Noise Induced Hearing Loos

Kelompok 13

Introducing

Environmental noise is a common cause of hearing loss in industrialized societies. Hearing loss that is caused by the noise exposure due to recreational or nonoccupational activities is termed socioacusis. Hearing loss due to injurious noise at workplace is referred to as occupational noise-induced hearing loss (ONIHL). The term acoustic trauma means the hearing loss due to single exposure to intense sound.ONIHL is a more common cause of noise-induced hearing loss (NIHL) and much more serious problem than socioacusis for the following 2 reasons: (1) The threat of loss of employment may convince people to remain in environments with noise levels higher than they would otherwise accept, and (2) in the workplace, high levels of noise may be sustained on a regular basis for many hours each day

Pathophysiology
exposed to noise for a long time Direct damage at sterocilia in hair cell Death of hair cell

Rupture of reissner membrane

disturbance impulse formation

vibration could not be delivered to the scale of the media and organ corti

no impulses are transmitted to the brain

Deafness

Clinical Manifestation
The first difficulty the patient usually notices is trouble understanding speech when a high level of ambient background noise is present. NIHL progresses, individuals may have difficulty understanding highpitched voices (eg, women's, children's) even in quiet conversational situations.

Hipotesis
Noise Induced Hearing Loss Presbiacusis

Audiometri

Derajat ketulian: 500 Hz+1000 Hz+2000 Hz+4000 Hz 4 = 35 dB (tuli sedang)

Interpretasi: AC & BC <25 dB berhimpit tuli sensorineural Grafik terus menurun sampai frekuensi 3000 Hz lalu kembali naik pada frekuensi 4000 Hz gambaran khas tuli sensorineural yang disebabkan oleh bising dimana terjadi kenaikan ambang dengar

DIAGNOSIS: TELINGA BILATERAL TULI SENSORI NEURAL DERAJAT RINGAN ET CAUSA NIHL

Dasar Diagnosis Sulit mendengar percakapan di keramaian Volume TV maksimal baru bisa mendengar Riwayat pekerjaan sebagai mekanik perusahaan tekstil selama 30 tahun dan tidak memakai APD (earplug) yang disediakan Hasil Audiometri

Penatalaksanaan
Upaya preventif 4 steps hearing conservations: Identifikasi sumber bunyi Menggunakan Alat Pelindung Diri (APD) Melakukan tes Audiometri secara berkala pada pekerja yang berisiko Mengurangi intensitas kebisingan : Pengendalian administrasi dan pengendalian teknik

Psikoterapi
Rujuk ke dokter spesialis THT

Prognosis
Ad Vitam Ad Fungsionam Ad Sanationam

: Ad Bonam : Dubia Ad Malam : Dubia Ad Malam

Daftar Pustaka
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Nilan J et al. Occupational hearing loss. Noise and hearing conservation in occupational medicine,1994: 258-96 Ilmu Kesehatan Telinga Hidung Tenggorok. Edisi 6. 2007. Jakarta: Balai Penerbit Fakultas Kedokteran Universitas Indonesia. p.49-52 Sanrota R. Tingkat penurunan pendengaran akibat kebisingan pada tenaga kerja Indonesia bagian pertenunan, Universitas Indonesia Jakarta,1992 Tesis Magister