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LIDAH

Macroglossia
 Dapat terjadi pd: congenital hypothyroidism, Down’s syndrome, acromegaly
Fissured tongue/ scrotal tongue
 Terapi
sugesti kondisi N disertai simptom
obat kumur chorhexidine
 Sindrom Melkersson – Rosenthal
Hairy Tongue (Black hairy Tongue)
 Abnormal coating
terjadi gangguan deskuamasi sel dan penumpukan keratin sehingga papila filiformis memanjang.
 Letak
depan sulkus terminal daerah dorsum lidah  papilla filliformis memanjang (15-20 mm) & o : 2mm
 Predileksi
midline posterior di sebelah anterior papila circumvalata.(dpn sulkus terminal)
 Terapi
tata laksana faktor predisposisi, jaga OH, bersihkan lidah, keratolytic agent
(contoh: Podophylin resin solution 1%, topical tretinoin)
Geographic tongue/ Erythema Migrans
 Bila simptomatik  lakukan pemeriksaan untuk melihat defisiensi haematinic
 Simptomatik: obat kumur analgesic, hindari makanan yang mengiritasi lidah, suplemen Zinc
Atrofi Lidah
 Lidah tampak merah, mengkilat, terasa sakit.
 Bila terjadi  pemeriksaan penunjang penyakit yang melatar belakangi seperti defisiensi besi, anemia megaloblastik, defisiensi nutrisi,
diabetes mellitus  Pemeriksaan lab kadar ferritin, B12 , asam folat dan kadar glukosa darah.
 Tambahan: dapat terjadi: keluhan sakit pada lidah
tanpa adanya gambaran klinis yang nyata  burning mouth
syndrome/glossodynia/glossopyrosis
Klasifikasi BMS
 Faktor lokal (±50%): tongue-thrusting, space untuk lidah terbatas karena pemakaian gigi tiruan
Faktor sistemik (±30%): defisiensi hematologis, diabetes, penyakit mukosa mulut
Faktor psikogenik (±20%): kecemasan, depresi, cancerophobia.
 Sering terjadi pada wanita menopause
 Tata laksana
terapi faktor sistemik, perbaiki gigi tiruan, yakinkan pasien, vitamin B1 300mg B6 50mg sebagai placebo, hormon replacement
 Bila tidak ada respons  obat psychoactive
EXTERNAL EAR
Non-inflammatory diseases and injuries of external ear
 Deformities & Malformations

Prominent ears

Hyperostoses and Exostoses

Auricular Appendages

Congenital Pre-auricula fistula & cyst

Opening at preauricular sites on the helical rim.

can be retro &/ infra auricular site.

Can be bilateral & familial

Recurrent infections need surgical excision.

Malformation of auricle

Stenosis and atresia EAC

DD : EAC cholesteatoma,tumours, FB, clotted blood

Complication : OE
 Injuries and Physical Damage

Auricular Hematoma, Auricular Seroma

Elicit injuries to:
Temporal bone
EAC
Middle ear
TMJ

Surgical evacuation w/ reattachment perichondrium and cartilage

Sharp auricular injuries and auricular avulsion

Burn and Frost bite injuries

DD : caustic chemical injuries, electrical injuries

Complication : cartilage deformity and permanent necrosis

Injuries to EAC
Inflammatory diseases and injuries of external ear
 Inflammation Auricle
Excema & Dermatitis

Symptoms : itchy & burning sensation w/ little pain. The skin is erythematous, may be dry and scaly, moist and weeping.

DD : pyoderma, perichondritis, cellulitis, dermatitis seborrheic, psoriasis

Tx : eliminate allergic causative agent, treatment based on dermatologic principle, AB for bacterial infection.
Perichondritis
Symptom :

Severe pain on rapid onset

Feeling of tension

conjunctivitis  Elevated sedimentation rate  Respiratory problems. systemic complications. Auricular Cellulitis/ Ersypelas  Acute streptococcal infection of the subcutaneous tissue auricle and surroundings  Symptoms :  Redness. Herpes Zoster Oticus  Inflammation EAC Otitis Externa Necrotizing Otitis Externa Otomycosis  Tumours of External Ear Tumours of Auricle Tumours of EAC .     Auricular contour might be change Swelling and tenderness of concha Enlarged cervical lymph nodes and painful Fever Symptoms if reccurence  local pain. warmth  Malaise. swelling.  Tx : AB penicillin high dose (IV). articular pain  Fever  Sensorineural hearing loss  Iritis. otalgia  DD : dermatitis. oedema. perichondritis. erythema. fever. analgetic (NSAID). herpes zoster oticus.  Complication : necrotizing fasciitis.