Wednesday, March 12, 2008

Darryl Virgiawan Tanod, S.ked


Indonesia is one of the biggest archipelago country in the world its also cover by big ocean, many of its resident work as a farmer and fisherman.

There are many of fisherman type in Indonesia one of them is traditional fisherman that searching fish by diving without any of dive appliance.

There are so many risk doing this job, one of them is barotrauma, barotrauma could affect to the lung function, cardiovascular function and hearing function. North Sulawesi itself have many of traditional fisherman and one of the place that reside many traditional fisherman is countryside of Bolung district Wori sub-province North Minahasa.


Whether diving during the time by the fisherman can bother their hearing function?


To know the hearing function of this traditional diver.


- Adding more knowledge and science about barotrauma.

- Pushing the traditional fisherman so that they can prevent the effect from diving for their hearing function.


A. Anatomy And Physiology of Hearing Organ.

1. Outter Ear : auriculus and meatus acusticus externa.

2. Middle Ear : loaded by the air = box with 6 side. There are bone of hearing : maleus, inkus, stapes.

3. Inside Ear: complex in such a way so its called a labyrinth

B. Hearing Function.

Hearing organ and balance.This function which is often annoyed by effect of barotraumas such as : vertigo and deafness.

C. Barotrauma.

Troubles that happened at ear can be happened at auricle, middle ear and inside ear. In this case barotrauma of ear often happened at middle ear and this disease inveterate found in United States and all the world.

Barotrauma that happened in middle ear specially related to its complicated function of the eustakius. Eustakius normally always closed but can be opened at swallow movement, munching, condensing, and with the valve maneuver.

Environmental pressure change and cause this case happened byt the make-up of pressure from environment hence will make the air in middle ear and in tuba eustakius become depressed. This matter tend to to cause the smallening poison the eustakius. If pressure difference between environmental and middle ear cavity too big ( around90 until 100 mmhg ), hence shares kartilaginosa from tuba eustakius will very narrow. Otherwise enhanced by air throught tuba eustakius to cure the middle ear volume, hence structures in middle ear and network at elbow will destroy more and more increase it pressure difference. Happened a damage network able to be estimated by continueing vacuum situation relative in middle ear cavity. Beginning of membrana timpani interested into. Retraktion cause the membran push and break the small channel of venous so that the picture of hypodermic and bula hemoragik at eardrum. more and more the increasing of pressure, small channel - small venous at middle mukosa ear also dilatation and break, generating hemotimpanum. Sometime pressure can cause the ruptur symptoms of barotrauma in middle ear including pain in bone, feel full and decrease of hearing. Diagnose ascertained by otoskop. Visible eardrum experience of the hypodermic with the forming of bleb hemoragik or existence of blood behind eardrum. Sometime timpanic membran will perforated. Can be accompanied by the conductive hearing trouble require to be emphasized by tinitus which remain to vertigo and deaf of sensorineural symptoms of inside ear damage. Middle ear Barotrauma not rarely generate the ear damage. In Every person who complain the hearing loss by barotrauma have to experience the hearing test with tuning fork to ensure that the hearing trouble have the character of conductive rather than sensorineural.

D. Hearing Function Test

Voice test ( whispering test, conversation test ) and Tuning Fork test

( scwabach, rinne, weber ).


- Age group which is at most suffering hearing trouble at group 41 - 50 years old, followed by the group 20 - 30 years old and least experience of the trouble is group 31 - 40 years old.

- Research result of Kaplan, saying that although there are no direct correlation between age with the decompression trouble, his discovered that most age often hit by barotraumas is 21 - 40 year, but direct effect from barotraumas above 50 years old.

- work as traditional diver, where hearing trouble there are at group profession which have during > 6 year, while fewest trouble there are group which have profession <>

- Visible diving frequency of many trouble at diving frequency 5 - 7x / week, while diver owning diving frequency > 7x / week from 2 one who checked both are trouble.

- According to the research from medical circle of oceaninc after diving suggested is 18 hour after previously conducted a diving, this matter to prevent the happening of decompression trouble to all divers.

- So if that will be flattened - smooth down the diving frequency interval 18 hour for the diving to the next is 4 times within a week to minimize the possibility to get the decompression trouble

- Diving deepness, all this traditional diver, discovered that deepness 5 - 8 metre there are trouble of equal to 8,33 % while at deepness > 9 metre equal to 60%.

- According to existing literature progressively in we dive hence pressure will growing larger where deepness 33 undersea feet hence us of get by pressure equal to 2 atm ( 1 atm come from air pressure above sea and 1 atm again come from weight irrigate itself ), deepness of its 66 pressure feet is 3 atm and so on.

- According to theory above, hence all diver diving deeper, in this case > 9 metre have the larger risk ones to get the decompression trouble compared by a diving <>


- Hearing Trouble which is the most suffered by all this traditional diver is conduction deafness.

- There are hearing trouble of traditional diver in countryside of Bolung district of Wori sub-province North Minahasa.

- Age, how long taking this profession, frequency, and also deepness become the determinant of natural hearing trouble to the traditional diver.


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