Hearing treshold before and after middle ear surgery in chronic suppurative otitis media (CSOM)

Hearing loss is a common symptom in chronic suppurative otitis media (CSOM), often cause social communication disturbance. Canal wall up tympanoplasty and canal wall down tympanoplasty are surgery procedures for managing this disease that no response to convensional treatment. These surgery procedures should consider to hearing function impact. The aim of this study was to evaluate the difference hearing threshold between before and after middle ear surgery on CSOM patients. It was an historical cohort study conducted from January 2015 to December 2016 involving CSOM patients who underwent canal wall up tympanoplasty surgery and canal wall down tympanoplasty in The Otology Division, Departement of Ear, Nose, Throat, Head and Neck Health, Dr. Sardjito General Hospital, Yogyakarta. The inclusion criteria included basic data, diagnostics, surgery reports, and audiometry results before and 3 months postoperatively, while the exclusion criteria were not complete medical record data. Total of 64 patients with CSOM were involved in this study consisting of 32 patients who underwent canal wall up tympanoplasty and 32 patients who underwent canal wall down tympanoplasty. Significantly different in the increasing of hearing threshold between before and after canal wall up tympanoplasty surgery compared to the canal wall down tympanoplasty was observed (p = 0.021). In addition, surgical technique was the main factor affecting postoperative hearing threshold in CSOM patients (p < 0.05). In conclusion, the increasing of hearing threshold in CSOM patients underwent canal wall up tympanoplasty surgery is better than those underwent canal wall down tympanoplasty

The effectiveness of rivanoltampon@ compared with burowi tampon in\u27acute diffuse otitis extern a

ABSTRACT IWayan Marthana Kedel, Edhie Samodra, Bambang Udji Djoko Rianto -The effectiveness of rivanol tampon" compared with burowi tampon in acute diffuse otitis externa (ADOE)patients Background: Acute diffuse otitis externa (ADOE) is one of the common diseases in ENT Department, Dr. Sardjito Hospital, with the frequency of 9-1 2%. The most common microorganism found is Pseudomonas aeruginosa. Infection usually occurrs after taking a bath, washing hair, and scratching the external ear canal. Treatment of acute diffuse otitis externa which consists of topical preparations, Le. antibiotics and antiinflammation tampon or ear drop, is relatively expensive. A rationale, high recovery rate, cheap, and easily found preparation is needed. Burowi solution is one of the recommended treatment, but it is less popular. Objective: The goal of this study was to know the effectiveness of Rivanol" tampon compared with Burowi tampon in acute diffuse otitis externa. Methods: A randomized single-blind controlled trial (RCT)was performed at the outpatient clinicof ENTDepartment of DrSardjito General Hospital, Yogyakarta. Sixty-five subjects who were\u27diagnosed as ADOEwho met inclusion criteria were randomly allocated into two groups, that is, Rivanol"group and Burowi group. The ear canal was cleaned, and then Rivanol"tampon or Burowi tampon was applied. Evaluation was performed on day 3 and 5. Primary outcome was the recovery rate, and secondary outcomes were adverse reaction and marginal costeffectiveness. Results: Of 65 subjects, 33 were alloc\u278ted into Rivanol"group and 32 were. allocated into Burowi group. The recovery rate in Rivanol"group was 75.4%, while in Burowigroups was 49.3%. The difference in recovery rate between the two groups was statistically significant (p: 0.018RR4.35095% CI1.225-15.442). Adverse reaction in Rivanol"group was dampness and soggy feeling in the ear canal (1.5%), while in the Burowigroup the adverse events were pain and burnt sensation inthe ear canal (3.1%), but they could be tolerated and disappeared on day 5. Analysis on marginal cost-effectiveness showed that the cost to cure one acute diffuse otitis externa patient with Rivanol"tamponwas Rp 1,000. Conclusion: Rivanol"tampon was more clinicallyeffective and more cost-effective than Burowitampon for acute diffuse otitis externa treatment. Key words: acute diffuse otitis externa, Rivanol(!),Burowi,.clinical and cost effectivenes

The influence of tympanic membrane perforation site on the hearing level of conductive hearing loss in chronic suppurative otitis media

Chronic suppurative otitis media (CSOM) is an infection of the middle ear cavity both partially and totally. It is characterized by ear discharge through a tympanic membrane perforation for over a period of 2 to 6 weeks. Hearing loss is the most common complication of CSOM. One of the degrees of hearing loss in tympanic membrane perforation is depending on the site of perforation, but this premise is still debatable because of pros and contras by some researchers. This study aimed to assess the degree of hearing loss in relation to the site of tympanic membrane perforation. A cross-sectional prospective study design was performed involving 43 patients of safe type CSOM who came to the Department of Otolaryngology Head and Neck Surgery from the period January 2016 to November 2018. All subjects were divided into 4 groups based on the site of perforation. There was a perforation in the posteroinferior, the posterosuperior, the anteroinferior, and the anterosuperior. A statistical analysis using Anova along with multivariate analysis was conducted. Our result showed that the most common site of tympanic membrane perforation was at the anteroinferior (30 samples, 59.8%). The highest hearing threshold was seen at posteroinferior with a mean hearing level of 37.7±2.0 dB, anteroinferior with a mean hearing level of 31.7±0.7 dB, anterosuperior with a mean hearing level 30.7±1.4 dB, and posterosuperior mean hearing level 28.9±1.5 dB. The difference was found significant with p=0.004. Posteroinferior tympanic membrane perforation had a higher number of hearing loss compared to the other sites. In conclusion, the tympanic membrane perforation site has an important role in the hearing level of conductive hearing loss in CSOM

PENGARUH HIPOKSIA HIPOBARIK TERHADAP FUNGSI SEL RAMBUT LUAR KOKHLEA

Cochlear hair cell is a sensoric cell of hearing system with a hair like structrure above it, which is a stereocilia. Cochlea is an organ that works continuously for 24 hours a day, receiving vascularization from a very small artery (a.cochlearis) without collateral and vasculary striae which is the prime energy for hair cells in organon Corti. Hypoxic condition can cause damage to the cell in human body. Cochlear outer hair cell is one of the cell that wont regenerate after receiving a damage, while this cell is very crucial for hearing process to work well. People who are frequently traveled by airplane, or pilot cadets, receiving a hypoxic hypobaric condition pretty often. This means that as a pilot cadets, they would have to endure a certain hypoxic hypobaric condition during training in the hypobaric chamber. The purpose of this study is to know the effects of hypoxic hypobaric condition in 18.000 feet high, to the pilot cadet�s outer cochlear hair cell function. The design of this study is quasi experimental. Statistical analysis using numerical calculation such as mean, deviation standart, and percentage. t-test also used to compare the mean of pre and post test in time series. The result of this study showed that there were 9 subject (18%) with cochlear outer hair cell function abnormality after 5 minutes inside the chamber, and after 25 minutes there were 16 subject (32%) with same abnormality. Blood oxygen saturation before and after 5 minutes and 25 minutes had significant difference (p<0,01). Mean of the blood oxygen saturation after 5 minute (71,42 SD 1,401) and after 25 minute (71,22 SD 1,329). Almost every parameter showed significant different before and after 5 minutes and befora and after 25 minutes in hypobarec chamber (p0,05). The SNR value in every frequencies was still above 6 dB, which mean that cochlear outer haircell still function normally. In conclusion cochlear outer haircell function was decreasing due to acute hypoxia in 18.000 ft