We are publishing the following translation of an article that recently appeared on the website of the Institute for Collection Action and was distributed to various activist listservs. We are doing so only out of solidarity with our comrades in Omsk. Although we believe what they tell us, we are aware that the lack of details in this article might leave a reader in the outside world somewhat befuddled. We apologize for the vagueness of the article and promise that we will update this posting as soon as more details become available. Unfortunately, in recent days and weeks, another wave of harassment of Russian leftists, oppositionists, and human rights activists  seems to have begun. With the blows coming fast and furious, not all activists have the means or the time to prepare detailed accounts of the state’s actions against them.

www.ikd.ru/node/11558

Authorities in Omsk have begun a campaign of persecution and coercion directed against members of the Siberian Confederation of Labor (SKT). The SKT, an interregional trade union organization, was founded in 1995 by the Confederation of Anarch0-Syndicalists.  The SKT has a large number of supporters and is involved in defending their labor and social rights. The SKT also has a youth organization, the Union of Autonomous Youth (SAM), and supports a committee for the defense of former orphanage students. The SKT’s active political stance has attracted the attention of law enforcement agencies, who have begun persecuting SKT activists. In this sense, they now practically function as a political police.

The trouble began on August 31, when SKT activists organized a demonstration against the violation of civil rights and liberties on the part of law enforcement officers. The immediate cause for the demonstration was the recent murder of a man by two police officers. A large number of young people gathered for the event and the actions of the activists were widely publicized in the mass media. The authorities tested methods for disrupting the demonstration by using plainclothes provocateurs (who were, naturally, police officers) and the Young Guard of United Russia, who tried to interfere with the demonstration. After this episode, the authorities began in earnest to persecute SKT activists for their convictions.

Subseqently [in October] another policeman committed a double homicide [and then killed himself]. A demonstration was organized by the Yabloko Party youth organization in which SKT activists took part. Despite the fact that the demonstration had official permission, it was attacked by approximately one hundred plainclothes police officers, who used Russian flags as weapons. The site of the demonstration was entirely cordoned off with buses [parked there by police]. Journalists were on hand, however, and Novaya Gazeta published an article about the demonstration. This greatly angered the police and local authorities.

In order to have an official excuse to summon SKT members and demonstration participants for questioning, the police have begun fabricating a case against an activist from another organization, the Left Front, which, in the opinion of law enforcement officials, is influenced by the SKT. The reason a criminal case has been opened against him is that the police allegedly found Nazi leaflets in his possession. In reality, SKT members themselves have always publicly taken a consistently internationalist and antifascist stance.

Nevertheless, at a subsequent demonstration police provocateurs handed out a leaflet in which Elena and Vasily Starostin, two founders of the SKT, were accused of ties with the Nazi movement. In addition, the authors of the text alleged that the SKT manipulates former orphanage students by promising to solve their problems. In reality, the SKT has initiated more than 120 successful lawsuits and approximately fifty young people have been granted housing as a result of these court rulings.

After this incident, the police began interrogating activists whom they had been able to identify during demonstrations. The Starostins were among those summoned. They were told by their interrogators that they were a bad influence on young people and they should cease their activities. The authorities have begun to pressure Elena Starostin’s employer by conducting various inspections: the goal is to coerce him to fire her.

The authorities have also begun to pressure young people who participate in SKT actions through the university. They are summoned to the rector’s office for discussions of their “extremist” activity and they are threatened with expulsion. As if that were not enough, the police have begun summoning their parents in order to pressure them to stop the activities of their children. In one case, an activist’s mother has been threatened with being fired from her job, and other parents can expect the same fate.

During their interrogation, police announced outright to the Starostins that the young people who go to protests and participate in the SKT will be unable to find employment in the city. In addition, police have begun to hint that they are physically threatened, saying things like “Aren’t you afraid that skinheads will break your arms and legs?” 

It is clear that the primary purpose of the actions of the police is to intimidate activists and make it impossible for them to organize new protests. Police officials do not want this story to go public beyond Omsk, and so SKT activists request that this information be distributed as widely as possible.

EPILÄ:

Epilä’s debut single Ajatuspoliisi will be released today on 14th of october by Terra Recordings. I can’t say much about the music because up until now it’s been rather hard to hear their songs outside live concerts (they don’t have a myspace and don’t give any samples on their website either). However, the band contains lovely and talented people who have previously played in groups such as Guava, Cartoon Tree, Jadecroon, Aknestik etc so I suppose it’s safe to assume that it will be great stuff. The debut album will follow in january.

Epilä Website

OMSK:

Omsk is a finnish folk act I found an hour ago (thanks to Antti) and since then I’ve been listening to their debut album on spotify. No final conclusions yet, but it is quite convincing stuff and I really like it.  In case you don’t have spotify, a lot of Omsk’s material is also available on the Omsk website and on their myspace.

Omsk Website
Omsk at myspace

Brad Pitt is accustomed to stopping passersby in their tracks, so it’s no surprise that he now has a new job that will have him do just that!

Traffic accidents in Russia are among the highest in Europe and Russian traffic police were running out of ideas on how to slow the traffic down. They therefore enlisted Brad Pitt to help them out with their endless battle against speeding!

Cardboard cutouts of Brad Pitt dressed as a traffic cop have been placed by the most dangerous intersections in the city of Omsk, Siberia, with the hopes that star-struck drivers will ease off the gas to gaze at the unusual image!!

Good news! Apparently, the campaign is working. Omsk officials say accidents are down quite a bit! Maybe Montreal Police should consider this tactic instead of those awful speeding cameras! What do you think?? Which other celebrity would slow down your tracks?!

Doug Pitt, the brother of actor Brad Pitt, has just announced that the Brad Pitt family, Doug and his wife Lisa and Rob and Julie Neal (nee Pitt) have made a $1 million donation to St. John’s in Springfield, Missouri!

A “new 31 pediatric unit, a 10-bedroom hospital-based Ronald McDonald House; and double the size the neonatal intensive and pediatric intensive care units,” will be funded from the donation, that also aids cancer research.

In honor of their mother, the medical center is being renamed. It will be called the St. John’s Jane Pitt Pediatric Cancer Center. Celebrities who give and who honor their parents are THE BEST! Let’s all do the same.

On Horiwood.Com here in Hollywood… here’s 10 hot entertainment posts right now. Happy Weekend. Give lots, smile lots and be all you can be in the world.

1. BRAD PITT CUT OUTS STOP TRAFFIC IN SIBERIA

2. CIRCUS ENCORE: BRITNEY SPEARS TOUR RETURNS TO THE US

3. NEW BLACK EYED PEAS: PUMP IT

4. LOL! SHEFFIELD ARENA GOES COMPLETELY SIDEWAY’S FOR SCOTLAND’S SUSAN BOYLE. MANCHESTER MISSES OUT!

5. ADAM LAMBERT’S 20/20 INTERVIEW

6. DISNEY PICKS TAYLOR KITSCH TO GIVE ROBERT PATTINSON & ZAC EFRON A RUN FOR THE MONEY AT THE BOX OFFICE

7. IS ROBERT PATTINSON PEOPLE’S NEXT SEXIEST MAN ALIVE?

8. FILM PRODUCER TISH CYRUS IS ON SET WITH MILEY IN GEORGIA: THE LAST SONG

9. NEW MUSIC: WHEN LOVE TAKES OVER: NEW DAVID GUETTA FEATURING KELLY ROWLAND

10. UGH! THE COMFORT WIPE: AMERICA JUST GOT MORE ENTITLED!

The AP News via google is reporting that:

MOSCOW (AP) — Brad Pitt is accustomed to stopping passersby in their tracks. The Hollywood heartthrob’s next job is slowing traffic in Siberia — or so Russian traffic police hope.

A Russian newspaper reports that cardboard cutouts of Pitt dressed as a traffic cop have been placed by the most dangerous intersections in the city of Omsk.

It’s the latest move by authorities in their endless battle against speeding. Traffic accidents in Russia are among the highest in Europe.

The campaign seems to be working. Omsk officials say accidents are down as star-struck drivers ease off the gas to gaze at the unusual image.

The paper, Argumenty i Fakty, quotes Dmitry Ziryanov, a local official who came up with the idea as saying Pitt is “kind of like a colleague for us.”

HW: You just know that Angelina Jolie is behind this little PR move, for her new film Salt where she plays a Russian spy in her new thriller. It’s great PR, it’s brilliant… (so, it reeks of Angie!) It’s a really a clever tribute from the world’s #1 celebrity, to support her man. Love it!

In appendice al rapporto del 2005 “Lavoro forzato nella Federazione Russia oggi: immigrazione irregolare e traffico di esseri umani” di Elena Tyuryukanova per conto dell’Organizzazione Internazionale del Lavoro (ILO, agenzia delle Nazioni Unite), si possono leggere delle interviste a vittime di lavoro forzato in Russia.

Ne riporto una fatta nella città di Stavropol ad un uomo di 33 anni proveniente dall’Uzbekistan che fa lavori occasionali ed è stato vittima di frode, restrizione del movimento e minacce:

Vengo da Nukus, Uzbekistan. Ho la cittadinanza uzbeka. Nel 1990, ho servito nell’esercito dell’Uzbekistan. Sono diplomato all’istituto di metallurgia e ho lavorato come operaio metallurgico a Nukus. Guadagnavo poco. Ho cercato di creare una mia attività (vendita di merce in Russia) ma è fallita. Ho lavorato nell’edilizia. Ma in Uzbekistan non c’è domanda perché non ci sono tanti ricchi. Inoltre, il nazionalismo e la discriminazione nei confronti degli stranieri è diffusa sia nelle forme più lievi sia in quelle più aggressive.  Nelle forme più lievi, gli uzbeki danno lavori più o meno buoni solo ai loro parenti o alle persone che appartengono al loro gruppo. Più aggressivamente, le persone di etnia russa sono sottoposte a minacce, costante oppressione e sono respinti dal paese. Ma la ragione principale per venire in Russia è l’assenza di lavoro (disoccupazione totale) e i salari estremamente bassi. Sono venuto a sapere della possibilità di guadagnare del denaro in Russia da amici. Sono anche venuto a sapere che nonostante sia possibile guadagnare di più in Russia, le condizioni di vita e il livello di sicurezza sono di gran lunga peggiori. Così sono andato direttamente nel nord del Caucaso, assieme ad altri consocenti (da 10 a 15 persone). Abbiamo viaggiato in un bus, il viaggio è durato da due a tre settimane. Abbiamo pagato 100$ per partire – è una somma enorme in Uzbekistan. Arrivati, i nostri documenti sono stati ritirati per la registrazione temporanea. Non ci potevamo muovere in modo indipendente – senza documenti, in una città ignota. In pratica non potevo scegliere dove lavorare. Forse uno può lasciare un datore di lavoro, ma può diventare ancora peggio dal punto di vista dei possibili problemi con le autorità. Lavoro  (per esempio, posa di piastrelle e piscine) con un salario parziale, perché lavoro per persone che legalizzano il mio status e lo status di altri immigrati. La registrazione comune è prevista per 3-6 mesi. Il mio capo ha un uomo che la sta facendo. Ma non è sempre possibile ottenere la registrazione. Senza di essa non posso andare in città. Due anni fa mi hanno arrestato e ho passato una notte nella stazione di polizia di Leninsky. È venuto il capo e mi ha fatto uscire pagando la cauzione, poi ho dovuto lavorare per risarcire il debito.

Tra le altre persone intervistate ci sono vittime di sfruttamento sessuale, minacce, sequestro, vere e proprie condizioni di schiavitù, persone vendute dai genitori e finite nella rete del traffico di esseri umani, persone sfruttate, sottopagate, perennemente impegnate a pagare i debiti contratti con i propri datori di lavoro per risarcire i costi del viaggio intrapreso per fuggire dalla miseria del loro paese di origine e per ottenere la residenza in Russia.

- posted by russellmania3000

It begins something like this:

Act I, Scene I: The scene opens to the cold light of dawn. Two middle-aged men exit a makeshift trading post/tavern made of rotting beechwood located on the desolate main drag of a lonely rural mining town. Their skin is leathery and worn full of crevices such that a close-up photograph of one of their cheeks might look like a topographical image of the Himalayas. They walk together, blowing steamy breath into clenched fists and speaking in hushed tones. They wear silly fur hats.

Dmitri: What is this, this Sonic? Day after day I see their advertisements on the moving picture box, teasing and tempting me with their patties of ground beef, and slushie happy hours, and tots! Oh, the tots! But here, in the frozen wastes of the Urals, such an establishment there is not. Believe me comrade, I have looked, for my eyes long for the sight and my tongue for the taste.

Vladimir: They are places of legend, my friend, for in all my wandering I have happened upon nary a one for many moons. You will not find Sonic and her fresh bounties within 500 leagues of this place. But I have many fond memories of a carefree childhood in Omsk, for it was there that my family took my sister and me weekly to market and, after a long day of trading and peddling our wares in the village square, we ate a hearty meal of breakfast burritos and onion rings. Those were happier days. But here in the mines of Narodnaya, for us there is only sweat and dust and the meager root stew.

Dmitri: But why, Vladimir, tell me, why do they mock us with promotional messages for goods which we cannot procure? Surely such a ruse is not worth the price!

Vladimir: It is a strange and cruel fate that we should be cast so from the light and warmth of the simple pleasures we desire most.

Exeunt Dmitri and Vladimir stage left. End scene.

Or in 3-panel strip form, if you prefer it.

Like many of you, for years I have seen Sonic ads on TV, shaken my fist at the heavens, spat at almighty God and persevered. Or just went to Five Guys. I don’t want to make pithy banter with a balding friend or dumpy-looking wife or chubby Paris Hilton lookalike and even more busted female. And by busted I don’t mean she has nice mammaries or resembles a plaster cast from the shoulders up. I mean that when photons bounce off her body and are recorded by a camera, and this recording is played back so that more photons in the pattern of her visage scurry in the direction of my ocular cavity, the net result is an unpleasant sensation in my cerebellum. No, I just want a burger.

Last week some coworkers and I took a little 20-minute excursion up I-95 to get to the nearest Sonic, which was out in Bensalem in a run down industrial area that I would have no reason to go to otherwise. This kind of thing isn’t uncommon for us; we’ve driven a half hour to get to an Arby’s because, let’s be honest, time out of the office is time out of the office any way you slice it. Sonic’s website says “[t]here are more than 3400 SONIC® Drive-In locations across the country.” Just none where you live. Especially if you live in a city. Bensalem is not a city. In any case, if you haven’t been or even seen one (both my seeing and tasting cherries were popped with one thrust), Sonic is indeed delicious, though it would have been more delicious if a girl on roller skates brought out our food on one of those trays that hooks onto the car door.

But all this skullduggery does have an explanation, and a method behind the apparent scattershot advertising strategy. National cable advertising is, at certain volumes, cheaper than regionally targeted advertising, so that’s a no brainer right there. But the genius of the whole thing is that it drives people mad with wonder and envy. How flabbergasting it must be, as say, a resident of metropolitan New York, to find yourself jealous of some yokel from Georgia or Tennessee or where-bumblefucking-ever because they have a Sonic and you don’t, and you have to pay out the ass for McDonald’s in NY. They’ve stumbled upon the holy grail of marketing, sort of. They’ve achieved the kind of viral, word-of-mouth-driven national discussion that everyone wants, over the subject of “where the fuck is there a Sonic,” simply by advertising something that’s not available. Now, whenever they open a new joint, they get all kinds of media coverage and blog hype and lines around the block because they’ve been advertising for years to people who want to be customers but can’t.

This is not a new strategy or phenomenon. Companies have been doing this for decades in areas where they plan to launch. You’ll notice the ambiguous “Respekt” outdoor ads for Cricket mobile phone services around Philadelphia presently. They’re not available here yet, but they will be soon, and at that point they’ll start to demystify their messaging and identify that top-heavy K with their wordmark/logotype (a befuddling design choice). The difference here is Cricket isn’t offering any specific deal or even saying who they are, which is…I don’t know, who cares. But Sonic is offering free tots and gigantic slushies for under $1 to anyone in the nation lucky enough to live by or drive by one and that’s apparently been pretty rabble-rousing. The more significant difference is that Cricket’s hype/awareness campaign, and most things of that nature, will last maybe weeks or months. I’m not positive but Leap, their owner, has indicated they hope to that by the end of this year they will have rolled out service in all 27 markets they won bids on in the 2006 FCC auction. By contrast, Sonic has been advertising in Philadelphia and other major metropolitan areas for years and have yet to announce any new locations there. In fact there may never be a Sonic in Philly. But their incessant advertising has given them a legion of customers-in-waiting who are ready for a cross-country road trip, or like me, the opportunity to take an extra long lunch.

I guess what I’m trying to say is that, as a marketing guy, I am delighted that a protracted campaign designed to frustrate and drive people bats might actually work really well. It would sure be fun to try.

PS: holy balls.

Negócio é o seguinte. Parece que alguns russos de maior estão criando pouco caso com os parques infantis daquele país. Prefeito vanguarda da pequenina Omsk, fronteira com Cazaquistão, decidiu inovar nos brinquedos. Daí, começou o reboliço.

Para o sujeito, as crianças precisam, desde criança mesmo, saber que “o mundo lá fora não é, assim, tão encantador como os pais, doidos, por sinal, gostam de lhes mostrar”. Decidiu-se construir as atrações de parquinho mais, vejamos, realistas.

Eu já fui criança (às vezes, tenho sérias dúvidas se passei, ou não, dessa fase, inclusive). E também já fui a parques amedrontadores. Na verdade, queria mesmo era me sujar com qualquer coisa suja mesmo. Pouco me importava se o palhaço era azul, verde, amarelo.

Agora, encontrar brinquedinho igual a este aí, da foto…

Faço a menor idéia onde estava com a cabeça, o tal prefeito.

Afinal, ninguém é perfeito.

KOMPLIKASI

Tendensi otitis media mendapat komplikasi tergantung pada kelainan patologik yang menyebabkan otore. Walaupun demikian organisme yang resisten dan kurang efektifnya pengobatan, akan menimbulkan komplikasi. biasanya komplikasi didapatkan pada pasien OMSK tipe maligna, tetapi suatu otitis media akut atau suatu eksaserbasi akut oleh kuman yang virulen pada OMSK tipe benigna pun dapat menyebabkan komplikasi1,2.

Komplikasi intra kranial yang serius lebih sering terlihat pada eksaserbasi

akut dari OMSK berhubungan dengan kolesteatom1,2.

A. Komplikasi ditelinga tengah :

1. Perforasi persisten

2. Erosi tulang pendengaran

3. Paralisis nervus fasial

B. Komplikasi telinga dalam

1. Fistel labirin

2. Labirinitis supuratif

3. Tuli saraf ( sensorineural)

C. Komplikasi ekstradural

1. Abses ekstradural

2. Trombosis sinus lateralis

3. Petrositis

D. Komplikasi ke susunan saraf pusat

1. Meningitis

2. Abses otak

3. Hindrosefalus otitis

Perjalanan komplikasi infeksi telinga tengah ke intra kranial harus melewati 3 macam lintasan1,2 :

1. Dari rongga telinga tengah ke selaput otak

2. Menembus selaput otak.

3. Masuk kejaringan otak.

PENATALAKSANAAN

Prinsip pengobatan tergantung dari jenis penyakit dan luasnya infeksi, dimana pengobatan dapat dibagi atas :

1. Konservatif

2. Operasi2,3

OMSK BENIGNA TENANG

Keadaan ini tidak memerlukan pengobatan, dan dinasehatkan untuk jangan mengorek telinga, air jangan masuk ke telinga sewaktu mandi, dilarang berenang dan segera berobat bila menderita infeksi saluran nafas atas. Bila fasilitas memungkinkan sebaiknya dilakukan operasi rekonstruksi (miringoplasti, timpanoplasti) untuk mencegah infeksi berulang serta gangguan pendengaran.

OMSK BENIGNA AKTIF

Prinsip pengobatan OMSK adalah3 :

1.Membersihkan liang telinga dan kavum timpani.

2.Pemberian antibiotika : – topikal antibiotik ( antimikroba)

- sistemik.

Pemberian antibiotik topikal

Pemberian antibiotik secara topikal pada telinga dan sekret yang banyak tanpa dibersihkan dulu, adalah tidak efektif. Bila sekret berkurang/tidak progresif lagi diberikan obat tetes yang mengandung antibiotik dan kortikosteroid.4 Mengingat pemberian obat topikal dimaksudkan agar masuk sampai telinga tengah, maka tidak dianjurkan antibiotik yang ototoksik misalnya neomisin dan lamanya tidak lebih dari 1 minggu. Cara pemilihan antibiotik yang paling baik dengan berdasarkan kultur kuman penyebab dan uji resistesni3.

Bubuk telinga yang digunakan seperti3 :

a. Acidum boricum dengan atau tanpa iodine

b. Terramycin.

c. Asidum borikum 2,5 gram dicampur dengan khloromicetin 250 mg

Pengobatan antibiotik topikal dapat digunakan secara luas untuk OMSK aktif yang dikombinasi dengan pembersihan telinga.

Antibiotika topikal yang dapat dipakai pada otitis media kronik adalah3 :

1. Polimiksin B atau polimiksin E

Obat ini bersifat bakterisid terhadap kuman gram negatif, Pseudomonas, E. Koli Klebeilla, Enterobakter, tetapi resisten terhadap gram positif, Proteus, B. fragilis Toksik terhadap ginjal dan susunan saraf.

2. Neomisin

Obat bakterisid pada kuma gram positif dan negatif, misalnya : Stafilokokus aureus, Proteus sp. Resisten pada semua anaerob dan Pseudomonas. Toksik terhadap ginjal dan telinga.

3. Kloramfenikol

Obat ini bersifat bakterisid

Pemberian antibiotik sistemik

Pemberian antibiotika tidak lebih dari 1 minggu dan harus disertai pembersihan sekret profus. Bila terjadi kegagalan pengobatan, perlu diperhatikan faktor penyebab kegagalan yang ada pada penderita tersebut. Antimikroba dapat dibagi menjadi 2 golongan. Golongan pertama daya bunuhnya tergantung kadarnya. Makin tinggi kadar obat, makin banyak kuman terbunuh, misalnya golongan aminoglikosida dengan kuinolon. Golongan kedua adalah antimikroba yang pada konsentrasi tertentu daya bunuhnya paling baik. Peninggian dosis tidak menambah daya bunuh antimikroba golongan ini, misalnya golongan beta laktam.

Terapi antibiotik sistemik yang dianjurkan pada Otitis media kronik adalah2,3. Pseudomonas Aminoglikosida ± karbenisilin

P. mirabilis Ampisilin atau sefalosforin

P. morganii, P. vulgaris Aminoglikosida ± Karbenisilin

Klebsiella Sefalosforin atau aminoglikosida

E. coli Ampisilin atau sefalosforin

S. Aureus Anti-stafilikokus penisilin, sefalosforin, eritromisin, aminoglikosida

Streptokokus Penisilin, sefalosforin, eritromisin, aminoglikosida

B. fragilis Klindamisin

Antibiotika golongan kuinolon (siprofloksasin, dan ofloksasin) yaitu dapat derivat asam nalidiksat yang mempunyai aktifitas anti pseudomonas dan dapat diberikan peroral. Tetapi tidak dianjurkan untuk anak dengan umur dibawah 16 tahun. Golongan sefalosforin generasi III ( sefotaksim, seftazidinm dan seftriakson) juga aktif terhadap pseudomonas, tetapi harus diberikan secara parenteral. Terapi ini sangat baik untuk OMA sedangkan untuk OMSK belum pasti cukup, meskipun dapat mengatasi OMSK. Metronidazol mempunyai efek bakterisid untuk kuman anaerob. Menurut Browsing dkk metronidazol dapat diberikan dengan dan tanpa antibiotik ( sefaleksin dan kotrimoksasol) pada OMSK aktif, dosis 400 mg per 8 jam selama 2 minggu atau 200 mg per 8 jam selama 2-4 minggu1,2,6.

OMSK MALIGNA

Pengobatan untuk OMSK maligna adalah operasi. Pengobatan konservatif dengan medikamentosa hanyalah merupakan terapi sementara sebelum dilakukan pembedahan. Bila terdapat abses subperiosteal, maka insisi abses sebaiknya dilakukan tersendiri sebelum kemudian dilakukan mastoidektomi3.

Ada beberapa jenis pembedahan atau tehnik operasi yang dapat dilakukan pada OMSK dengan mastoiditis kronis, baik tipe benigna atau maligna, antara lain3:

1.Mastoidektomi sederhana ( simple mastoidectomy)

2.Mastoidektomi radikal

3.Mastoidektomi radikal dengan modifikasi

4.Miringoplasti

5.Timpanoplasti

6.Pendekatan ganda timpanoplasti ( Combined approach tympanoplasty)

Tujuan operasi adalah menghentikan infeksi secara permanen, memperbaiki membran timpani yang perforasi, mencegah terjadinya komplikasi atau kerusakan pendengaran yang lebih berat, serta memperbaiki pendengaran. Pedoman umum pengobatan penderita OMSK adalah Algoritma berikut2,7.

 KLASIFIKASI OMSK

OMSK dapat dibagi atas 2 tipe yaitu2,11 :

1. Tipe tubotimpani = tipe jinak = tipe aman = tipe rhinogen.

Penyakit tubotimpani ditandai oleh adanya perforasi sentral atau pars tensa dan gejala klinik yang bervariasi dari luas dan keparahan penyakit.

Secara klinis penyakit tubotimpani terbagi atas:

1.1. Penyakit aktif

Pada jenis ini terdapat sekret pada telinga dan tuli. Biasanya didahului oleh perluasan infeksi saluran nafas atas melalui tuba eutachius, atau setelah berenang dimana kuman masuk melalui liang telinga luar. Sekret bervariasi dari mukoid sampai mukopurulen1,2.

1.2. Penyakit tidak aktif

` Pada pemeriksaan telinga dijumpai perforasi total yang kering dengan mukosa telinga tengah yang pucat. Gejala yang dijumpai berupa tuli konduktif ringan. Gejala lain yang dijumpai seperti vertigo, tinitus,atau suatu rasa penuh dalam telinga1,4.

2. Tipe atikoantral = tipe ganas = tipe tidak aman = tipe tulang

Pada tipe ini ditemukan adanya kolesteatom dan berbahaya. Penyakit atikoantral lebih sering mengenai pars flasida dan khasnya dengan terbentuknya kantong retraksi yang mana bertumpuknya keratin sampai menghasilkan kolesteatom. Kolesteatom dapat dibagi atas 2 tipe yaitu :1,3

a. Kongenital

b. Didapat.

Pada umumnya kolesteatom terdapat pada otitis media kronik dengan perforasi marginal. teori itu adalah2,5 :

1. Epitel dari liang telinga masuk melalui perforasi kedalam kavum timpani dan disini ia membentuk kolesteatom ( migration teori menurut Hartmann); epitel yang masuk menjadi nekrotis, terangkat keatas.

2. Embrional sudah ada pulau-pulau kecil dan ini yang akan menjadi kolesteatom.

3. Mukosa dari kavum timpani mengadakan metaplasia oleh karena infeksi (metaplasia teori menurut Wendt).

4. Ada pula kolesteatom yang letaknya pada pars plasida ( attic retraction cholesteatom).

1. Perforasi sentral

Lokasi pada pars tensa, bisa antero-inferior, postero-inferior dan postero-superior, kadang-kadang sub total1,2,4.

2. Perforasi marginal

Terdapat pada pinggir membran timpani dengan adanya erosi dari anulus fibrosus. Perforasi marginal yang sangat besar digambarkan sebagai perforasi total. Perforasi pada pinggir postero-superior berhubungan dengan kolesteatom1,2,4

3. Perforasi atik

Terjadi pada pars flasida, berhubungan dengan primary acquired cholesteatoma1,2,4.

V. EPIDEMIOLOGI

Prevalensi OMSK pada beberapa negara antara lain dipengaruhi, kondisi sosial, ekonomi, suku, tempat tinggal yang padat, hygiene dan nutrisi yang jelek. Kebanyakan melaporkan prevalensi OMSK pada anak termasuk anak yang mempunyai kolesteatom, tetapi tidak mempunyai data yang tepat, apalagi insiden OMSK saja, tidak ada data yang tersedia7,9.

 KLASIFIKASI OMSK

OMSK dapat dibagi atas 2 tipe yaitu2,11 :

1. Tipe tubotimpani = tipe jinak = tipe aman = tipe rhinogen.

Penyakit tubotimpani ditandai oleh adanya perforasi sentral atau pars tensa dan gejala klinik yang bervariasi dari luas dan keparahan penyakit.

Secara klinis penyakit tubotimpani terbagi atas:

1.1. Penyakit aktif

Pada jenis ini terdapat sekret pada telinga dan tuli. Biasanya didahului oleh perluasan infeksi saluran nafas atas melalui tuba eutachius, atau setelah berenang dimana kuman masuk melalui liang telinga luar. Sekret bervariasi dari mukoid sampai mukopurulen1,2.

1.2. Penyakit tidak aktif

` Pada pemeriksaan telinga dijumpai perforasi total yang kering dengan mukosa telinga tengah yang pucat. Gejala yang dijumpai berupa tuli konduktif ringan. Gejala lain yang dijumpai seperti vertigo, tinitus,atau suatu rasa penuh dalam telinga1,4.

2. Tipe atikoantral = tipe ganas = tipe tidak aman = tipe tulang

Pada tipe ini ditemukan adanya kolesteatom dan berbahaya. Penyakit atikoantral lebih sering mengenai pars flasida dan khasnya dengan terbentuknya kantong retraksi yang mana bertumpuknya keratin sampai menghasilkan kolesteatom. Kolesteatom dapat dibagi atas 2 tipe yaitu :1,3

a. Kongenital

b. Didapat.

Pada umumnya kolesteatom terdapat pada otitis media kronik dengan perforasi marginal. teori itu adalah2,5 :

1. Epitel dari liang telinga masuk melalui perforasi kedalam kavum timpani dan disini ia membentuk kolesteatom ( migration teori menurut Hartmann); epitel yang masuk menjadi nekrotis, terangkat keatas.

2. Embrional sudah ada pulau-pulau kecil dan ini yang akan menjadi kolesteatom.

3. Mukosa dari kavum timpani mengadakan metaplasia oleh karena infeksi (metaplasia teori menurut Wendt).

4. Ada pula kolesteatom yang letaknya pada pars plasida ( attic retraction cholesteatom).

1. Perforasi sentral

Lokasi pada pars tensa, bisa antero-inferior, postero-inferior dan postero-superior, kadang-kadang sub total1,2,4.

2. Perforasi marginal

Terdapat pada pinggir membran timpani dengan adanya erosi dari anulus fibrosus. Perforasi marginal yang sangat besar digambarkan sebagai perforasi total. Perforasi pada pinggir postero-superior berhubungan dengan kolesteatom1,2,4

3. Perforasi atik

Terjadi pada pars flasida, berhubungan dengan primary acquired cholesteatoma1,2,4.

V. EPIDEMIOLOGI

Prevalensi OMSK pada beberapa negara antara lain dipengaruhi, kondisi sosial, ekonomi, suku, tempat tinggal yang padat, hygiene dan nutrisi yang jelek. Kebanyakan melaporkan prevalensi OMSK pada anak termasuk anak yang mempunyai kolesteatom, tetapi tidak mempunyai data yang tepat, apalagi insiden OMSK saja, tidak ada data yang tersedia7,9.