Tesis

Perbedaan perubahan ambang perfrekuensi dan signal to noise ratio antara terapi metil prednisolon dengan terapi metil prednisolon dan oksigen hiperbarik pada tuli mendadak (Penelitian Pendahuluan). = Differences in frequency threshold and signal to noise ratio changes between methyl prednisolone therapy with methyl prednisolone and hyperbaric oxygen therapy on sudden deafness (A Preliminary Research).

Terapi oksigen hiperbarik (TOH) telah direkomendasikan sebagai terapi adjuvan dari terapi utama steroid pada tuli mendadak, dengan mekanisme peningkatan oksigenasi jaringan dan penekanan inflamasi dan edema akibat iskemia. Belum didapatkan penelitian tentang perbandingan ambang perfrekuensi dan signal to noise ratio (SNR) antara terapi steroid metil prednisolon (MP) dibanding kombinasi MP dan TOH pada tuli mendadak. Penelitian uji klinis acak tersamar tunggal ini dilakukan di Poliklinik Neurotologi Departemen THT-KL FKUI/RSCM dan Unit Hiperbarik RSAL Mintohardjo pada bulan Juni-Desember 2013, melibatkan 20 subjek tuli mendadak, dengan 10 subjek kelompok terapi MP dan 10 subjek kelompok terapi MP dan TOH. Analisis dilakukan pada pemeriksaan audiometri nada murni pada 9 frekuensi dan Distortion Product Otoacoustic Emission (DPOAE) pada 5 frekuensi, pada awal terapi dan hari ke15. Penelitian ini tidak mendapatkan perbedaan perubahan ambang perfrekuensi dan SNR yang bermakna secara statistik antara kedua kelompok, didapatkan kecenderungan perubahan ambang perfrekuensi yang lebih besar pada frekuensi 1000, 2000, 4000, 10000, 12000 dan 16000 Hz pada kelompok MP dan TOH, dan perubahan SNR yang lebih besar pada frekuensi 12000 Hz pada kelompok MP dan TOH. Tidak didapatkannya perbedaan perubahan ambang perfrekuensi dan SNR yang bermakna, dimungkinkan karena penelitian ini merupakan penelitian pendahuluan. Penelitian juga membatasi analisis hingga terapi hari ke-15, sedangkan subjek tuli mendadak di Poli Neurotologi THT-KL RSCM sedianya dilanjutkan evaluasi hingga hari ke-90 (3 bulan). Penelitian lebih lanjut dengan besar subjek yang sesuai serta waktu evaluasi yang lebih lama, diharapkan dapat lebih menganalisis kecenderungan perubahan ambang perfrekuensi dan SNR yang lebih besar pada kelompok MP dan TOH.
Kata kunci: TOH, MP, ambang perfrekuensi, SNR


Hyperbaric oxygen therapy (HBOT) has been recommended as an adjuvant therapy of primary steroid therapy in sudden deafness, the mechanism by increasing of tissue oxygenation and suppression of inflammation and edema due to ischemia. Differences in frequency threshold and signal to noise ratio changes between methyl prednisolone (MP) therapy with MP and HBOT on sudden deafness, has not been obtained. This single-blind randomized clinical trial study was conducted at the Neurotology clinic of CMH ENT Department and Hyperbaric Unit of Mintohardjo Navy Hospital in June-December, 2013, involving 20 sudden deafness subjects, with 10 subjects in MP therapy group and 10 subjects in MP and HBOT group. Analysis was performed on pure tone audiometric examination at 9 frequencies and Distortion Product Otoacoustic Emission (DPOAE) at 5 frequencies, at the start of therapy and day 15. This study does not get the statistically significant difference in frequency threshold and SNR changes between the two groups, it was found that the tendency of changes in frequency threshold was greater in frequencies 1000, 2000, 4000, 10000, 12000 and 16000 Hz in the MP and HBOT group, and the change in SNR was greater in frequency of 12000 Hz in the MP and HBOT group. The statistically significant difference in frequency threshold and SNR changes between the two groups does not obtained, possible because this study is preliminary research. The study also restrict the analysis to the 15th day of therapy, while the subject of sudden deafness in Neurotology Clinic of CMH ENT Department originally continued evaluation until the 90th day (3 months). Further studies with larger appropriate subject and a longer evaluation period, is expected to further analyze trends and greater changes in frequency threshold and SNR in the MP and HBOT gorup.
Keywords: HBOT, MP, frequency threshold, SNR.