dr. tolkha presentasi
DESCRIPTION
CERUMENTRANSCRIPT
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Cerumen Prop
Dr. Tolkha Amaruddin, M.Kes, SpTHT
RSUD SARAS HUSADA PURWOREJO 2008
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Definition Cerumen prop : obstruction of the
EAC by cerumen The term cerumen earwax Cerumen the secretory product
of the ceruminous glands in the EAC, it’s just one component of earwax
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Physiology
Ear wax : mixture of secretions of the ceruminose & pilosebaseus glands, squames of epithelium, dust & other foreign debris located in the cartilaginous portion of the ears canal. Protection acid condition : PH 6 Transport of debris Lubricant Bactericid efect
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Different types of cerumen
Cerumen : dry or wet, soft or hard
DRY - HARDWET - SOFT
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Pathophysiology
Its quantity varies individually & its consistency is determined by proportions of mixture
In a normal condition cerumen can migrate from canalis auditory external in flake by open the mouth and mastication
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Cause of obstruction : 1. Over production2. Dry type wax3. Malformation of the external
auditory canal (anatomic)4. Cleaning the ear inappropriatly
push the cerumen posteriorly impaction
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Symtomps : Hearing impairment (deafness)
CHL Earache Reflex cough Fullness in the ear Tinitus – vertigo
ObjectiveFinding the cerumen in the canalis
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Treatment
1. Ceruminolytics Epithelial acumulation desquamation &
debris collection. A ceruminolytic disrupt the structural
integrity of the keratin sheets and thereby soften, loosen, liquefy, &/ dissolve cerumen and perhaps even float it out.
The integrity of the cell membrane ▼, which allows water to pass into the corneocytes along an osmotic gradient.
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2. Technique Instrumentation2.1. Syringing2.2. Suction2.3. Hooking under direct vision.
A careful history: tympanic membrane perforation previous ear surgery
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Education
Do not to attempt self removal of cerumen with the use of any devices such of: cutton bud, and hairpins:
1. Increase impaction 2. Secondary infection
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Cerumen Prop vs Keratosis Obturans
Cerumen Prop Keratosis Obturans
Definition Obstruction of EAC keratolitic mass of by cerumen desquamating squamous epitheliumLocation Cartilage Portion Bony PortionAetiology Over production Probably related to of cerumen faulty migration of squamous epithelial cellsSymptom obstructed pain, otorrhoea
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