Anmnesis Riwayat Penyakit

penurunan pendengaran
Umur (Tahun)

Hiperkolesterolemia
telinga berdengung
No Nama IMT

Infeksi Telinga
Ototoksik
Merokok
Diabetes
Pusing

CVD
1 Agustinus Tjia Yan Tjun 74 Normal N N N N Y Y N N N
2 Ana 77 Normal Y Y N N N N N N Y
3 C. Ngatinah 68 Normal Y Y N N N N N N N
4 Lies Lies 54 Normal N N N Y Y Y N N N
5 Nurhayati 74 Normal Y N N Y N Y N N N
6 Sri Ferina 77 Kurus Y N N Y N N N N N
7 Maria Setiawati 90 Normal Y N N N N N N N N
8 Lie Sien Lan 80 Normal Y N N N N N N N N
9 Chatarina Istiyah 79 Kurus N N N N N N N N N
10 Betty 79 Normal N N Y N N N N N N
11 Yohana Yahi 75 Normal Y Y N N N N N N N
12 Martha Tukijah 70 Normal N N Y Y Y N N N N
13 Maryamah 68 Normal N N Y N N N N N N
14 Djapar 79 Normal Y N N N N Y N N N
15 Len The 75 Normal Y N Y N N N N N N
16 Effendi 66 Normal N N N N N N Y N N
17 Paulus Liao Hay Yung 65 Kurus N N N N N N N N N
18 Ali Hasan 85 Normal Y N N N N N N N N
19 Tjun Tjin Lan 70 Normal Y N Y N N N N N N
20 F. Gunawan 67 Normal Y Y Y N N Y N N N
21 Munardi 69 Kurus Y N N N N N N N N
22 Bon Nyok Cin 92 Normal Y N N N N N N N N
23 Bernadetta Tukiyok 62 Normal Y N N N Y N N N N
24 Agnes Aven 65 Normal Y N Y N N N N N N
25 Monica Rinawati 62 Normal Y N Y N N N N N Y
26 Christina Sugiyami 62 Normal Y Y N N N N Y N N
27 Tanti Mariana 80 kurus Y N N N N N Y N N
28 Robertus Tan 63 Normal N Y Y N N N Y Y N
29 Charles 69 Normal Y N Y N N N N N N
30 Lie Kim Wan 80 Normal N N N N N N N N N
31 David Kurniawan 87 Normal Y N N N Y N N N N
32 Rita Suwatan 71 Normal N N N N N N N N N
33 Suziwati 77 Normal N N N N N N N N N
34 Roosalia 69 Normal Y Y Y N N N N N N
35 Tutik 40 Normal N N N N N N N N N
36 Sr. Benarda 76 KegemukaY N N N Y N N N N
37 Sr. Bernardin 76 KegemukaY N N N N N N N Y
38 Sr. Yasinta 75 Normal Y N N N N N N N N
39 Sr. Leonarda 76 KegemukaY N N N N N N N N
40 Sr. Clementine 72 Normal Y N N N N N N N N
 Otoskopi OAE Audiometri

AD
CP unilateral

CP bilateral

Normal
OMK

OME

AD AS
500 1000 2000 4000 6000 8000 500
V Pass Pass 45 40 30 30 50 45 35
V Refer Refer 80 85 110 110 110 105 85
V refer refer 60 45 50 40 70 90 45
V refer refer 40 60 65 80 80 85 50
V Pass refer 55 55 50 70 75 80 60
V refer refer 80 75 85 90 90 90 50
V refer refer 40 40 35 30 30 35 45
V refer refer 60 70 70 75 75 80 70
V refer refer 55 50 40 40 65 65 40
V refer refer 25 30 25 15 25 50 35
V refer refer 45 60 75 95 100 120 50
V refer refer 60 60 55 80 85 85 70
V refer refer 50 50 50 55 65 60 50
V refer pass 40 35 25 45 85 75 50
V refer refer 55 60 55 80 75 80 55
V Pass Pass 40 35 35 60 85 85 45
V refer Pass 30 30 40 40 50 60 25
V refer Pass 40 40 40 50 75 80 35
V Pass Pass 50 50 55 60 60 70 90
V Pass refer 30 30 30 45 40 35 40
V refer refer 90 100 90 95 95 95 80
V refer refer 75 80 75 80 85 85 60
V Pass Pass 30 40 50 60 70 75 70
V refer refer 65 80 65 60 70 85 60
V refer refer 50 60 55 70 80 70 45
V refer refer 100 90 105 110 110 110 35
V refer refer 50 55 70 75 80 100 80
V Pass Pass 35 35 25 40 30 55 30
V Refer Refer 60 40 25 40 65 70 60
V PASS PASS 30 40 50 60 70 65 70
V Refer Refer 50 50 65 65 95 100 75
V PASS PASS 60 70 80 80 80 80 50
V Pass Pass 40 60 65 75 80 85 50
V Pass Pass 60 55 50 55 50 70 70
V refer Refer 60 70 65 70 75 75 70
V Pass Pass 30 25 30 30 70 60 40
V Pass Refer 25 30 35 35 30 35 30
V refer Refer 50 40 30 35 50 45 55
V Pass Refer 45 40 40 45 50 60 40
V refer Refer 45 60 70 65 70 70 45
ometri Interpretasi

AS AD

1000 2000 4000 6000 8000

30 25 25 40 40 Sensorineural derajat ringan (36.25 dB)
90 90 90 105 105 Sensorineural derajat sangat berat (>90dB)
45 45 50 80 95 Sensorineural derjat sedang (48.75 db)
50 55 65 70 75 Sensorineural derjat sedang berat (62,5 db)
65 60 75 75 90 Sensorineural derjat berat (76,25 db)
55 65 70 75 80 Sensorineural derjat sedang berat (60 db)
50 45 45 50 50 Sensorineural derajat ringan (38,75 dB)
65 65 80 80 85 Sensorineural derjat sedang berat (68,75 db)
50 45 50 65 75 Sensorineural derajat sedang (46,25 dB)
30 30 20 25 65 Normal (23,75 dB)
65 65 65 70 80 Sensorineural derajat sedang berat (68,75 dB)
65 70 85 80 80 Sensorineural derajat sedang berat (63,75 dB)
40 65 60 75 75 Sensorineural derajat sedang (47,5 dB dB)
35 25 50 70 80 Sensorineural derajat ringan (36,25 dB)
50 55 60 75 80 Sensorineural derajat sedang berat (56,25 dB)
40 45 65 80 85 Sensorineural derajat sedang (42,5 dB)
25 25 35 40 60 Sensorineural derajat ringan (35 dB)
40 30 45 65 85 Sensorineural derajat sedang(42,5 dB)
95 80 75 90 95 Tuli Campuran derajat sedang (53,75 dB)
40 45 65 55 50 Sensorineural derajat ringan (33,75 dB)
80 85 85 90 90 Sensorineural derajat sangat berat (93,75 dB)
70 70 75 80 80 Sensorineural derajat berat (77,5 dB)
75 80 85 100 110 Sensorineural derajat sedang(43 dB)
75 70 70 90 90 Tuli Campuran derajat sedang berat (67,5 dB)
55 60 60 60 80 Sensorineural derajat sedang-berat (58,75 dB)
40 45 60 80 70 Sensorineural derajat Sangat berat (> 90 dB)
80 95 95 95 105 Sensorineural derajat sedang-berat (62,5 dB)
25 30 25 40 60 Sensorineural derajat ringan (33,75 dB)
45 30 40 60 80 Sensorineural derajat Sedang (41,25 dB)
75 80 85 100 110 Sensorineural derajat Sedang (45 dB)
85 85 105 110 110 Sensorineural derajat sedang-berat (57,5 dB)
45 55 55 65 60 Sensorineural derajat berat (72,5 dB)
50 55 65 70 75 Sensorineural derajat sedang-berat (60 dB)
65 70 80 90 80 Campuran derajat sedang (55 db)
80 75 90 90 90 Sensorineural derajat sedang-berat (66,25 dB)
30 30 45 55 70 konduksi derajat ringan (28,75 db)
30 45 35 55 70 konduksi derajat ringan (28,75 db)
45 40 45 55 70 Sensorineural derajat ringan (38,75 dB)
45 50 50 55 80 Sensorineural derajat sedang (42,5 dB)
55 60 60 65 70 Sensorineural derajat sedang-berat (60 dB)
Interpretasi

AS

HHI-E DHI THI

Sensorineural derajat ringan (28.75 dB) Tidak Ringan grade 1

Sensorineural derajat sangat berat (>90dB) Berat Ringan grade 4
Sensorineural derjat sedang (46.25 db) Tidak Ringan grade 1
Sensorineural derjat sedang (65 db) Tidak Ringan grade 1
Sensorineural derjat sedang berat (65 db) Tidak Ringan grade 1
Sensorineural derjat sedang berat (60 db) Ringan-Sedang Ringan grade 1
Sensorineural derjat sedang (45,5 db) Tidak Ringan grade 1
Sensorineural derjat sedang berat (70 db) Tidak Ringan grade 1
Sensorineural derajat sedang (46,25) Tidak Ringan grade 1
Sensorineural derajat ringan (28,75dB) Tidak Ringan grade 1
Sensorineural derajat sedang berat (61,25 dB) Tidak Ringan grade 2
Sensorineural derajat berat (73,25 dB) Ringan-sedang Ringan grade 1
Sensorineural derajat berat (73,25 dB) Tidak Ringan grade 1
Sensorineural derajat ringan (40 dB) Tidak Sedang grade 1
Sensorineural derajat sedang (55 dB) Tidak Ringan grade 2
Sensorineural derajat sedang (48,75 dB) Tidak Ringan grade 1
Sensorineural derajat ringan (27,5 dB) Tidak Ringan grade 1
Tuli Campuran derajat ringan (37,5) Tidak Ringan grade 1
Tuli Campuran derajat berat (85 dB) Ringan-Sedang Ringan grade 1
Sensorineural derajat sedang (47,5 dB) Berat Berat grade 2
Sensorineural derajat sangat berat (82,5 dB) Ringan-Sedang Ringan grade 1
Sensorineural derajat sedang berat (68,75 dB) Tidak Ringan grade 1
Sensorineural derajat berat (77,5 dB) Tidak Ringan grade 1
Tuli campuran derajat sedang berat (68,75 dB) Berat Sedang grade 1
Sensorineural derajat sedang (55 dB) Berat Sedang grade1
Sensorineural derajat sedang (45 dB) Ringan-Sedang Ringan grade 2
Tuli Campuran derajat berat (87,5 dB) Berat Ringan grade 1
Sensorineural derajat ringan (27,5 dB) tidak ada ringan grade 1
Sensorineural derajat sedang (43,7 dB) Ringan-Sedang ringan grade 1
Sensorineural derajat BERAT (77,5dB) TIDAK ADA RINGAN GRADE 1
Sensorineural derajat berat (85 dB) Ringan-Sedang RINGAN GRADE 1
Sensorineural derajat Sedang (51,2 dB) TIDAK ADA RINGAN GRADE 1
Sensorineural derajat sedang (55 dB) Tidak Ringan Grade 1
Campuran derajat berat (71,25 db) ringan-sedang Sedang Grade 4
Sensorineural derajat berat (78,7 dB) tidak ringan grade 1
konduksi derajat ringan (36,25 db) ringan-sedang ringan grade 1
konduksi derajat ringan (35 db) ringan-sedang ringan grade 1
Sensorineural derajat sedang (46,25 dB) tidak ringan grade 1
Sensorineural derajat sedang (46,25 dB) tidak ringan grade 1
Sensorineural derajat sedang (55 dB) Tidak ringan grade 1
 OAE
No Nama Umur AD AS AD
500 1000 2000
 Audiometri
AD AS
4000 6000 8000 500 1000 2000 4000 6000 8000
 Interpretasi
AD AS