear canal, orientation of the fascial nerve, dimensions of the malleus incus complex, incus stapes connection and completeness of the stapes structure.

Results: The mean middle ear volume, distance and angle of orientation of the fascial nerve, medial diameter of the ear canal, dimensions of the malleus incus complex, mastoid volume, round window diameter and oval  window diameter were significantly (p<0.05) smaller in the microtia ear than the contralateral side.

Conclusion: Based on several parameters of the middle ear of unilateral microtia measured by CT scan, all parameters of the middle ear of the microtia side have a smaller size than the contralateral."

"Terapi radiasi adalah pengobatan dengan menggunakan sinar pengion, yang saat ini merupakan salah satu jenis terapi penting untuk penyakit kanker di samping pembedahan dan kemoterapi. Pada dasarnya tujuan pemberian terapi radiasi ialah untuk mengeradikasi tumor invivo dengan memberikan sejumlah dosis radiasi yang diperlukan secara tepat pada daerah target radiasi, tanpa merusak jaringan sehat di sekitarya. Akan tetapi kerusakan pada jaringan sehat merupakan hal yang tak bisa dihindari, terutama pada tumor yang letaknya di bagian dalam tubuh. Oleh karena itu penting bagi kita untuk memperhatikan gejala atau keluhan yang timbul pada jaringan sehat akibat pemberian terapi radiasi.

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Radiation therapy is treatment using ionizing beams, which is currently one of the important types of therapy for cancer in addition to surgery and chemotherapy. Basically, the purpose of providing radiation therapy is to radiate in vivo tumors by providing the right amount of radiation doses to the radiation target area, without damaging healthy tissues in the vicinity. However, damage to healthy tissue is inevitable, especially in tumors located in the inside of the body. Therefore, it is important for us to pay attention to symptoms or complaints that arise in healthy tissues due to the administration of radiation therapy."

"This book follows a symptomatic approach for evaluation and prioritisation of common presentations, and provides guidance on primary care assessment and management, and on when and why to refer for a specialist opinion. Fully revised to reflect the current practice of oto-rhino-laryngology and head and neck surgery, new chapters address the increasing specialization and improved understanding of the likely causes and specialist treatment for symptoms such as tinnitus, nasal discharge, nasal obstruction, facial plastic surgery, head and neck trauma and foreign bodies, and non-specialist assessment and examination. There is new content on rhinoplasty, pinnaplasty, non-melanoma skin tumours, thyroid disease and head and neck cancer, with many new full colour illustrations and algorithms throughout.ABC of Ear, Nose and Throat is a long established best-selling guide to the management of common conditions of the Ears, Nose and Throat. It follows a symptomatic approach for evaluation and prioritisation of common presentations, and provides guidance on primary care assessment and management, and on when and why to refer for a specialist opinion. Fully revised to reflect the current practice of oto-rhino-laryngology and head and neck surgery, new chapters address the increasing specialization and improved understanding of the likely causes and specialist treatment for symptoms such as tinn."