Tesis

Analisis Faktor Risiko yang Memengaruhi Fungsi Pendengaran pada Pasien Otitis Media Supuratif Kronik Tipe Aman Tenang Pasca Timpanoplasti Tipe 1 = Analysis of Risk Factors Affecting Hearing Function in Patients with Tubotympanic Chronic Otitis Media Post Type 1 Tympanoplasty.

Latar belakang: Timpanoplasti tipe 1 merupakan prosedur dalam bidang otologi untuk menangani pasien Otitis Media Supuratif Kronik (OMSK). Prosedur ini bertujuan untuk memperbaiki membran timpani, menjaga telinga tengah dari patogen luar dan pada akhirnya memperbaiki fungsi pendengaran. Terdapat banyak faktor yang memengaruhi hasil timpanoplasti, diantaranya faktor operator, faktor alat dan faktor pasien. Tujuan: Mengidentifikasi karakteristik klinis preoperasi sebagai faktor yang memengaruhi fungsi pendengaran pascatimpanoplasti tipe 1. Metode: Penelitian dengan rancangan studi kohort prospektif pada pasien OMSK tipe aman tenang yang telah menjalani timpanoplasti tipe 1. Subjek dengan membran timpani utuh pascaoperasi masuk dalam kriteria penelitian. Data mengenai demografi, riwayat penyakit dan karakteristik klinis preoperasi berupa ukuran perforasi, letak perforasi dan fungsi Tuba Eustachius dikumpulkan melalui rekam medis. Pemeriksaan audiometri nada murni dilakukan untuk mengetahui fungsi pendengaran pascatimpanoplasti. Perbaikan Air Bone Gap (ABG) pascaoperasi dibanding preoperasi sebanyak 10dB atau lebih di 2 frekuensi yang berdekatan merupakan kategori perbaikan fungsi pendengaran. Hasil: Rata-rata ambang dengar preoperasi 44,7 dB  15,9dB menurun menjadi 33,2 dB  14,4dB pascaoperasi. Rata-rata Air Bone Gap (ABG) preoperasi 41,9 dB menurun menjadi 14,4 dB. Perbaikan fungsi pendengaran pascatimpanoplasti lebih dari 1 tahun terdapat pada 82,3% (n = 28) dan tidak adanya perbaikan fungsi pendengaran pada 17,6% (n = 6). Tidak ditemukan hubungan yang bermakna antara ukuran perforasi, letak perforasi dan fungsi Tuba Eustachius preoperasi terhadap fungsi pendengaran pascatimpanoplasti tipe 1. Kesimpulan: Sebanyak 17,6% subjek OMSK tipe aman tenang pascatimpanoplasti tipe 1 tidak mengalami perbaikan fungsi pendengaran. Terdapat faktor selain ukuran perforasi, letak perforasi dan fungsi Tuba Eustachius preoperasi yang memengaruhi fungsi pendengaran.
Kata kunci: Air Bone Gap, Otitis Media Supuratif Kronik, Pendengaran, Timpanoplasti


Background: Type 1 tympanoplasty is a procedure in otology to treat patients with Chronic Otitis Media. It aims to repair the tympanic membrane, protect the middle ear from external pathogens and ultimately improve hearing function. There are many factors that affect the outcome of tympanoplasty, including operator factors, tool factors and patient factors. Objective: Identify preoperative clinical characteristics as factors affecting hearing function after type 1 tympanoplasty. Methods: The study was a prospective cohort design involving patients with tubotympanic type CSOM who had undergone type 1 tympanoplasty. Subjects with an intact tympanic membrane postoperatively were included in the study criteria. Data regarding demographics, medical history, and preoperative clinical characteristics such as perforation size, perforation location, and Eustachian tube function were collected from medical records. Pure tone audiometry was performed to determine postoperative hearing function. A postoperative air-bone gap (ABG) improvement of 10 dB or more in two adjacent frequencies compared to preoperative levels was considered indicative of improved hearing function Results: The preoperative hearing threshold of44.7 dB 15.9dB decreased to 33.2 dB  14.4dB postoperatively. The preoperative Air-Bone Gap (ABG) value of 41.9 dB decreased to 14.4 dB. Improvement in hearing function more than one year after tympanoplasty was found in 82.3% (n = 28) of patients, while 17.6% (n = 6) showed no improvement. There was no significant relationship between perforation size, perforation location, and preoperative Eustachian tube function on postoperative hearing function in type 1 tympanoplasty Conclusion: A total of 17.6% of tubotympanic type CSOM subjects after type 1 tympanoplasty had no improvement in hearing function. There are factors other than perforation size, perforation location and preoperative Eustachian tube function that affect hearing function.
Keywords: Air Bone Gap, Chronic Otitis Media, Hearing, Tympanoplasty