Otitis Media

Supuratif
Akut
Dr. H. Edi Handoko, Sp. THT-KL (K)
Durrotul Ikrimah
0910710007
Irsyad Robani Wihardi
105070106111007

Content
Definisi
Epidemiologi, Etiologi dan Faktor
Predisposisi
Patogenesis dan Patofisiologi

Prosedur Diagnostik

Terapi

Komplikasi

Otitis Media Supuratif Akut

Otitis Media Supuratif Akut (OMSA)
adalah Inflamasi akut telinga tengah
yang disebabkan organisme pyogenik

Dhingra, P., 2007. Disease of Ear, Nose and Throat. In:

Disorders of Middle Ear. 4th Edition ed. s.l.:Elsevier, pp.
61-73

Etiologi
35
30

30

25
20
15

20
12

10

Persentase

5
0

Dhingra, P., 2007. Disease of Ear, Nose and Throat.

In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

Pyogen

Etiologi

Ramakrishnan, K., Sparks, R. A. & Berryhill, W.

E., 2007. Diagnosis and Treatment of Otitis
Media. American Academy of Family Physicians,
Volume 76(Number 11), pp. 1651-1658.

Rute Infeksi

Via tuba
eustachi
us

Via
telinga
eksterna

Blood
borne
Dhingra, P., 2007. Disease of Ear, Nose and Throat.
In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

Faktor Predisposisi

Recurrent
attack
Common cold
ISPA
Demam
exanthema

Infeksi tonsil
dan adenoid

Cleft palate

Menggang
gu fungsi
normal
tuba
eustachius
Tumor
nasofaring,
epistaksis

Rhinitis
kronis dan
sinusitis

Nasal
allergy
Dhingra, P., 2007. Disease of Ear, Nose and Throat.
In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

Patofisiologi
1. Stage tuba oklusi
Edema dan hyperemia tuba eustachius nasofaringeal end
absorpsi udara, tekanan negative retraksi MT+efusi

2. Stage Pre-supuratif
Organisme pyogen menginvasi rongga
Eksudat inflamasi muncul di telinga tengah MT mulai
kongesti

3. Stage Supuratif

Formasi pus di middle ear+mastoid air cells.

MT bulging ruptur

4. Stage Resolusi/Komplikasi
Dhingra, P., 2007. Disease of Ear, Nose and Throat.
In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

OMSA
Staging

Stage tuba oklusi

Tanda

Gejala

Stage Pre-supuratif

Tanda

Gejala

Stage Supuratif

Tanda

Gejala

Stage
Resolusi/Komplikasi
Dhingra, P., 2007. Disease of Ear, Nose and Throat.
In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

Tanda

Gejala

Retraksi membrane
timpani
Tes garpu tala : tuli
konduksi
Tuli dan sakit telinga
(not marked)
No fever
Kongesti pars tensa,
membrane timpani
merah
Tes garpu tala: tuli
konduksi
Sakit telinga
Tuli dan tinnitus
Demam
tinggi+restless
MT merah dan
bulging, loss of
Nyeri
padaantrum
landmark
ruptur
mastoid
Nyeri telinga
memberat, demam
Diikuti
tinggi. muntah dan
konvulsi
Blood discharge ->
mucopurulen
Perforasi MT sdh
terlihat
Hiperemia hilang
Relieved dengan
evakuasi pus

Kriteria Diagnostik
middle ear
effusion:
rapid onset of
symptoms

American Academy of Pediatrics Subcommittee

on Management of Acute Otitis Media. Diagnosis
and management of acute otitis media.
Pediatrics 2004;113:1451-65.

bulging
tympanic
membrane,
limited or
absent mobility
of membrane
air-fluid level
behind
membrane

signs and
symptoms of
middle ear
inflammation

Differential
Diagnosis

Ramakrishnan, K., Sparks, R. A. & Berryhill, W.

E., 2007. Diagnosis and Treatment of Otitis
Media. American Academy of Family Physicians,
Volume 76(Number 11), pp. 1651-1658.

Pemeriksaan Penunjang

Pneumatic Otoscopy

Tympanometry

Ramakrishnan, K., Sparks, R. A. & Berryhill,

W. E., 2007. Diagnosis and Treatment of
Otitis Media. American Academy of Family
Physicians, Volume 76(Number 11), pp.
1651-1658.

Tatalaksana
1.

Antibiotik

2.

Decongestant Nasal
Drops

3.

Oral Nasal Decongestant

4.

Analgetik antipiretik

5.

Ear toilet

6.

Dry Local Heat

Myringotomy

Dhingra,
7.P., 2007. Disease of Ear, Nose and Throat.
In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

Antibiotik hingga 10 hari

Komplikasi
acute
mastoiditis
labyrinthitis

meningitis

Dhingra, P., 2007. Disease of Ear, Nose and Throat.

In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73

subperiosteal
abscess

Facial paralysis

petrositis

extradural
abscess

brain abscess

lateral sinus
thrombophlebi
tis

Terimakasih

Dhingra, P., 2007. Disease of Ear, Nose and Throat.

In: Disorders of Middle Ear. 4th Edition ed.
s.l.:Elsevier, pp. 61-73