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cara serumen prop THT korotoran telinga
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Serumen Prop
Defenisi Serumen
Serumen adalah hasil produksi kelenjar sebasea, kelenjar seruminosa, epitel kulit yang
terlepas dan partikel debu.
Dalam Keadaan normal serumen terdapat di sepertiga luar linag telinga karena
kelenjar tersebut banyak terdapat pada daerah ini.
Konsistensinya biasa ludang tetapi terkadang kering dan dipengaruhi oleh faktor
keturunan, iklim, usia, dan keadaan lingkungan.
Serumen dapat keluar sendiri dari liang telinga akibat migrasi epitel kulit yang
bergerak dari arah membran timpani menuju ke luar serta dibantu oleh gerakan rahang
sewaktu mengunyah.
Fungsi Serumen :
Sebagai proteksi yaitu dengan mengikat kotoran, menyebarkan aroma yang
tidak disenangi serangga sehingga serangga tidak masuk ke liang telinga.
sarana pengangkut debris epitel dan komtaminan untuk dikelurkan dari
membran timpani.
Pelumas dan mencegah kekeringan dan pembentukan fisura pada epidermis.
Faktor-faktor yang dapat menyebabkan serumen terkumpul dan mengeras
diliang telinga :
1). Dermatitis kronik liang telinga luar
2). Liang telinga sempit
3). Produksi serumen banyak dan kental
4). Adanya benda asing di liang telinga
5). Adanya eksostosis liang telinga
6). Serumen terdorong oleh jari tangan atau ujung handuk setelah mandi atau
kebiasaan mengorek telinga
Serumen dapat dibersihkan dengan konsistensinya.
Serumen Lembek dapat menggunakan kapas yang dililitkan pada pelilit kapas.
Serumen yang keras dapat dikeluarkan dengan pengait atau kuret.
Apabila kedua cara ini tidak dapat mengeluarkan serumen maka dapat
dilunakkan lebih dahulu menggunakan tetes karbolgliserin 10% selama 3 hari.
Serumen yang sudah terlalu jauh terdorong ke dalam liang telinga dapat
dikeluarkan dengan mengalirkan air hangat sesuai suhu tubuh.
IndicationsCerumen in the external ear canal is physiological. Indications to address the cerumen
include the following[4] :
Difficulty in examining the full tympanic membrane
Otitis externa
Wax occlusion of the external ear canal
As part of the workup for conductive hearing loss
Prior to taking the impression for hearing aid fitting
Suspected external ear canal or middle ear cholesteatoma
Suspected external ear canal pathology such as squamous cell carcinoma or
eczema
As part of the follow-up to canal wall down mastoidectomy
As part of grommet insertion or middle ear surgery (preoperatively or
perioperatively)
Patient request
ContraindicationsSpecific contraindications exist for each specific procedure. Individual assessment
should dictate which technique is the most appropriate.
Contraindications to irrigation include the presence or history of a perforated
tympanic membrane, previous pain on irrigation, or previous surgery to the
middle ear.
A relative contraindication to probing is the inability to visualize the ear canal.
Relative contraindications to microsuction are severe previous exacerbation of
tinnitus, very hard cerumen, and an uncooperative patient.
Exceptional caution has to be used when clearing cerumen in patients who
have undergone a mastoidectomy in the past, during which sensitive
anatomical structures like the facial nerve and semicircular canals may have
been exposed.
Preparation and visual assessmentAssemble and prepare all necessary equipment.
Take time to explain the procedure to the patient and obtain consent.
Connect suction tip and turn on the suction machine and microscope light.
Position the patient’s head facing away from the operator, the neck flexed
laterally and the shoulder pulled down.
Examine the pinna, outer portions of the external canal, and the adjacent scalp
for any evidence of previous surgery incision scars, signs of infection, or
discharge.
Inspect the outer ear canal opening, using the appropriate aural
o The speculum should be the largest size that fits. It should be placed
deep enough to clear the hair-bearing skin but not deeper, as
unnecessary pain may result.
o The speculum should be held with the first and second fingers. Use the
other fingers to retract the pinna up and backward in an adult (retract
the pinna up and downward in a child).
Assess the cerumen. Gently probe with a blunt instrument such as Jobson
Horne curette to determine whether the cerumen is soft, hard, or bony hard.
Assess whether tympanic membrane is visible. Look for any air spaces around
the cerumen.
Before beginning the cerumen removal, ensure that the microscope and
operator are optimally positioned. The microscope should be positioned to
provide the optimal view of the ear canal, and the operator should be sitting
comfortably and with a straight back.