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FACULTY OF MEDICINE HASANUDDIN UNIVERSITYOBJECTIVE STRUCTURED ORAL CASE ANALYSIS

SPECIAL SENSE SYSTEMACADEMIC YEAR 2012-2013

Makassar, October 2012

Case Synopsis 2

Women B, 20 years came to the clinic with chief complaints of slowly progressive

conductive hearing loss in the right ear since 5 years ago accompanied by a purulent

ear charged, smells, fever and .malaise.

Physical examination :General conditions: Good, not anemic. Height: 156 cm, Weight: 50kg.Vital signs are within normal limit.

Inspection : D/S Auricel normal, cervical abscess deep to thesternocleidomastoid

Palpation : protruding auricle that is laterally and inferiorly displaced

fluctuant, erythematous, tender area behind the ear

Otoskopy : Right external acoustic meatus and right tympanic cavity mucoushyperemic, subtotal central perforation of right tympanic membrane,

purulen secretions in the right external acoustic meatus.Left acoustic meatus and left tympanic membrane normal

Faringoscopy : Within normal limitsAnterior Rhinoscopy : Nasal cavity, nasal septum and nasal turbinate normal

Laboratory examination: Hb 14 g / dl, leukocytes 12,600 g%, LED 45 / 1 hourTuning fork Examination:

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Weber : lateralisation to rightRinne : negatifSwabach : too longBing Test : negatif (right side)

Pure Tone Audiometry examination :D/ : Severe Conductive Hearing LossS/ : Normal Hearing

Mastoid foto : Radiolucent and Right air cel mastoid is claudy, left air cel mastoidnomalExamination of Vestibuler function : NormalKultur : BacteroidesSensitivity : Ciprofloxacin Sensitif

Chest X-Ray : NormalMastoid CT-Scan : Right Tympanic cavity and air cel mastoid is claudy, left air celmastoid nomal

CT scan can demonstrate abscesscortical defect in the mastoid

Diagnosis : Right Chronic Supurative Otitis Media, cholesteatoma, Mastoiditis andSubperiosteal abscess

Therapy : Antibiotics high doseabscess is drainedmastoidectomy is performed and the cholesteatoma matrix is removed

in the standard manner

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STUDENT ASSESMENT :

MAKE THESE ASSESMENTS, DISCUSS AND PRESENT IN THE CLASS PBL:

1. CONCEPT MAPPING:

2. ETIOLOGY OF CHRONIC SUPURATIVE OTITIS MEDIA:

3. SYMPTOMS AND SIGNS OF HEARING DISTURBANCE:

4. SYMPTOMS AND SIGNS OF CHRONIC SUPURATIVE OTITIS MEDIS

5. PATHOGENESIS OF CHRONIC SUPURATIVE OTITIS MEDIS

6. PATHOPHYSIOLOGY OF SYMPTOMS AND SIGNS OF CHRONIC SUPURATIVE OTITIS

MEDIA

7. PRINCIPLES OF MANAGEMENT THREATENED CHRONIC SUPURATIVE OTITISMEDIA

8. PROGNOSIS OF THREATENED CHRONIC SUPURATIVE OTITIS MEDIA

9. CATEGORIES OF CHRONIC SUPURATIVE OTITIS MEDIA

10. DIFFERENTIAL DIAGNOSIS OF CHRONIC SUPURATIVE OTITIS MEDIA