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Complications of otitis externa

Complications associated with otitis externa are usually uncommon. However, the the following complications can sometimes occur.

Abscesses
Abscesses are usually painful, pus-filled growths that can form in and around the affected ear after an infection. They usually heal on their own but, in some cases, your GP may need to drain the pus from them.

Stenosis of the ear canal


Stenosis is the name given to the build-up of thick, dry skin in your ear canal, which can occur if you have the condition chronic otitis externa. It can affect your hearing because the build-up of skin makes your ear canal narrower. In rare cases, it can cause deafness. Stenosis of the ear canal can be treated using eardrops.

Inflamed or perforated eardrum


It is possible for any infection to spread to your eardrum. In some cases, the infection may cause pus to build up inside your inner ear and may rupture (tear) your eardrum. This is know as a perforated eardrum. Symptoms include: temporary hearing loss earache or discomfort a discharge of mucus from your ear ringing or buzzing in your ear (tinnitus)

In many cases a perforated eardrum will heal without treatment in around two months. If it shows no signs of healing after this time then surgery may be recommended.

Cellulitis
Cellulitis is a bacterial skin infection that can occur after otitis externa. It's when bacteria, which normally live harmlessly on the surface of your skin, enter your skin's deeper layers through damaged areas, such as those caused by otitis externa. Cellulitis causes affected areas of skin to become red, painful, hot and tender to the touch. Other symptoms include: feeling sick shivering chills a general sense of feeling unwell

Most cases of cellulitis can be treated with a seven-day course of antibiotics.

If cellulitis occurs in a person who was already very ill or who is very vulnerable to the effects of infection, they may need to be admitted to hospital as a precaution.

Malignant otitis externa


Malignant otitis externa is a serious but very rare complication of otitis externa, in which the infection spreads to the bone that surrounds your ear canal. Malignant otitis externa usually affects adults more than children. In particular, adults who are immunocompromised (have a weakened immune system) have an increased risk of developing it. This includes people having chemotherapy treatment or who have a chronic (long-term) health condition, such as diabetes, HIV or AIDS. If you have malignant otitis externa, you may have one or more of the following symptoms: severe ear pain and headaches exposed bone visible in your ear canal facial nerve palsy, where your face droops on the side of the affected ear

Without treatment, malignant otitis externa can be fatal. However, it can be effectively treated using antibiotics and surgery to remove any damaged tissue.

Otitis Eksterna
OTITIS EKSTERNA = radang liang telinga (MAE) akut maupun kronis

ETIOLOGI Bakteri : Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus, Streptococcus, dan beberapa bakteri gram negatif. Jamur golongan Aspergillus atau Candida sp. KLASIFIKASI 1. Inflammatory external otitis

a. Acute localized external otitis / otitis eksterna sirkumskripta, misal : furunkulosis, infeksi yang terbatas pada 1/3 pars kartilago MAE b. Acute diffuse external otitis / otitis eksterna diffusa (swimmers ear), infeksi yang mengenai kulit MAE 2/3 dalam. c. Chronic diffuse external otitis, umumnya disebabkan oleh jamur/otomikosis 2. Eczematoid external otitis 3. Seborrheic external otitis PATOFISIOLOGI 1. Inflammatory external otitis

2. Eczematoid external otitis

PENEGAKKAN DIAGNOSIS Anamnesis Gejala awal dapat berupa gatal Didapatkan riwayat faktor predisposisi Rasa gatal berlanjut menjadi nyeri yang sangat dan terkadang tidak sesuai dengan kondisi penyakitnya (mis, pada folikulitis atau otitis eksterna sirkumskripta). Nyeri terutama ketika daun telinga ditarik, nyeri tekan tragus, dan ketika mengunyah makanan. Rasa gatal dan nyeri disertai keluarnya sekret encer, bening sampai kental purulen tergantung pada kuman atau jamur yang menginfeksi. Pada jamur biasanya akan bermanifestasi sekret kental berwarna putih keabu-abuan dan berbau. Pendengaran normal atau sedikit berkurang. Pemeriksaan Fisik Kulit MAE edema, hiperemi merata sampai ke membran timpani dengan MAE penuh dengan sekret. Jika edema hebat, membran timpani dapat tidak tampak. Pada folikulitis akan didapatkan edema, hiperemi pada pars kartilagenous MAE. Nyeri tragus (+) Adenopati reguler dan terkadang didapatkan nyeri tekan. DIAGNOSIS BANDING Otitis eksterna bullosa Otitis eksterna nekrotikans Otitis media efusi Herpes zoster otikus

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KOMPLIKASI 1. Perikondritis

2. Selulitis 3. Dermatitis aurikularis PENATALAKSANAAN Prinsip penatalaksanaan otitis eksterna a.l: Membersihkan liang telinga dengan pengisap atau kapas dengan berhati-hati. Penilaian terhadap sekret, edema dinding kanalis, dan membrana timpani bilamana mungkin keputusan apakah akan menggunakan sumbu untuk mengoleskan obat. Pemilihan pengobatan lokal. Acute localized external otitis/otitis eksterna sirkumskripta Bila sudah jadi abses, diaspirasi secara steril untuk mengeluarkan nanahnya Berikan antibiotika baik oral maupun topikal, selama 5 hari. Antibiotika yang digunakan biasanya sensitif kuman Staphylococcus aureus, yaitu neomycin atau polymixin B yang dikombinasi dengan kortikosteroid. Pemanasan Analgetika (mis : asam mefenamat dan antalgin)
Posted by Khalifah Akhmad at 2:02 AM

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Sumbatan saluran napas atas dapat dibagi menjadi 4 derajat berdasarkan kriteria Jackson. 1. Jackson I ditandai dengan sesak, stridor inspirasi ringan, retraksi suprasternal, tanpa sianosis. 2. Jackson II adalah gejala sesuai Jackson I tetapi lebih berat yaitu disertai retraksi supra dan infraklavikula, sianosis ringan, dan pasien tampak mulai gelisah. 3. Jackson III adalah Jackson II yang bertambah berat disertai retraksi interkostal, epigastrium, dan sianosis lebih jelas. 4. Jackson IV ditandai dengan gejala Jackson III disertai wajah yang tampak tegang, dan terkadang gagal napas
5. 6. 7. 8. 9. 10. 11. Stadium I : cekungan sedikit pada inspirasi di daerah suprasternal, kadang-kadang belum ada stridor. Stadium II : cekungan di suprasternal dan epigastrium, stridor mulai terdengar. Stadium III : cekungan terdapat di suprasternal, epigastrium, interkostal, dan supraklavikula. Stridor jelas terdengar dan anak tampak gelisah. Stadium IV : cekungan bertambah dalam, sianosis, anak yang mula-mula gelisah, mulai tampak bertambah lemah dan akhirnya diam dengan kesadaran menurun.