SKENARIO 2PEGAWAI KAMAR MESIN KAPALDisusun oleh :KELOMPOK A- 4APRILIA NOVITA SARI1102007040ATHIEAH AS!-S!AHIDAH11020070"1#HAESARANI P$TRI 11020070%7DEVI 11020070&1D!AH 'ITRAH MATASARI11020070("ERNITA ROS!ANTI DE)I 1102007102'ITA 'ITRIANTI1102007122ILMAH !AN$ARTI11020071*(INDRA SAP$TRA1102007142FAKULTAS KEDOKTERAN UNIVERSITAS YARSI2009/2010Skenari 2PEGAWAI KAMAR MESIN KAPALSeo+,n- l,.i-l,.i /e+n,0, A usi, 4" 1,hun2 ,3,l,h seo+,n- 4e-,5,i .,0,+ 0esin 3i se/u,h .,4,l/,+,n-6A /e.e+7,3i .,0,+ 0esin.,4,l 1e+se/u1 se7,.usi,201,hun6 Men7,-,0esin.,4,l1e+4,4,+/isin-0esin.,4,l!/"90 #a$%ai 100&e#i'e()100 &*+sel,0, .u+,n- le/ih& 7,0se1i,4 h,+in8,6 Se1i,4 /e.e+7, 0en--un,.,n ear %(,n-6Se/elu0 /e.e+7, .e3u, 1elin-,n A seh,16 Me0e+i.s,.,n .e 3o.1e+ 4e+us,h,,n 3en-,n .eluh,nk,ran- %en&en-aran 4,3, .e3u, 1elin-,6 A 0en-eluh .u+,n- 7el,s 0ene+i0, 4e0/i9,+,,n /il,3i,7,./e+/i9,+,3en-,n1e0,nse.,n1o+2 ,4,l,-i s,,1 0enel4on6 H,l ini 3i+,s,.,nse0,.in0e0/e+,1 3,l,0 .u+un 5,.1u se1,un /el,.,n-,n ini6P,3,4e0e+i.s,,n-ar%,.a(a3,na,&i$e.ri3i3,4,1.,n.,(i %er#e%.i/&era0a.'era.4,3,.e3u,1elin-,6 Anen,n8,.,n.e4,3,3o.1e+ .e0un-.in,nse0/uh3,4,1 0en3en-,+ se4e+1ise0ul,6Do.1e+ 0en8,+,n.,n 4,sien un1u. le/ih 0en7,-, .eseh,1,n in3+, 4en3en-,+ /,i. se9,+, 0e3is0,u4un se9,+, isl,062STEP 116 Me0,h,0i ,n,1o0i 1elin-,26 Me0,h,0i :isiolo-i 4en3en-,+,n*6 Me0,h,0i 7enis-7enis -,n--u,n 4en3en-,+,n46 Me0,h,0i 7enis-7enis 4e0e+i.s,,n 1elin-, 3,n 1es 4en3en-,+,n"6 Me0,h,0i 4en8,.i1-4en8,.i1 8,n- 3,4,1 0en-,.i/,1.,n -,n--u,n 4en3en-,+,n%6 Men7,-, 1elin-, 3,n 4en3en-,+,n /e+3,s,+.,n ,7,+,n isl,03STEP 2MANDIRI4STEP *11 Me$a2a$i ana.$i .e(in-aTelin-, 1e+3i+i 3,+i 1elin-, lu,+2 1en-,h 3,n 3,l,06 Telin-, 0,nusi, 0ene+i0, 3,n0en1+,ns0isi.,n -elo0/,n- /un8i .e o1,. 3i0,n, /un8i 1e+se/u1 ,.,n 3i ,n,lis, 3,n 3iin1+e4+e1,si.,n6 #,+,4,lin-0u3,hun1u.0en--,0/,+.,n:un-si 3,+i 1elin-,,3,l,h3en-,n0en--,0/,+.,n9,+,/un8i 3i/,5,3,+i 4e+0ul,,ns,04,i ,.hi+ 3,+i se1i,4/,-i,n-/,-i,n 1elin-, 8,n- /e+/e3,6Telin-, 0e04un8,i +es41o+ /,-i 2 0o3,li1,s +ese41o+ senso+i. :11 Pen&en-aran )N1 34(eari#+Telin-, 3i/,-i 0en7,3i * /,-i,n :Te(in-a (,ar- Au+i9ul,Men-u04ul.,n su,+, 8,n- 3i1e+i0,- Me,1us A9us1i9us E.s1e+nusMen8,lu+.,n ,1,u 0ene+us.,n su,+, .e .,n,lis ,u3i1o+ius e.s1e+n,- #,n,lis Au3i1o+ius E.s1e+nusMene+us.,n su,+, .e 0e0/e+,n 1i04,ni - Me0/+,n 1i04,ni5Se/,-,i +eson,1o+ 0en-u/,h -elo0/,n- u3,+, 0en7,3i -elo0/,n- 0e.,ni.6Te(in-a .en-a2 Telin-,1en-,h,3,l,h+u,n-/e+isi u3,+,8,n-0en-hu/un-.,n+on--,hi3un-3,n1en--o+o.,n3ihu/un-.,n0el,lui 1u/,eus1,9hius2 8,n-:un-sin8, 0en8,0,.,n1e.,n,n u3,+, 4,3, .e3u, sisi -en3,n- 1elin-,6 Tu/, eus1,9hius l,;i0n8, 3,l,0 .e,3,,n1e+1u1u4,.,n1e1,4i 3,4,1 1e+/u., se9,+, ,l,0i .e1i., ,n3, 0enel,n3,n0en-u,46Se1el,h s,04,i 4,3, -en3,n- 1elin-,2 -elo0/,n- su,+, ,.,n 0en8e/,/.,n /e+-e1,+n8,-en3,n- 1elin-,2 l,lu 3en-,n 4e+l,h,n 3is,lu+.,n 4,3, +,n-.,i,n 1ul,n--1ul,n-4en3en-,+,n6 Tul,n--1ul,n- 8,n- s,lin- /e+hu/un-,n ini - se+in- 3ise/u1 < 0,+1il2l,n3,s,n2 3,ns,n--u+3ieus1,9hius?Pen-hu/un- :,+in- 3,n 9,=u0 n,so :,+in-un1u. :P+o1e.si: 0elin3un-i n3,+i .u0,nD+,in,se: 0en-elu,+.,n 9,i+,n6Ae+u:un-si: 0en8,0,.,n 1e.,n,n lu,+ 3,n 3,l,0- Tu/, 4en3en-,+,n >0,leus2 in.us2 3,n s1,4es?Me04e+.u,1 -e+,.,n 0e.,ni. 3,n 0e0/+,n 1i04,ni un1u. 3i1e+us.,n .e :o+,0en o=,le4,3, .o.le, sehin--, 4e+ili0:e 4,3, s.,l, =es1i/ule ,.,n /e+.e0/,n-6 O1o1 @ O1o1 Ossi9ul, :M6 Tenso+ T804,ni6 Ori- : #,+1il,-o Tu/, ,u3i1i=, 3,n 3in3in- 1ul,n- s,lu+,nn8, sen3i+i6 In#er#i : O1o1 l,n-sin- ini /e+7,l,n .e /el,.,n- 3,n /e+,.hi+ se/,-,i 1en3o /ul,18,n-0e0/elo..el,1e+,l 3i se.i1,+4+o9essus9o9hle,+i:o+0is3,n/e+inse+sio4,3, 0,nu/+iu0 0,llei6 Per#ara/an: Se/u,h 9,/,n- 3,+i s,+,: 8,n- 0enu7u 0641e+8-oi3eus 0e3i,lis28,n- 0e+u4,.,n 9,/,n- 3,+i 3i=isi 0,n3i/ul,+is n6 1+i-e0inus6 F,n-#i: Se9,+,+e:le.s0e+e3,0-e1,+,n0,lleus 3en-,nle/ih0ene-,n-.,n0e0/+,ne 1804,ni6M6 s1,4e3ius Ori- : Din3in- 3,l,0 48+,0is 8,n- /e+on--,6 In#er#i: Ten3o 0un9ul 3,+i 4un9,. 48+,0is 3,n/e+inse+sio 4,3, /,-i,n/el,.,n- 9ollu0 s1,4e3is6 Per#ara/an : N6 :,9i,lis 8,n- 1e+le1,. 3i /el,.,n- 48+,0is6 F,n-#i : Se9,+, +e:le.s 0e+e3,0 -e1,+,n s1,4es 3en-,n 0en,+i. 9ollu0n8,6Te(in-a Da(a$ Telin-, 3,l,0 1e+3i+i 3,+i :Ko.le,S.,l, =es1i/ule: 0en-,n3un- 4e+ili0:eS.,l, 0e3i,: 0en-,n3un- en3oli0:eS.,l, 1i04,ni: 0en-,n3un- 4e+ili0:eO+-,n 9o+1iMen-,n3un- sel-sel +,0/u1 8,n- 0e+u4,.,n +esse41o+ 4en3en-,+,n 3i 0e0/e+,n/,sil,+is6Telin-,3,l,03i4enuhi oleh9,i+,n3,n1e+3i+i 3,+i 0is,ln8, 0elo04,1 ,1,u /e+,3, 3,l,0 ele=,1o+?6Per&ara2anTelin-, 3,l,0 0e04e+oleh 4e+3,+,h,n 3,+i ,6 ,u3i1o+i in1e+n, >,6 l,/i+in1in? 8,n-/e+,s,l 3,+i ,6 se+e/elli in:e+io+ ,n1e+io+ ,1,u l,n-sun- 3,+i ,6 /,sil,+is 8,n- 0e+u4,.,nsu,1u en3 ,+1e+i 3,n 1i3,. 0e04un8,i 4e0/uluh 3,+,h ,n,s1o0osis6 Se1el,h 0e0,su.i0e,1us ,.us1i.us in1e+nus2 ,+1e+i ini /e+9,/,n- * 8,i1u : &-1016 A+1e+i =es1i/ul,+is ,n1e+io+ 8,n- 0en3,+,hi 0,.ul, u1+i.uli2 se/,-i,n 0,9ul, s,.uli2.+is1, ,04ul,+is2 .,n,lis se0isi+.ul,+is su4e+io+ 3,n l,1e+,l se+1, se/,-i,n 3,+i u1+i.ulus3,n s,.ulus626A+1e+i =es1i/ulo.o.le,+is2 0en3,+,hi 0,.ul,s,.uli2 .,n,lisse0isi+.ul,+is4os1e+io+2/,-i,n in:e+io+ u1+i.ulus 3,n s,.ulus se+1, 4u1,+,n /,s,l 3,+i .o.le,6*6 A+1e+i .o.le,+is 8,n-0e0,su.i 0o3iolus 3,n0en7,3i 4e0/uluh-4e0/uluh,+1e+is4i+,l 8,n- 0en3,+,hi o+-,n #o+1i2 s.,l, =es1i/uli2 s.,l, 1i04,ni se/elu0 /e+,.hi+ 4,3,s1+i, =,s.ul,+is6Ali+,n=en, 4,3, 1elin-, 3,l,00el,lui *7,lu+ u1,0,6 Ven, ,u3i1o+i n1e+n,0en3,+,hi 4u1,+,n1en-,h3,n,4i.,l .o.le,6 Ven, ,.u,3u.1us .o.le,+is 0en3,+,hi84u1,+,n /,sile+ .o.le,2 s,.ulus 3,n u1+i.ulus 3,n /e+,.hi+ 4,3, sinus 4e1+osus in:e+io+6Ven, ,.u,3u.1us =es1i/ul,+is 0en3,+,hi .,n,lis se0isi+.ul,+is s,04,i u1+i.ulus6 Ven, ini0en-i.u1i 3u.1us en3oli0:,1i.us 3,n 0,su. .e sinus si-0oi36Per#ara/anN6 ,.us1i.us /e+s,0, N6 :,si,lis 0,su. .e 3,l,0 4o+us 3,+i 0e,1us ,.us1i.us in1e+nus3,n /e+9,/,n- 3u, se/,-,i N6 =es1i/ul,+is 3,n N6 .o.le,+is6 P,3, 3,s,+ 0e,1us ,.us1i.usin1e+nus 1e+le1,. -,n-lion =es1i/ul,+e 3,n 4,3, 0o3iolus 1e+le1,. -,n-lion s4i+,le621 Me$a2a$i /i#i(-i %en&en-aranP+oses Men3en-,+Be1,+,n su,+, 3i1,n-.,4 oleh 3,un 1elin-, 8,n- 3i1e+us.,n .e li,n- 1elin-,3,n 0en-en,i 0e0/+,n 1i04,ni sehin--, 0e0/+,n 1i04,ni /e+-e1,+6 Be1,+,n ini3i1e+us.,n .e 1ul,n--1ul,n- 4en3en-,+,n 8,n- /e+hu/un-,n s,1u s,0, l,in6Sel,n7u1n8, s1,4es 0en--e+,..,n :o+,0en o=,le 8,n- 7u-, 0en--e+,..,n 4e+ili0:e3,l,0 s.,l, =es1i/uli6 Be1,+,n 3i1e+us.,n 0el,lui 0e0/+,n Reissne+ 8,n-0en3o+on- en3oli0:e 3,n 0e0/+,n /,s,lis .e ,+,h /,5,h 3,n 4e+ili0:e 3,l,0s.,l, 1i04,ni ,.,n /e+-e+,. sehin--, :o+,0en +o1un3u0 1e+3o+on- .e ,+,h lu,+6P,3, 5,.1u is1i+,h,12 u7un- sel +,0/u1 #o+1i /e+.elo.2 3,n 3en-,n 1e+3o+on-n8,0e0/+,n /,s,l2 u7un- sel +,0/u1 i1u 0en7,3i lu+us6 R,n-s,n-,n :isi. ini /e+u/,h 0en7,3i +,n-s,n-,n lis1+i. ,.i/,1 ,3,n8, 4e+/e3,,n ion N,1+iu03,n K,liu0 8,n- 3i1e+us.,n .e 9,/,n--9,/,n- N6 VIII2 .e0u3i,n 0ene+us.,n +,n-s,n-,n i1u .e4us,1 senso+i. 4en3en-,+,n 3i o1,. 0el,lui s,+,: 4us,1 8,n- ,3, 3i lo/us 1e04o+,lis6>Soe4,+3i EA2 Is.,n3,+ N2 E36 Cu.u ,7,+ il0u 4en8,.i1 THT?9Su,+,,3,l,hsens,si 8,n-1i0/ul ,4,/il,-e1,+,nlon-i1u3in,l 0ole.ul 3i lin-.un-,ne.s1e+n,l2 8,i1u 0,s, 4e0,3,1,n 3,n 4elon--,+,n 0ole.ul 8,n- 1e+7,3i /e+sel,n- selin- 0en-en,i0e0/e+,n1i04,ni6 Plo1 -e+,.,n--e+,.,ninise/,-,i 4e+u/,h,n1e.,n,n3i 0e0/e+,n1i04,ni4e+s,1u,n 5,.1u ,3,l,h s,1u,n -elo0/,n-2 3,n -e+,.,n se0,9,0 i1u 3,l,0 lin-u.,n-,n se9,+,u0u0 3ise/u1 -elo0/,n- su,+,6Se9,+, u0u0 .e.e+,s,n su,+, /e+.,i1,n 3en-,n ,04li1u3o -elo0/,n- su,+, 3,nn,3, /e+.,i1,n 3en-,n 4+e.uensi >7u0l,h -elo0/,n- 4e+s,1u,n 5,.1u?6Se0,.in /es,+su,+, se0,.in /es,+ ,04li1u3o2 se0,.in 1in--i :+e.uensi 3,n se0,.in 1in--i n,3,6N,0un n,3, 7u-, 3i1en1u.,n oleh :,91o+ - :,.1o+ l,in 8,n- /elu0 se4enuhn8, 3i4,h,0isel,in:+e.uensi 3,n:+e.uensi 0e04en-,+uhi .e.e+,s,n2 .,+en,,0/,n-4en3en-,+,nle/ih +en3,h 4,3, :+e.uensi 3i/,n3in-.,n 3en-,n :+e.uensi l,in6 Belo0/,n- su,+,0e0ili.i 4ol, /e+ul,n-2 5,l,u4un 0,sin- - 0,sin- -elo0/,n- /e+si:,1 .o04le.s23i3en-,+ se/,-,i su,+, 0usi.2 -e1,+,n ,4+io3i. 8,n- 1i3,. /e+ul,n-0en8e/,/,.,nsens,si /isin-6 Se/,-i,n 3,+i su,+, 0usi. /e+s,l, 3,+i -elo0/,n- 3,n :+e.uensi 4+i0e+8,n-0enen1u.,nsu,+,3i1,0/,hse7u0l,-e1,+,nh,+0oni.8,n-0en8e/,/.,nsu,+,0e0ili.i 1i0/+e 8,n- .h,s6 V,+i,si 1i0/+e 0e04en-,+uhi 0en-e1,hhi su,+, /e+/,-,i ,l,10usi. 5,l,u4un ,l,1 1e+se/u1 0e0/e+i.,n n,3, 8,n- s,0,6 >)illi,0 '6B,nnon-2 1((&?Tel,h 3i.e1,hui /,h5, ,3,n8, su,1u su,+, ,.,n 0enu+un.,n .e0,04u,nseseo+,n- 0en3en-,+ su,+, l,in6 'eno0en, ini 3i.en,l se/,-,i 0,s.in- >4en8,0,+,n?6'eno0en, ini 3i4e+.i+,.,n 3ise/,/.,n oleh +e:+,.1e+ +el,1i=e ,1,u ,/solu1e 4,3, +ese41o+3,nu+,1 s,+,: 4,3, s,+,: ,u3io1i.8,n-se/elu0n8, 1e+,ns,n-oleh+,ns,n-,nl,in6Tin-.,1 su,1u su,+, 0enu1u4i su,+, l,in /e+.,i1,n 3en-,n n,3,n8,6 Ke9u,li 4,3,lin-.un-,n8,n-s,n-,1 .e3,4su,+,2 E:e.4en8,0,+,nsu,+,l,1,,.,n0enin-.,1,n,0/,n- 4en3en-,+,n 3en-,n /es,+ 8,n- 1e+1en1u 3,n 3,4,1 3iu.i+6Pen8,lu+,nsu,+,4+osesn8,,3,l,h1elin-,0en-u/,h-elo0/,n-su,+,3i lin-.un-,ne.s1e+n,l 0en7,3i 4o1ensi ,.si 3i s,+,: 4en3en-,+,nBelo0/,n- 3iu/,h oleh -en3,n-1elin-,3,n1ul,n--1ul,n-4en3en-,+,n0en7,3i -e+,.,n--e+,.,nle04en-.,.i s1,4es6Be+,.,n ini 0eni0/ul.,n -elo0/,n- 3,l,0 9,i+,n 1elin-, 3,l,06 E:e. -elo0/,n- 4,3,o+-,n #o+1i 0eni0/ul.,n 4o1ensi,l ,.si3i se+,1-se+,1 s,+,:6 >)illi,0 '6B,nno021((&?51 Me$a2a$i 0eni#"0eni# -an--,an %en&en-aran6eni# 7 0eni# -an--,an %en&en-aran &ian.aran8a a&a(a2 9,6 B,n--u,n 4en3en-,+,n Kon3u.1i: : 1e+7,3i .e1i., -elo0/,n- su,+,2 1e+h,l,n-0,su.n8, 3,+i lu/,n- 1elin-, 3,n -en3,n- 1elin-, 0enu7u .e +u0,h si4u1 > .o.le, ?3,n S,+,: Pen3en-,+,n>Au3i1o+8 Ne+=e?6Tuli .on3u.1i:2 3ise/,/.,n oleh .el,in,n 8,n- 1e+3,4,1 3i 1elin-, lu,+ ,1,u 1elin-,1en-,h6 Kel,in,n 3i 1elin-, lu,+ 8,n- 0en8e/,/.,n 1uli .on3u.1i: i,l,h ,1+esi, li,n-1elin-,2 su0/,1,n oleh se+u0en2 o1i1is e.s1e+n, si+.u0s.+i41,2 os1eo0, li,n- 1elin-,6Kel,in,n 3i 1elin-, 1en-,h 8,n- 0en8e/,/.,n 1uli .on3u.1i: i,l,h 1u/,.,1,+Dsu0/,1,n 1u/, eus1,9hius2 o1i1is 0e3i,2 o1os.le+osis2 1i04,nos.le+osis2he0o1i04,nu0 3,n 3islo.,si 1ul,n- 4en3en-,+,n6/6 B,n--u,n 4en3en-,+,n Senso+ineu+,lD S,+,: : 1e+7,3i .e1i., +u0,h si4u1 > .o.le,?,1,u s,+,: 4en3en-,+,n :un-sin8, 0enu+un 610Pen3en-,+,n senso+ineu+,l 7u-, 3i.en,l se/,-,i .o.le, -,n--u,n 4en3en-,+,n2-,n--u,n4en3en-,+,n1elin-, /,-i,n3,l,0,1,us,+,: .ehil,n-,n4en3en-,+,nloss6Senso+ineu+,l 3i.,i1.,n3en-,n1elin-, /,-i,n3,l,06 Ini ,3,l,h7enis 8,n-4,lin-u0u0-,n--u,n4en3en-,+,n6 Di4e+.i+,.,nh,04i+(04e+seno+,n-8,n-0e0,.,i ,l,1 /,n1u 3en-,+ /en,+-/en,+ 0en-,l,0i -,n--u,n 4en3en-,+,nsenso+ineu+,l6 H,l ini 3,4,1 1e+7,3i .,+en,4enu,,n2 .,+en,1e+4,4,+ su,+,.e+,s20,s,l,h3en-,ns,+,: 4en3en-,+,n2 0e0ili.i 0,s,l,h3en-,nsi+.ul,si 3,+,h3i1elin-, ,1,u ,3, 0,s,l,h 3en-,n 1elin-, 3,l,0 9,i+,n6 Eenis -,n--u,n 4en3en-,+,n,3,l,h 4e+0,nen 3i ,l,02 3,n s,1u-s,1un8, solusi 8,n- 0e0,.,i ,l,1 /,n1u 3en-,+,1,u 0e0ilih un1u. .o.le, i04l,n696 B,n--u,n 4en3en-,+,n 9,04u+,n : 9,04u+,n ,n1,+, -,n--u,n 4en3en-,+,n.on3u.1i: 3,n s,+,:6Pen3en-,+,n 9,04u+,n 0e+u4,.,n .o0/in,si 3,+i senso+ineu+,l 3,n -,n--u,n4en3en-,+,n .on3u.1i:6 Se0en1,+, .ehil,n-,n 4en3en-,+,n sen1+,l ,3,l,h .e1i., ,3,0,s,l,h 3en-,n sis1e0 s,+,: 4us,1 3,n sin8,l lis1+i. 1i3,. 3i1ul,+.,n 0el,lui s,+,:4en3en-,+,n .e o1,.6Kek,ran-an %en&en-aran!,n-3i0,.su33en-,n.e.u+,n-,n4en3en-,+,n,3,l,h.e,3,,n3i0,n,seo+,n-.u+,n- 34,1 0en3en-,+ 3,n 0en-e+1i su,+, ,1,u 4e+9,.4,n 8,n- 3i3en-,+ un1u.0en3i,-nosis .u+,n- 4en3en-,+,n6Eenis KP /e+3,s,+.,n lo.,lis,si lesi :,6 KP 7enis h,n1,+,n Lo.,lis,si -,n--u,n ,1,u lesi 1e+le1,. 4,3, 1elin-, lu,+ 3,n ,1,u 1elin-, 1en-,h6/6 KP 7enis senso+ineu+,lLo.,lis,si -,n--u,n ,1,u lesi 1e+le1,. 4,3, 1elin-, 3,l,0 >4,3, .o.le, 3,n N6VIII?96 KP 7enis 9,04u+,nLo.,lis,si -,n--u,n ,1,u lesi 1e+le1,. 4,3, 1elin-, 1en-,h 3,n 1elin-, 3,l,0636 KP 7enis sen1+,lLo.,lis,si -,n--u,n ,1,u lesi 1e+le1,. 4,3, nu9leus ,u3i1o+ius 3i/,1,n- o1,. s,04,i3en-,n .o+1e.s o1,.6e6 KP 7enis :un-sion,lP,3,KP 7enisini 1i3,.3i7u04,i ,3,n8,-,n--u,n,1,ulesi o+-,ni94,3,s8s1e04en3en-,+,n /,i. 4e+i:e+ 0,u4un sen1+,l2 0el,in.,n /e+3,3,s,+.,n ,3,n8, 0,s,l,h4si.olo-is ,1,u e0osion,l6:1 Me$a2a$i 0eni#"0eni# %e$erik#aan .e(in-a &an .e# %en&en-aranTe# F,n-#i Pen&en-aran Pe0e+i.s,,n ,u3io0e1+i Ke1,7,0,n4en3en-,+,nse+in-3iu.u+3en-,nsu,1u,u3io0e1+i6Al,1ini 0en-h,sil.,nn,3,-n,3, 0u+ni 3en-,n :+e.uensi 0el,lui ,e+4hon6 P,3, ses1i,4 :+e.uensi 3i1en1u.,n in1ensi1,s11,0/,n-3,n3i4lo1.,n4,3,se/u,h-+,:i.se/,-,i 4+sen1,si 3,+i 4en3en-,+,nno+0,l6 H,l ini0en-h,sil.,n 4en-u.u+,n o/8e.1i: 3e+,7,1 .e1uli,n 3,n -,0/,+,n 0en-en,i +en1,n- n,3, 8,n-4,lin- 1e+4en-,+uh6De:inisi Au3io0e1+i /e+,s,l 3,+i .,1, ,u3i+ 3,n 0e1+ios 8,n- /e+,+1i 0en3en-,+ 3,n0en-u.u+>u7i 4en3en-,+,n?6 Au3io0e1+i 1i3,. s,7, 3i4e+-un,.,n un1u. 0en-u.u+ .e1,7,0,n 4en3en-,+,n21e1,4i 7u-, 3,4,1 3i4e+-un,.,n un1u. 0enen1u.,n lo.,lis,si .e+us,.,n ,n,1o0is 8,n-0eni0/ul.,n -,n--u,n 4en3en-,+,n6Au3io0e1+i ,3,l,hsu/u,h ,l,1 8,n- 3i-un,.,n un1u.0en-1,hui le=el 4en3en-,+,n seseo+,n-6Den-,n /,n1u,n se/u,h ,l,1 8,n- 3ise/u1 3en-,n ,u3io0e1+i2 0,., 3e+,7,1 .e1,7,0,n4en3en-,+,nseseo+,n-3,F,1 3inil,i6 Tes ,u3io0e1+i 3i4e+lu.,n/,-i seseo+,n-8,n-0e+,s,0e0ili.i -,n--u,n 4en3en-e+,n ,1,u seseo+,n- 8,- ,.,n/e.e+7, 4,3, su,1u/i3,n- 8,n-0e0e+lu.,n .e1,7,0,n 4en3n-,+,n6Pe0e+i.s,,n ,u3io0e1+i 0e0e+lu.,n ,u3io0e1+i +u,n- .e3,4 su,+,2 ,u3iolo-is 3,n 4,sien 8,n-.oo4e+,1i:6 Pe0e+i.s,,n s1,n3,+ 8,n- 3il,.u.,n ,3,l,h :A,&i$e.ri na&a $,rni Su,1u sisi1e0 u7i 4en3en-,+,n 3en-,n 0en--un,.,n ,l,1 lis1+i. 8,n- 3,4,1 0en-h,sil.,n/un8i n,3,-n,3, 0u+ni 3,+i /e+/,-,i :+e.uensi 2"0-"002 1000-20002 4000-&000 3,n 3,4,1 3i,1u+in1ensi1,sn8,3,l,0s,1u,n>3C?6Cun8i8,n- 3ih,sil.,n 3is,lu+.,n0el,lui1ele4on .e4,l, 3,n=i/+,1o+ 1ul,n- .e1elin-, o+,n- 8,n- 3i4e+i.s, 4en3en-,+,nn8,6 M,sin--0,sin- un1u. 0enu.u+.e1,7,0,n4en3en-,+,n0el,lui hn1,+,nu3,+,3,nh,n1+,n1ul,n-4,3,1in-.,1 in1ensi1,snil,i,0/,n-2 sehin--, ,.,n 3i3,4,1.,n.u+=, h,n1,+,n 1ul,n- 3,n h,n1,+,n u3,+,6 Den-,n 0e0/,9,,u3io-+,0 ini .i1, 3,4,1 0en-1,hui 7enis 3,n 3e+,7,1 .u+,n- 4en3en-,+,n seseo+,n-6 B,0/,+,n,u3io-+,0 +,1,-+,1, se7u0l,h o+,n- 8,n- /e+4en3en-,+,n no+0,l 3,n /e+usi, se.i1,+ 20-2( 1,hun0e+u4,.,n nil,i ,0/,n- /,.u 4en3en-,+,n un1u. n,3, 0u+i6Telin-,0,nusi,no+0,l 0,04u0en3en-,+ su,+,3en-,n.is,+,n:+e.5uensi 20-206000H;6'+e.5ensi 3,+i "00-2000 H; 8,n- 4,lin- 4en1in- un1u. 0e0,h,0i 4e+9,.,4,n seh,+i-h,+i6T,/el /e+i.u10e04e+lih,1.,n .l,si:i.,si .ehil,n-,n 4en3en-,+,n12Kehil,n-,n 3,l,0Desi/elKl,si:i.,si0-1" Pen3en-,+,n no+0,lG1"-2" Kehil,n-,n 4en3en-,+,n .e9ilG2"-40 Kehil,n-,n 4en3en-,+,n +in-,nG40-"" Kehil,n-,n 4en3en-,+,n se3,n-G""-70 Kehil,n-,n 4en3enn-,+,n se3,n-s,04,i /e+,1G70-(0 Kehil,n-,n 4en3en-,+,n /e+,1G(0 Kehil,n-,n 4en3en-,+,n /e+,1 se.,liPe0e+i.s,,n ini 0en-h,sil.,n -+,:i. nil,i ,0/,n- 4en3en-,+,n 4sien 4,3, s1i0ulus n,3, 0u+ni6Nil,i ,0/,n- 3iu.u+ 3en-,n :+e.uensi 8,n- /e+/e3,-/e3,6 Se9,+, .,s,+ /,h5, 4en3en-,+,n 8,n-no+0,l-+,:i./e+,3,3i,1,s6B+,:i.n8, 1e+3i+i 3,+i s.,l, 3e9i/el2su,+,3i4+esen1,si.,n 3en-,n,e+4hon >,i+ .on3u1ion? 3,n s.,l, s.ull =i/+,1o+ >/one 9on3u91ion?6 Cil, 1e+7,3i ,i+ /one -,4 0,.,0en-in3i.,si.,n ,3,n8, #HL6 Tu+unn8, nil,i ,0/,n- 4en3en-,+,n oleh /one 9on3u91ion0en--,0/,+.,n SNHL6 A,&i$e.ri .,.,rAu3io0e1+i 1u1u+,3,l,hs8s1e0u7i 4en3en-,+,n8,n-0en--un,.,n.,1,-.,1,1e+4ilih8,n-1el,h3i/,.u.,n2 3i1u1u+.,n0el,lui su,1u,l,1 8,n-1el,h3i.,li/e+,si2 un1u.0+n-u.u+/e/e+,4, ,s4e. .e0,04u,n 4en3en-,+,n6 P+insi4 ,u3io0e1+i 1u1u+ h,04i+ s,0, 3en-,n,u3io0e1+i n,3, 0u+ni2 h,n8, 3isni se/,-,i ,l,1 u7i 4en3en-,+,n 3i-un,.,n 3,:1,+ .,1, 1e+4uilih8,n-3i1u1u+.,n4,3,4en3e+i1,6 K,1,-.,1,1e+se/u1 3,4,1 3i1u1u+.,nl,n-sun-oleh4e0e+i.s,0el,lui 0i.+o4on 8,n- 3ihu/un-.,n3en-,n,u3io0e1+i 1u1u+2 .e0u3i,n3is,lu+.,n0el,lui1ele4on .e4,l, .e 1elin-, 8,n- 3i4e+i.s, 4en3en-,+,nn8,2 ,1,u .,1,-.,1, +e.,0 le/ih 3,hulu 4,3,4i+in-,n hi1,0,1,u 4i1, +e.,0,n2 .e0u3i,n /,+u 3i4u1,+ .e0/,li 3,n 3is,lu+.,n 0el,lui,u3io0e1e+ 1u1u+6 Pen3e+i1, 3i0in1, un1u. 0eni+u.,n 3en-,n 7el,s se1i4 .,1, 8,n- 3i3en-,+2 3,n,4,/il, .,1,-.,1, 8,n- 3i3en-,+ 0,.in 1i3,. 7el,s .,+en, in1ensi1,sn8, 0,.in 3ile0,h.,n24en3en-,+ 3i0in1, un1u. 0ne/,.n8,6Pe0e+i.s, 0en9,1,1, 4+esen1,se .,1,-.,1, 8,n- 3i1i+u.,n3en-,n/en,+ 3,+i 1i,43en,h4,3,1i,4in1ensi1,s6 H,sil ini 3,4,1 3i-,0/,+.,n4,3, su,1u3i,-+,08,n-,/sisn8,,3,l,hin1ensi1,ssu,+,.,1,-.,1,8,n-3i3en-,+2se3,n-.,no+3in,1n8,,3,l,h 4+esen1,si .,1,-.,1, 8,n,- 3i1u+un.,n 3en-,n /en,+6 D,+i ,u3io-+,0 1u1u+ 3,4,1 3i.e1,hui3u, 3i0ensi .e0,04u,n 4en3en-,+,n 8,i1u :Ke0,04u,n 4en3en-,+,n 3,l,0 0en,n-.,4 "0A 3,+i se7u0l,h .,1,-.,1, 8,n- 3i1u1u+.,n 4,3,su,1uin1ensi1,s 0ini0,l 3en-,n/en,+2 8,n-l,;i0n8, 3ise/u1 4e+se4si 1u1u+ ,1,uNPT2 3,n3in8,1,.,n 3en-,n s,1u,n 3e-si/el >3C?6Ke0,04u,n 0,.si0,l 4e+n3en-,+,n un1u. 0en3is.+i0in,si.,n 1i,4 s,1u,n/un8i>:one0? 3,l,0 .,1,-.,1, 8,n- 3i1u1u+.,n 8,n- 3in8,1,.,n 3en-,n nil,i 3is.+i0in,si 1u1u+,1,uNDT6S,1u,n4en-u.u+,nNDTi1u,3,l,h4e+sen1,si 0,.si0,l .,1,-.,1,8,n-3i1i+u.,n3en-,n /en,+2 se3,n-.,n in1ensi1,s su,+, /,+,4, s,7,6 Den-,n 3e0i.i,n2 /e+/e3, 3en-,n,u3io0e1+i n,3, 0u+ni 4,3, ,u3io0e1+i 1u1u+ in1ensi1,s 4en-u.u+,n 4en3en-,+,n 1i3,. s,7, 4,3,1in-.,1 nil,i ,0/,n- >NPT?2 1e1,4i 7u-, 7,uh 3i,1,sn8,6Au3io0e1+i 1u1u+4,3,4+insi4n8,4,sien3isu+uh0en3en-,+.,1,-.,1,8,n-7el,s,+1in8,4,3,in1ensi1,s0,n,0ul,i 1e+7,3i -,n--u,ns,04,i "0A1i3,.3,4,1 0eni+u.,n.,1,-.,1,3en-,n1e4,16K+i1e+i, o+,n- 1uli : Rin-,n 0,sih /is, 0en3en-,+ 4,3, in1ensi1,s 20-40 3CSe3,n- 0,sih /is, 0en3en-,+ 4,3, in1ensi1,s 40-%0 3CCe+,1 su3,h 1i3,. 3,4,1 0en3en-,+ 4,3, in1ensi1,s %0-&0 3CCe+,1 se.,li 1i3,. 3,4,1 0en3en-,+ 4,3, in1ensi1,s G&0 3CP,3, 3,s,+n8, 1uli 0en-,.i/,1.,n -,n--u,n .o0uni.,si2 ,4,/il, seseo+,n- 0,sih0e0ili.i sis,4en3en-,+,n3ih,+,4.,n3en-,n/,n1u,n,l,1 /,n1u3en-,+>ACDDhe,+in- AID?su,+, 8,n- ,3, 3i,04li:i.,si2 3i.e+,s.,n oleh ACD sehin--, /is, 1e+3en-,+6 P+insi4n8, se0u, 1es4en3en-,+,n ,-,+ ,.u+,1 h,siln8,2 1e1,4 h,+us 4,3, +u,n- .e3,4 su,+, 0ini0,l sun8i6 K,+en, .i1,0e0/e+i.,n 1es 4,,:+e.uensi 1e+1e1u3en-,n in1ensi1,sle0,h2.,l,u ,3, -,n--u,nsu,+,4,s1i,.,n 0en--,n--u 4enil,i,n6 P,3, ,u3io0e1+i 1u1u+2 0e0n- .,1,-.,1, 1e+1en1u 3en-,n =o9,l 3,n13.onson,n1e+1en1u8,n- 3i4,4,+.,n.e4en3+i1,6 In1ensi1,s 4,34e0e++i.s,,n,u3io0,1+i /is,3i0ul,i 3,+i 20 3C /il, 1i3,. 0en3en-,+ 40 3C 3,n se1e+usn8,2/il, 0en3en-,+ in1ensi1,s /is,3i1u+un.,n 03C2/e+,+1i4en3en-,+,n /,i.6Tesse/elu03il,.u.,n,u3io0e1+i1en1us,7, 4e+lu4e0e+i.s,,n 1elin-, : ,4,.,h 9on-o. ,1,u 1i3,. >,3, 9,i+,n 3,l,0 1elin-,?2 ,4,.,h ,3, .o1o+,n1elin-,>se+u0en?2 ,4,.,h,3,lu/,n--en3,n-1elin-,2 un1u.0enen1u.,n4en8,/,/.u+,n-4en3en-,+,n6Tes1 RinneTu7u,n : $n1u. 0e0/,n3in-.,n ,1,+, h,n1,+,n 1ul,n- 3en-,n h,n1,+,n u3,+, 4,3, s,1u 1elin-, 4,sien6 A3, 2 0,9,0 1es +inne 2 8,i1u :B,+4u1,l,"12H;.i1,/un8i.,nse9,+,lun,.l,lu0ene04,1.,n1,n-.,in8,1e-,.lu+us4,3,4l,nu0 0,s1oi3 4,sien >/el,.,n- 0e,1us ,.us1i.us e.s1e+nus?6 Se1el,h 4,sien 1i3,. 0en3en-,+/un8in8,2 se-e+, -,+4u 1,l, .i1, 4in3,h.,n 3i3e4,n 0e,1us ,.us1i.us e.s1e+nus 4,sien6 Tes Rinne4osi1i: 7i., 4,sien 0,sih 3,4,1 0en3en-,+n8,6 Se/,li.n8, 1es +inne ne-,1i: 7i., 4,sien 1i3,. 3,4,10en3en-,+n8,B,+4u1,l,"12H;.i1,/un8i.,nse9,+,lun,.l,lu0ene04,1.,n1,n-.,in8,Se9,+,1e-,.lu+us4,3,4l,nu00,s1oi34,sien6 Se-e+,4in3,h.,n-,+4u1,l,3i3e4,n0e,1us,.us1i.use.s1e+nus6 Ki1,0en,n8,.,n.e4,3,4,sien,4,.,h/un8i -,+4u1,l,3i3e4,n0e,1us,.us1i.us e.s1e+nus le/ih .e+,s 3,+i 4,3, 3i/el,.,n- 0e,1us s.us1i.us e.s1e+nus >4l,nu00,s1oi3?6 Tes +inne 4osi1i: 7i., 4,sien 0en3en-,+ 3i3e4,n 0,e1us ,.us1i.us e.s1e+nus le/ih .e+,s6Se/,li.n8,1es+innene-,1i:7i.,4,sien0en3en-,+ 3i3e4,n0e,1us,.us1i.use.s1e+nusle/ihle0,h ,1,u le/ih .e+,s 3i/el,.,n-6A3, * in1e+4+e1,si 3,+i h,sil 1es +inne : No+0,l : 1es +inne 4osi1i: Tuli .on3u.si: 1es +ine ne-,1i: >-e1,+,n 3,4,1 3i3en-,+ 0el,lui 1ul,n- le/ih l,0,?Tuli 4e+se4si2 1e+3,4,1 * .e0un-.in,n :Cil, 4,3, 4osisi II 4en3e+i1, 0,sih 0en3en-,+ /un8i -e1,+,n -,+4u 1,l,6Ei., 4osisi II 4en3e+i1, +,-u-+,-u 0en3en-,+ ,1,u 1i3,. >1es +inne: HD-?Pseu3o ne-,1i:: 1e+7,3i 4,3, 4en3e+i1, 1elin-, .,n,n 1uli 4e+se4si 4,3, 4osisi I 8,n- 0en3en-,+7us1+u 1elin-, .i+i 8,n- no+0,l sehin--, 0ul,-0ul, 1i0/ul6 Kes,l,h,n 4e0e+i.s,,n 4,3, 1es +inne 3,4,1 1e+7,3i /,i. /e+,s,l 3,+i 4e0e+i.s, 0,u4un4,sien6 Kes,l,h 3,+i 4e0e+i.s, 0is,ln8, 0ele1,..,n -,+4u1,l, 1i3,. 1e-,. lu+us2 1,n-.,i-,+4u1,l,0en-en,i +,0/u1 4,sien3,n.,.i -,+4u1,l,0en-en,i ,u+i.ulu04,sien6 Eu-,/is,.,+en, 7,+in-,n le0,. 4l,nu0 0,s1oi3 4,sien 1e/,l6Kes,l,h,n 3,+i 4,sien 0is,ln8, 4,sien l,0/,1 0e0/e+i.,n is8,+,1 /,h5, i, su3,h 1i3,.0en3en-,+ /un8i -,+4u1,l, s,,1 .i1, 0ene04,1.,n -,+4u1,l, 3i 4l,nu00,s1oi3 4,sien6A.i/,1n8, -e1,+,n .e3u, .,.i -,+4u1,l, su3,h /e+hen1i s,,1 .i1, 0e0in3,h.,n -,+4u1,l, .e3e4,n0e,1us ,.us1u.us e.s1e+nus6 Tes1 )e/e+Tu7u,n :$n1u. 0e0/,n3in-.,n h,n1,+,n 1ul,n- ,n1,+, .e3u, 1elin-, 4,sien6 #,+,.i1, 0el,.u.,n1es 5e/e+ 8,i1u: 0e0/un8i.,n-,+4u1,l,"12H;l,lu1,n-.,in8, .i1,le1,..,n 1e-,. lu+us 4,3, -,+is ho+i;on1,l6 Menu+u1 4,sien2 1elin-, 0,n, 8,n- 0en3en-,+ ,1,u0en3en-,+ le/ih .e+,s6 Ei., 1elin-, 4,sien 0en3en-,+ ,1,u 0en3en-,+ le/ih .e+,s 1 1elin-, 0,.,1e+7,3i l,1e+,lis,si .esisi1elin-,1e+se/u16 Ei.,.e3u,4,siens,0,-s,0,1i3,.0en3en-,+,1,us,0-s,0, 0en3en-,,+ 0,., /e+,+1i 1i3,. ,3, l,1e+,lis,si614Be1,+,n0el,lui1ul,n-,.,n3i,li+.,n.ese-,l,,+,holeh1en-.o+,.2 sehin--,,.,n1e+3en-,+3iselu+uh/,-i,n.e4,l,6 P,3,.e,3,,n41olo-is4,3,MAE,1,u9,=u01i04,ni 0iss,l:o1i1is0e3i, 4u+ulen1, 4,3, 1elin-, .,n,n6 Eu-, ,3,n8, 9,i+,n ,1,u 4us 3i 3,l,0 9,=u0 1i04,ni ini ,.,n/e+-e1,+2 /i,l, ,3, /un8i se-,l, -e1,+,n ,.,n 3i3en-,+.,n 3i se/el,h .,n,n6In1e+4+e1,si:Cil, 4en3en-,+0en3en-,+le/ih .e+,s 4,3, sisi3ise/el,h .,n,n 3ise/u1l,1e+,lis,i.e .,n,n23ise/u1 no+0,l /il, ,n1,+, sisi .,n,n 3,n .i+i s,0, .e+,sn8,6P,3, l,1e+,lis,i .e .,n,n 1e+3,4,1 .e0un-.in,nn8,:Tuli .on3u.si se/el,h .,n,n2 0iss,l ,3,n8, o1o1is 0e3i, 3ise/el,h .,n,n6Tuli .on3u.si 4,3, .e3u, 1elin-,2 1e1,4i -,n--u,nn8, 4,3, 1elin-, .,n,n e/ih he/,16Tuli 4e+se4si se/el,h.i+i se/,/h,n1,+,n.ese/el,h.i+i 1e+-,n--u2 0,.,3i 3en-,+ se/el,h.,n,n6Tuli 4e+se4si 4,3, .e3u, 1elin-2 1e1,4i se/el,h .i+i le/ih he/,,,,1 3,+i 4,3, se/el,h .,n,n6Tuli 4e+se4si 1elin-, 3,n 1uli .on3u.si se/el,h .,n, 7,+,n- 1e+3,4,16Tes1 S5,/,9hTu7u,n :Me0/,n3in-.,n 3,8, 1+,ns4o+1 0el,lui 1ul,n- 0,s1oi3 ,n1,+, 4e0e+i.s, >no+0,l? 3en-,n4+o/,n3us6D,s,+ :Belo0/,n---elo0/,n- 3,l,0 en3ol804he 3,4,1 3i1i0/ul.,n oleh :Be1,+,n8,n-3,1,n-0el,lui u3,+,6 Be1,+,n8,n-3,1,n-0el,lui 1en-.o+,.2 .hususn8,os1eo1e04o+,le#,+, Ke+7, : Pen-u7i 0ele1,..,n4,n-.,l -,+4u1,l,8,n-su3,h3i-e1,+.,n4,3,4un9,..e4,l,4+o/,n3us6P+o/,n3us ,.,n 0en3en-,+ su,+, -,+4u1,l, i1u 0,.in l,0, 0,.in 0ele0,h 3,n ,.hi+n8, 1i3,.0en3en-,+ su,+,-,+4u1,l,l,-i6 P,3,s,,1 -,+4u1,l,1i3,.0en3en-,+ su,+,-,+4u1,l,2 0,.,4en-u7i ,.,n se-e+, 0e0in3,h.,n -,+4u1,l, i1u2 .e 4un9,. .e4,l, o+,n- 8,n- 3i.e1,hui no+0,l.e1,7,0,n4en3en-,+,nn8,>4e0/,n3in-?6 C,-i 4e0/,n3in-3u,.e0un-.in,n3,4,1 1e+7,3i :,.,n 0en3en-,+ su,+,2 ,1,u 1i3,. 0en3en-,+ su,+,6"6 Me0,h,0i 4en8,.i1-4en8,.i1 8,n- 3,4,1 0en-,.i/,1.,n -,n--u,n 4en3en-,+,nB,n--u,n 4en3en-,+,n 3,4,1 3ise/,/.,n :Se4ara Gene.ikI Os1eo-enesis i04e+:e91,I Leo4,+3 s8n3+o0e >0ul1i4le len1i-ines?I O1os9le+osisI Ro/inson 184e e91o3e+0,l 38s4l,si,I #o9.,8ne s8n3+o0eI C7o+n 4ili 1o+1i ,n3 3e,:ness s8n3+o0eI Mul1i4le s8nos1osis s8n3+o0eI Hun1e+ s8n3+o0eI T,8/i o1o-4,l,1o-3i-i1,l s8n3+o0eI He+e3i1,+8 ne4h+i1isI Moh+ s8n3+o0eI Hu+le+ s8n3+o0e15I ),,+3en/u+- s8n3+o0eI K,+1,-ene+ s8n3+o0eI '+on1o-0e1,4h8se,l 38s4l,si, s8n3+o0eI Mo+Juio s8n3+o0eI T+iso08 1* SI Mul1i4le len1i-ines s8n3+o0eI T+e,9he+ #ollins s8n3+o0eI S1i9.le+ s8n3+o0eSe0ak La2ir 7 Ka#,# %a&a 'a8iI Ru/ell, s8n3+o0eI #on-eni1,l ,1+esi, o: 1he eK1e+n,l ,u3i1o+8 9,n,lI #on-eni1,l 981o0e-,lo=i+usI #on-eni1,l 4e+il804h,1i9 :is1ul,I 'e1,l 0e1h8l 0e+9u+8 e::e91sI 'e1,l io3ine 3e:i9ien98 e::e91sIn/ek#i; Menin-i1is Menin-i1is ,3,l,h in:e.si 8,n- 3ise/,/.,n +,3,n- 4,3, 0e0/+,n 8,n- 0enu1u4 o1,. 3,ns4in,l 9o+36 Menin-i1is 8,n- /u.,n 3ise/,/.,n oleh /,.1e+i 3ise/u1 se/,-, L,se41i9 0enin-i1isM6 Se3,n-.,n 8,n- 3ise/,/.,n oleh /,.1e+i 3ise/u1 L4u+ulen1 0enin-i1isN Be7,l,n8, 4usin- 3ise+1,i 3e0,0 3,n sensi1i: 1e+h,3,4 9,h,8,6I Pen8,.i1 -on3o.I #,04,.; In:e.si Telin-, @ A.u1 >o1i1is 0e3i,? Dise/,/.,n oleh 'lu 3,n Sinus2 Ale+-i2 As,4 Te0/,.,u Ro.o. ,1,u i+i1,si2 Ale+-i2 In:e.siA3enoi3 ,1,u A3enoi3n8, .ele/ih,n ho+0on2 Kele/ih,n 4+o3u.si Mu9us 3,n S,li=, 4,3,s,,1 4e+1u0/uh,n -i-i; S9,+le1 :e=e+ Pen8,.i1 8,n- 3ise/,/.,n .,+en, in:e.si 1en--o+o.,n .l,si:i.,si -+u4 A /e1,-he0ol81i9 s1+e41o9o99,l /,91e+i, Be7,l,n8, 3ise+1,i R,3,n- Ten--o+o.,n2 De0,02 +u,0 4,3, 3,3, 3,n lehe+2 li3,h /e+5,+n, se4e+1i s1+,5/e+i2 4usin-2 0en--i-il 3,n n8e+i 4,3, o1o1 OTra,$a:I T+,u0, -en3,n- 1elin-, >/e+lu/,n-?I P,1,h Ten-.o+,. >1e04o+,l /one?I T+,u0, A.us1i.Dise/,/.,n oleh le3,.,n2 4e1,s,n2 1e0/,.,n2 .onse+ +o9. 3,n >e,+4hone?6D,4,1 3ise/,/.,n oleh su,+, 1in--i >/es,+? 3,n se9,+, 1i/,-1i/, ,1,u se9,+, 4e+l,h,n-l,h,n2 .e/isin-,n 3,n 1inni1usGANGGUAN PENDENGARAN AKI*AT *ISINGDE'INISI16Cisin- ,3,l,h su,+, ,1,u /un8i 8,n- 0en--,n--u ,1,u 1i3,. 3i.ehen3,.i6 D,+i 3e:inisiini 0enun7u..,n /,h5, se/en,+n8, /isin- i1u s,n-,1 su/8e.1i:2 1e+-,n1un- 3,+i 0,sin--0,sin-in3i=i3u2 5,.1u 3,n 1e04,1 1e+7,3in8, /isin-6Se3,n-.,n se9,+, ,u3iolo-i2 /isin- ,3,l,h9,04u+,n /un8i n,3, 0u+ni 3en-,n /e+/,-,i :+e.5ensi6 #,9,1 4en3en-,+,n ,.i/,1 .e+7,> o99u4,1ion,l 3e,:ness D noise in3u9e3 he,+in- loss ? ,3,l,h hil,n-n8, se/,h,-i,n ,1,u selu+uh4en3en-,+,n seseo+,n- 8,n- /e+si:,1 4e+0,nen2 0en-en,i s,1u ,1,u .e3u, 1elin-, 8,n-3ise/,/.,noleh/isin-1e+us0ene+us3ilin-.un-,n1e04,1 .e+7,6 D,l,0lin-.un-,nin3us1+i2se0,.in 1in--i in1ensi1,s .e/isin-,n 3,n se0,.in l,0, 5,.1u 4e0,4,+,n .e/isin-,n 8,n-3i,l,0i oleh4,+,4e.e+7,2 se0,.in/e+,1 -,n--u,n4en3en-,+,n8,n-3i1i0/ul.,n4,3,4,+,4e.e+7, 1e+se/u16ETIOLOBI',.1o+-:,.1o+ 8,n- 0e04en-,+uhi 4e0,4,+,n .e/isin-,n :16 In1ensi1,s .e/isin-,n26 '+e.5ensi .e/isin-,n*6 L,0,n8, 5,.1u 4e0,4,+,n /isin-46 Ke+en1,n,n in3i=i3u"6 Eenis .el,0in%6 $si,76 Kel,in,n 3i 1elin-, 1en-,hPENBAR$H KECISINBAN PADA PENDENBARANPe+u/,h,n ,0/,n- 3en-,+ ,.i/,1 4,4,+,n /isin- 1e+-,n1un- 4,3, :+e.5ensi/un8i2 in1ensi1,s 3,n l,0, 5,.1u 4,4,+,n2 3,4,1 /e+u4, :16 A3,41,siCil,1elin-,1e+4,4,+ oleh.e/isin-,n0ul,-0ul,1elin-,,.,n0e+,s,1e+-,n--uoleh.e/isin-,n 1e+se/u12 1e1,4i l,0,-.el,0,,n 1elin-, 1i3,. 0e+,s, 1e+-,n--u l,-i .,+en, su,+, 1e+,s,1i3,. /e-i1u .e+,s se4e+1i 4,3, ,5,l 4e0,4,+,n626 Penin-.,1,n ,0/,n- 3en-,+ se0en1,+,Te+7,3i .en,i.,n ,0/,n- 4en3en-,+,n se0en1,+, 8,n- se9,+, 4e+l,h,nl,h,n ,.,n.e0/,li se4e+1i se0ul,6 Ke,3,,n ini /e+l,n-sun- /e/e+,4, 0eni1 s,04,i /e/e+,4, 7,0 /,h.,ns,04,i /e/e+,4, 0in--u se1el,h 4e0,4,+,n6 Ken,i.,n ,0/,n- 4en3en-,+,n se0en1,+, ini 0ul,-0ul,1e+7,3i 4,3,:+e.5ensi4000 H;2 1e1,4i/il, 4e0e4,+,n /e+l,n-sun- l,0,0,., .en,i.,nnil,i ,0/,n-4en3en-,+,nse0en1,+,,.,n0en8e/,+4,3,:+e.5ensi se.i1,+n8,6 M,.in1in--iin1ensi1,s3,nl,0,5,.1u4e0,4,+,n0,.in/es,+ 4e+u/,h,nnil,i ,0/,n-4en3en-,+,nn8,6Res4on 1i,4 in3i=i3u 1e+h,3,4 .e/isin-,n 1i3,. s,0, 1e+-,n1un- 3,+i sensi1i=i1,s 0,sin--0,sin-in3i=i3u6*6 Penin-.,1,n ,0/,n- 3en-,+ 0ene1,4Ken,i.,n 1e+7,3i se1el,h seseo+,n- 9u.u4 l,0, 1e+4,4,+ .e/isin-,n2 1e+u1,0, 1e+7,3i 4,3,:+e.5ensi 4000 H;6 B,n--u,n ini 4,lin- /,n8,. 3i1e0u.,n 3,n /e+si:,1 4e+0,nen2 1i3,. 3,4,13ise0/uh.,n 6 Ken,i.,n ,0/,n- 4en3en-,+,n 8,n- 0ene1,4 3,4,1 1e+7,3i se1el,h *2" s,04,i 201,hun 1e+7,3i 4e0,4,+,n2 ,3, 8,n- 0en-,1,.,n /,+u se1el,h 10-1" 1,hun se1el,h 1e+7,3i4e0,4,+,n6 Pen3e+i1, 0un-.in 1i3,. 0en8,3,+i /,h5, 4en3en-,+,nn8, 1el,h /e+.u+,n- 3,n /,+u3i.e1,hui se1el,h3il,.u.,n4e0e+i.s,,n,u3io-+,06 Hil,n-n8,4en3en-,+,nse0en1,+,,.i/,14e0,4,+,n /isin- /i,s,n8, se0/uh se1el,h is1i+,h,1 /e/e+,4, 7,0 > 1 @ 2 7,0 ?6 Cisin- 3en-,n17in1ensi1,s 1in--i 3,l,0 5,.1u 8,n- 9u.u4 l,0, > 10 @ 1" 1,hun ? ,.,n 0en8e/,/.,n +o/e.n8,sel-sel +,0/u1 o+-,n #o+1i s,04,i 1e+7,3i 3es1+u.si 1o1,l o+-,n #o+1i6 P+oses ini /elu0 7el,s1e+7,3in8,2 1e1,4i 0un-.in.,+en,+,n-s,n-,n/un8i 8,n-/e+le/ih,n3,l,05,.1ul,0,3,4,10en-,.i/,1.,n 4e+u/,h,n 0e1,/olis0e 3,n =,s.ule+ sehin--, 1e+7,3i .e+us,.,n 3e-ene+,1i: 4,3,s1+u.1u+sel-sel+,0/u1o+-,n#o+1i6 A.i/,1n8,1e+7,3i.ehil,n-,n4en3en-,+,n8,n-4e+0,nen6$0u0n8,:+e.5ensi 4en3en-,+,n8,n-0en-,l,0i 4enu+un,nin1ensi1,s,3,l,h,n1,+,*000@%000 H; 3,n .e+us,.,n ,l,1 #o+1i un1u. +ese41o+ /un8i 8,n- 1e+/e+,1 1e+7,3i 4,3, :+e.5ensi 4000H; >4 Kno19h?6 Ini 0e+u4,.,n 4+oses 8,n- l,0/,1 3,n 1e+se0/un8i2sehin--, 4,3, 1,h,4 ,5,l1i3,. 3is,3,+i oleh 4,+, 4e.e+7,6 H,l ini h,n8, 3,4,1 3i/u.1i.,n 3en-,n 4e0e+i.s,,n ,u3io0e1+i6A4,/il, /isin- 3en-,n in1ensi1,s 1in--i 1e+se/u1 1e+us /e+l,n-sun- 3,l,0 5,.1u 8,n- 9u.u4 l,0,2,.hi+n8, 4en-,+uh 4enu+un,n 4en3en-,+,n ,.,n 0en8e/,+ .e :+e.5ensi 4e+9,.,4,n > "00 @ 2000H; ?6 P,3, s,,1 i1u 4e.e+7, 0ul,i 0e+,s,.,n .e1uli,n .,+en, 1i3,. 3,4,1 0en3en-,+4e0/i9,+,,n se.i1,+n8,6KLASI'IKASISe9,+, u0u0 e:e. .e/isin-,n 1e+h,3,4 4en3en-,+,n 3,4,1 3i/,-i ,1,s 2.,1e-o+i 8,i1u : 16 Noise In3u9e3 Te04o+,+8 Th+eshol3 Shi:1 > TTS ?26 Noise In3u9e3 Pe+0,nen1 Th+eshol3 Shi:1 > NIPTS ?NOISE IND$#ED TEMPORAR! THRESHOLD SHI'T > NITTS ?Seseo+,n- 8,n- 4e+1,0, se.,li 1e+4,4,+ su,+, /isin- ,.,n 0en-,l,0i /e+/,-,i4e+u/,h,n2 8,n- 0ul,-0ul, 1,04,. ,3,l,h ,0/,n- 4en3en-,+,n /e+1,0/,h 1in--i 4,3,:+e.5ensi 1in--i6 P,3, -,0/,+,n ,u3io0e1+i 1,04,. se/,-,i Lno19h L 8,n- 9u+,0 4,3, :+e.5ensi4000 H;2 8,n- 3ise/u1 7u-, ,9ous1i9 no19h6P,3, 1in-.,1 ,5,l 1e+7,3i 4e+-ese+,n ,0/,n- 4en3en-,+,n 8,n- /e+si:,1 se0en1,+,2 8,n-3ise/u1 7u-,NITTS6 A4,/il,/e+is1i+,h,13ilu,+ lin-.un-,n /isin- /i,s,n8,4en3en-,+,n3,4,1.e0/,li no+0,l6NOISE IND$#ED PERMANENT THRESHOLD SHI'T > NIPTS ?Di3,l,0 4+,.1e. seh,+i-h,+i se+in- 3i1e0u.,n .,sus .ehil,n-,n 4en3en-,+,n ,.i/,1 su,+,/isin-2 3,nh,l ini 3ise/u1 3en-,nLo99u4,1ion,lhe,+in-lossL,1,u.ehil,n-,n4en3en-,+,n.,+en, 4e.e+7,,n ,1,u n,0, l,inn8, .e1uli,n ,.i/,1 /isin- in3us1+i6Di.,1,.,n /,h5, un1u. 0e+u/,h NITTS 0en7,3i NIPTS 3i4e+lu.,n 5,.1u /e.e+7, 3ilin-.un-,n/isin- sel,0, 10 @ 1" 1,hun2 1e1,4i h,l ini /e+-,n1un- 7u-, .e4,3, :16 1in-.,1 su,+, /isin-26 .e4e.,,n seseo+,n- 1e+h,3,4 su,+, /isin-NIPTS /i,s,n8, 1e+7,3i 3ise.i1,+ :+e.5ensi 4000 H; 3,n 4e+l,h,n-l,h,n 0enin-.,1 3,n 0en8e/,+.e :+e.5ensi se.i1,+n8,6 NIPTS 0ul,-0ul, 1,n4, .eluh,n2 1e1,4i ,4,/il, su3,h 0en8e/,+ s,04,i.e:+e.5ensi 8,n-le/ih+en3,h> 20003,n*000H;? .eluh,n,.,n1i0/ul6 P,3,0ul,n8,seseo+,n- ,.,n 0en-,l,0i .esuli1,n un1u. 0en-,3,.,n 4e0/i9,+,,n 3i 1e04,1 8,n- +,0,i2 1e1,4i/il, su3,h 0en8e/,+ .e :+e.5ensi 8,n- le/ih +en3,h 0,., ,.,n 1i0/ul .esuli1,n un1u.0en3en-,+ su,+, 8,n- s,n-,1 le0,h6 No19h /e+0ul, 4,3, :+e.5ensi *000 @ %000 H;2 3,n se1el,h/e/e+,4, 5,.1u -,0/,+,n ,u3io-+,0 0en7,3i 3,1,+ 4,3, :+e.5ensi 8,n- le/ih 1in--i6 Kehil,n-,n4en3en-,+,n 4,3, :+e.5ensi 4000 H; ,.,n 1e+us /e+1,0/,h 3,n 0ene1,4 se1el,h 10 1,hun 3,n.e0u3i,n 4e+.e0/,n-,nn8, 0en7,3i le/ih l,0/,1618PATOBENESISTuli ,.i/,1 /isin- 0e04en-,+uhi o+-,n #o+1i 3i .o.le, 1e+u1,0, sel-sel +,0/u16 D,e+,h8,n-4e+1,0,1e+.en,,3,l,hsel-sel +,0/u1 lu,+ 8,n-0enun7u..,n,3,n8,3e-ene+,si 8,n-0enin-.,1 sesu,i 3en-,n in1ensi1,s 3,nl,0, 4,4,+,n6 S1e+eosili, 4,3, sel-sel +,0/u1 lu,+0en7,3i .u+,n-.,.usehin--,0en-u+,n-i +es4on1e+h,3,4s1i0ul,si6 Den-,n/e+1,0/,hn8,in1ensi1,s 3,n 3u+,si 4,4,+,n ,.,n 3i7u04,i le/ih /,n8,. .e+us,.,n se4e+1i hil,n-n8, s1e+eosili,6D,e+,h8,n-4e+1,0,.,li 1e+.en,,3,l,h3,e+,h/,s,l6 Den-,nhil,n-n8, s1e+eosili,2 sel-sel+,0/u1 0,1i 3,n 3i-,n1i.,n oleh 7,+in-,n 4,+u16 Se0,.in 1in--i in1ensi1,s 4,4,+,n /un8i2 sel-sel+,0/u1 3,l,0 3,n sel-sel 4enun7,n- 7u-, +us,.6 Den-,n se0,.in lu,sn8, .e+us,.,n 4,3, sel-sel+,0/u12 3,4,11i0/ul 3e-ene+,si 4,3,s,+,:8,n-7u-,3,4,13i7u04,i 3i nu.leus4en3en-,+,n4,3, /,1,n- o1,.6 Pe+u/,h,n ,n,1o0i 8,n- /e+hu/un-,n 3en-,n 4,4,+,n /isin- D,+i su3u10,.+o0e.,ni.,l .e1i.,-elo0/,n-su,+,le5,12 0e0/+,ne/,sil,+is0e+e-,n-se4,n7,n-sisili-,0en1u0 s4i+,lis2 3i0,n, /,-i,n 1en-,hn8, 1i3,. 3iso.on-6 P,3, 3,e+,h ini 1e+7,3i4en8i04,n-,n 8,n- 0,.si0,l6 Sel-sel 4enun7,n- 3ise.i1,+ sel +,0/u1 3,l,07u-, se+in-0en-,l,0i .e+us,.,n ,.i/,1 4,4,+,n /isin- 8,n- s,n-,1 .u,1 3,n h,l ini .e0un-.in,n0e+u4,.,n 4en8e/,/ 0en-,4, /,+is 4e+1,0, sel +,0/u1 lu,+ 8,n- /,-i,n ,1,sn8, /e+sin--un-,n3en-,n4h,l,n-e,l 4+o9ess 3,+isel4il,+ lu,+3,n 3,l,0 0e+u4,.,n3,e+,h8,n-4,lin-se+in-+us,.6 C,-,i0,n, ene+-i 0e.,nis 3i1+,ns3u.si.,n .e3,l,0 4e+is1i5, in1+,selule+ 8,n- 0e0,9u4ele4,s,nneu+o1+,ns0i11e+ PS,lu+,n1+,ns3u.si /e+,3,4,3,0e0/+,n4l,s0,4,3,0,sin--0,sin- sili,2 /,i. 3i3,e+,h 1i4 ,1,u se4,n7,n- 1,n-.,i > sh,:1 ?2 8,n- 3i.on1+ol oleh 1i4 lin.s2 8,i1u7e0/,1,n .e9il 3i,n1,+, sili, /,-i,n ,1,s 8,n- /e+hu/un-,n s,1u s,0, l,in6 Be+,.,n 0e.,nis 4,3,/,+is,n 8,n- 4,lin- ,1,s 0e0/u., .e s,lu+,n 0en8e/,/.,n in:lu.s KH3,n #,HH3,n0en-h,sil.,n 3e4ol,+is,si 0e0/+,n 4l,s0,6 Pe+-e+,.,n 3,e+,h 8,n- /e+l,5,n,n ,.,n 0enu1u4s,lu+,n se+1, 0enu+un.,n 7u0l,h 3e4ol,+is,si 0e0/+,n6 A4,/il, 3e4ol,+is,si 0en9,4,i 1i1i. .+i1is3,4,1 0e0,9u4e+is1i5,in1+,selule+6 Tel,h3i.e1,hui /,h5,sel +,0/u1 lu,+ 0e0ili.i se3i.i1,::e+en3,n/,n8,.e::e+en6 Be+,.,n0e.,nis0e0/+,n,/,sil,+is0e+,n-s,n-sel +,0/u1 lu,+/e+.on1+,.si sehin--, 0enin-.,1.,n -e+,.,n 4,3, 3,e+,h s1i0ul,si 3,n 0enin-.,1.,n -e+,.,n0e.,nis 8,n- ,.,n 3i1e+us.,n .e sel +,0/u1 3,l,0 3i0,n,neu+o1+,ns0isi 1e+7,3i6 Ke+us,.,n sel+,0/u1 lu,+ 0en-u+,n-i sensi1i:i1,s 3,+i /,-i,n .o.le, 8,n- +us,.6Ke.,.u,n sili, /e+hu/un-,n 3en-,n 1i4 lin.s 8,n- 3,4,1 0elu,s .e 3,e+,h /,s,l 0el,luil,4is,n .u1i.ule+ sel +,0/u160e04e+lih,1.,n .e,3,,n ,.u1 3,n .+onis 4,3, ,5,l .e7,3i,n 3,n.e0u3i,n 4,3, s1i0ul,si 8,n- le/ih 1in--i2 :+,.1u+ 3,e+,h /,s,l 3,n hu/un-,n 3en-,n hil,n-n8,sensi1i:i1,s s,+,: ,.i/,1 /isin-6 '+,.1u+ 3,e+,h /,s,l 0en8e/,/.,n .e0,1i,n sel6 P,4,+,n /isin-3en-,n in1ensi1,s +en3,h 0en8e/,/.,n .e+us,.,n 0ini0,l sili,2 1,n4, :+,.1u+ 3,e+,h /,s,l ,1,u.e+us,.,n 1i4 lin.s 8,n- lu,s6 Te1,4i su,+, 3en-,n in1ensi1,s 1in--i 3,4,1 0en8e/,/.,n .e+us,.,n1i4lin.s sehin--,0en8e/,/.,n.e+us,.,n8,n-/e+,12 :+,.1u+ 3,e+,h/,s,l 3,n4e+u/,h,n-4e+u/,h,n sel 8,n- i++e=e+si/el6PER$CAHAN HISTOPATOLOBI TELINBA AKICAT KECISINBANLo.,si3,n4e+u/,h,nhis1o4,1olo-i 8,n- 1e+7,3i 4,3, 1elin-,,.i/,1 .e/isin-,n ,3,l,hse/,-,i /e+i.u1 :16 Ke+us,.,n 4,3, sel senso+is,6 3e-ene+,si 4,3, 3,e+,h /,s,l 3,+i 3u.1us .o.le,+is/6 4e0/en-.,.,n 3,n +o/e.,n 3,+i sel-sel senso+is96 ,no.si,1926 Ke+us,.,n 4,3, s1+i, =,s.ul,+isSu,+,3en-,nin1ensi1,s 1in--i 3,4,1 0en8e/,/.,n.e+us,.,ns1+i,=,s.ul,+isoleh.,+en,4enu+un,n /,h.,n 4en-hen1i,n ,li+,n 3,+,h 4,3, s1+i, =,s.ul,+is 3,nli-,0en s4i+,lis sesu3,h 1e+7,3i +,n-s,n-,n su,+, 3en-,n in1ensi1,s 1in--i6*6 Ke+us,.,n 4,3, se+,/u1 s,+,: 3,n L ne+=e en3in- LKe,3,,n ini 0,sih /,n8,. 3i4e+1en1,n-.,n21e1,4i 4,3, u0u0n8, .e+us,.,n ini 0e+u4,.,n,.i/,1 se.un3e+ 3,+i .e+us,.,n-.e+us,.,n sel-sel senso+is646 Hi3+o4s en3oli0:BAMCARAN KLINISTuli ,.i/,1 /isin- 3,4,1 0e04en-,+uhi 3is.+i0in,si 3,l,0 /e+/i9,+, > s4ee9h3is9+i0in,1ion ? 3,n :un-si sosi,l6 B,n--u,n 4,3, :+e.5ensi 1in--i 3,4,1 0en8e/,/.,n .esuli1,n3,l,0 0ene+i0, 3,n 0e0/e3,.,n /un8i .onson,n6 Cun8i 3en-,n n,3, 1in--i2 se4e+1i su,+, /,8i0en,n-is,1,u3e+in-,n1ele4on3,4,1 1i3,.3i3en-,+s,0,se.,li6 Ke1uli,n/i,s,n8,/il,1e+,l6Sel,ini1u1inni1us0e+u4,.,n-e7,l,8,n-se+in-3i.eluh.,n3,n,.hi+n8,3,4,1 0en--,n--u.e1,7,0,n4en3en-,+,n 3,n .onsen1+,si6Se9,+, u0u0 -,0/,+,n .e1uli,n 4,3, 1uli ,.i/,1 /isin- > noise in3u9e3 he,+in- loss ? ,3,l,h : 16 Ce+si:,1 senso+ineu+,l26 H,04i+ sel,lu /il,1e+,l*6 E,+,n- 0en8e/,/.,n 1uli 3e+,7,1 s,n-,1 /e+,1 > 4+o:oun3 he,+in- loss ?De+,7,1 .e1uli,n /e+.is,+ ,n1,+, 40 sD3 7" 3C646 A4,/il, 4,4,+,n /isin- 3ihen1i.,n2 1i3,. 3i7u04,i l,-i 4enu+un,n 4en3en-,+,n 8,n-si-ni:i.,n6"6 Ke+us,.,n 1elin-, 3,l,0 0ul,-0ul, 1e+7,3i 4,3, :+e.5ensi *0002 4000 3,n %000 H;2 3i0,n,.e+us,.,n 8,n- 4,lin- /e+,1 1e+7,3i 4,3, :+e.5ensi 4000 H;6%6 Den-,n 4,4,+,n /isin- 8,n- .ons1,n2 .e1uli,n 4,3, :+e.5ensi *0002 4000 3,n %000 H; ,.,n0en9,4,i 1in-.,1 8,n- 0,.si0,l 3,l,0 10 @ 1" 1,hun6 Sel,in 4en-,+uh 1e+h,3,4 4en3en-,+,n> ,u3i1o+8 ?2 /isin- 8,n- /e+le/ih,n 7u-, 0e04un8,i 4en-,+uh non ,u3i1o+8 se4e+1i 4en-,+uh1e+h,3,4.o0uni.,si 5i9,+,2 -,n--u,n.onsen1+,si2 -,n--u,n1i3u+ s,04,i 0e0i9us1+ess,.i/,1 -,n--u,n 4en3en-,+,n 8,n- 1e+7,3i6DIABNOSISDi3,l,0 0ene-,..,n 3i,-nosis NIHL2 ,hli THT h,+us 0el,.u.,n ,n,0nesis 8,n- 1eli1i24e0e+i.s,,n :isi. se+1, 4e0e+i.s,,n ,u3iolo-i.61&D,+i ,n,0nesis 3i3,4,1i +i5,8,1 4en,h/e.e+7, ,1,u se3,n- /e.e+7, 3i lin-.un-,n /isin- 3,l,0 7,n-., 5,.1u 8,n- 9u.u4 l,0,2 /i,s,n8,le/ih3,+i "1,hun6 Se3,n-.,n4,3, 4e0e+i.s,,no1os.o4i.1i3,.3i1e0u.,n.el,in,n6 P,3,4e0e+i.s,,n 1es 4en,l, 3i3,4,1.,n h,sil Rinne 4osi1i42 )e/e+ l,1e+,lis,si .e 1elin-, 8,n-4en3en-,+,nn8, le/ih/,i.3,nS9h5,/,9h0e0en3e.6 Kes,n7enis .e1uli,nn8, ,3,l,h1ulisenso+ineu+,l 8,n-/i,s,n8, 0en-en,i .e3u,1elin-,6 Ke1uli,n1i0/ul se9,+,/e+1,h,43,l,07,n-., 5,.1u/e+1,hun-1,hun2 8,n- /i,s,n8, 1e+7,3i 3,l,0&@101,hun4e+1,0, 4,4,+,n6Pe0e+i.s,,n ,u3io0e1+i9 n,3, 0u+ni 3i3,4,1.,n 1uli senso+ineu+,l 4,3, :+e.5ensi 1in--i> u0u0n8, *000 @ %000 H; ? 3,n 4,3, :+e.5ensi 4000 H; se+in- 1e+3,4,1 1,.i. > no19h ? 8,n-4,1o-no0oni.un1u.7enis.e1uli,nini6 Se3,n-.,n4e0e+i.s,,n,u3iolo-i .hususse4e+1i SISI> Sho+1 In9+e0en1 Sensi1i=i18 In3eK ?2 ACLC > Al1e+n,1e Cin,u+,l Lou3ness C,l,n9e ? 3,n S4ee9hAu3io0e1+8 0enun7u..,n ,3,n8, :eno0en, +e.+u10en > +e9+ui10en1 ? 8,n- .h,s un1u. 1uli s,+,:.o.le,620$n1u. 0ene-,..,n 3i,-nosis .lini. 3,+i .e1uli,n 8,n- 3ise/,/.,n oleh /isin- 3,n hu/un-,nn8,3en-,n 4e.e+7,2 0,., seo+,n- 3o.1e+ h,+us 0e04e+1i0/,n-.,n :,.1o+-:,.1o+ /e+i.u1 : 16 Ri5,8,1 1i0/uln8, .e1uli,n 3,n 4+o-+esi:i1,sn8,626 Ri5,8,1 4e.e+7,,n2 7enis 4e.e+7,,n 3,n l,0,n8, /e.e+7,6*6 Ri5,8,1 4en--un,,n 4+o1e.si 4en3en-,+,n646 Meneli1i /isin- 3i 1e04,1 .e+7,2 un1u. 0enen1u.,n in1ensi1,s 3,n 3u+,si /isin-8,n- 0en8e/,/.,n .e1uli,n6"6 H,sil 4e0e+i.s,,n ,u3io0e1+i se/elu0 .e+7, 3,n /e+.,l, sel,0, .e+7,6Pen1in-n8, 0en-e1,hui 1in-.,1 4en3en-,+,n ,5,l 4,+, 4e.e+7, 3en-,n 0el,.u.,n4e0e+i.s,,n ,u3io0e1+i se/elu0 /e.e+7, ,3,l,h /il, ,u3io-+,0 0enun7u..,n .e1uli,n2 0,.,3,4,1 3i4e+.i+,.,n /e+.u+,n-n8, 4en3en-,+,n 1e+se/u1 ,.i/,1 .e/isin-,n 3i 1e04,1 .e+7,6%6 I3en1i:i.,si 4en8e/,/ un1u. 0en8in-.i+.,n 4en8e/,/ .e1uli,n non in3us1+i,lse4e+1i +i5,8,1 4en--un,,n o/,1-o/,1 o1o1o.si. ,1,u +i5,8,1 4en8,.i1 se/elu0n8,6PENATALAKSANAANSesu,i 3en-,n 4en8e/,/ .e1uli,n2 4en3e+i1, se/,i.n8, 3i4in3,h.,n .e+7,n8, 3,+ilin-.un-,n/isin-6 Cil,1i3,.0un-.in3i4in3,h.,n3,4,1 3i4e+-un,.,n,l,1 4elin3un-1elin-,8,i1u/e+u4,su0/,1 1elin-,> e,+ 4lu-s ?2 1u1u41elin-,> e,+ 0u::s? 3,n4elin3un-.e4,l,>hel0e1?6 Oleh .,+en, 1uli ,.i/,1 /isin- ,3,l,h 1uli s,+,: .o.le, 8,n- /e+si:,1 0ene1,4>i++e=e+si/le ?2 /il, -,n--u,n 4en3en-,+,n su3,h 0en-,.i/,1.,n .esuli1,n /e+.o0uni.,si 3en-,n=olu0e 4e+9,.,4,n /i,s,2 3,4,1 3i9o/, 4e0,s,n-,n ,l,1 /,n1u 3en-,+ > ACD?6 A4,/il,4en3en-,+,nn8, 1el,h se3e0i.i,n /u+u.2 sehin--, 3en-,n 0e0,.,i ACD4un 1i3,. 3,4,1/e+.o0uni.,si 3en-,n ,3e.u,12 4e+lu 3il,.u.,n 4si.o1e+,4i su4,8, 4,sien 3,4,1 0ene+i0,.e,3,,nn8,6L,1ih,n4en3en-,+,n>,u3i1o+8 1+,inin-? 7u-, 3,4,13il,.u.,n ,-,+4,sien3,4,10en--un,.,nsis,4en3en-,+,n3en-,n ACDse9,+,e:isien3i/,n1u3en-,n0e0/,9,u9,4,n/i/i+ >li4 +e,3in-?2 0i0i. 3,n -e+,.,n ,n--o1, /,3,n se+1, /,h,s, is8,+,1 un1u. 3,4,1/e+.o0uni.,si6PROBNOSISOleh .,+en, 7enis .e1uli,n ,.i/,1 1e+4,4,+ /isin- ,3,l,h 1uli s,+,: .o.le, 8,n- si:,1n8,0ene1,42 3,n 1i3,. 3,4,1 3io/,1i se9,+, 0e3i.,0en1os, 0,u4un 4e0/e3,h,n2 0,.,4+o-nosisn8, .u+,n- /,i.6 Oleh se/,/ i1u 8,n- 1e+4en1in- ,3,l,h 4en9e-,h,n 1e+7,3in8, .e1uli,n6PEN#EBAHANTu7u,n u1,0, 4e+lin3un-,n 1e+h,3,4 4en3en-,+,n ,3,l,h un1u. 0en9e-,h 1e+7,3in8, NIHL 8,n-3ise/,/.,n oleh .e/isin-,n 3i lin-.un-,n .e+7,6P+o-+,0 ini 1e+3i+i 3,+i * /,-i,n 8,i1u :16 Pen-u.u+,n 4en3en-,+,nTes1 4en3en-,+,n 8,n- h,+us 3il,.u.,n ,3, 2 0,9,02 8,i1u :,6 Pen-u.u+,n 4en3en-,+,n se/elu0 3i1e+i0, /e.e+7,6/6 Pen-u.u+,n 4en3en-,+,n se9,+, 4e+io3i.626 Pen-en3,li,n su,+, /isin-D,4,1 3il,.u.,n 3en-,n 2 9,+, 8,i1u :,6 Melin3un-i 1elin-, 4,+, 4e.e+7, se9,+, l,n-sun- 3en-,n 0e0,.,i e,+ 0u:: > 1u1u4 1elin-, ?2e,+ 4lu-s > su0/,1 1elin-, ? 3,n hel0e1 >4elin3un- .e4,l, ?6/6 Men-en3,li.,n su,+, /isin- 3,+i su0/e+n8,2 3,4,1 3il,.u.,n 3en-,n 9,+, :- 0e0,s,n- 4e+e3,0 su,+,21- 0ene04,1.,n su,+, /isin- > 0esin ? 3i3,l,0 su,1u +u,n-,n 8,n- 1e+4is,h 3,+i 4e.e+7,*6 An,lis, /isin-An,lis,/isin- ini 3i.e+7,.,n3en-,n 7,l,n0enil,iin1ensi1,s /isin-2:+e.5ensi/isin-2 l,0,3,n 3is1+i/usi 4e0,4,+,n se+1, 5,.1u 1o1,l 4e0,4,+,n /isin-6 Al,1 u1,0, 3,l,0 4en-u.u+,n.e/isin-,n ,3,l,h soun3 le=el 0e1e+ 6SO$ND LEVEL METER > SLM ?SLM ,3,l,h su,1u ,l,1 8,n- 3i-un,.,n un1u. 0en-u.u+ 1in-.,1 .e/isin-,n2 8,n- 1e+3i+i3,+i 0i.+o:on2 ,04li:ie+2 si+.ui1 L,11enu,1o+N 3,n/e/e+,4, ,l,1 l,inn8,6 Al,1 ini 0en-u.u+.e/isin-,n,n1,+,*0@1*03C3,n3,+i :+e.5ensi 20@206000H;6 SLM3i/u,1 /e+3,s,+.,ns1,n3,+ ANSI > A0e+i9,n N,1ion,l S1,n3,+3 Ins1i1u1e ? 1,hun 1(77 3,n 3ilen-.,4i 3en-,n ,l,14en-u.u+ * 0,9,0 :+e.5ensi 8,i1u A2 C 3,n # 8,n- 0enen1u.,n se9,+, .,s,+ :+e.5ensi /isin-1e+se/u16 E,+in-,n:+e.5ensi A0en3e.,1i :+e.5ensi .,+,.1e+is1i.+es4on1elin-,un1u.su,+,+en3,h8,n-.i+,-.i+,3i/,5,h""3C6 E,+in-,n:+e.5ensi C3i0,.su3.,n0en3e.,1i +e,.si1elin-,un1u./,1,s,n1,+,""@&"3C6 Se3,n-.,n7,+in-,n:+e.5ensi #/e+hu/un-,n3en-,n+e,.si 1elin-, un1u. /,1,s 3i,1,s &" 3C6 %6 Men7,-, 1elin-, 3,n 4en3en-,+,n /e+3,s,+.,n ,7,+,n isl,0All,h 1el,h 0en-u1,0,.,n 3,n 0en3,hulu.,n 4en3en-,+,n 3,+i4,3, 4en-lih,1,n6Se/,/2 4en3en-,+,n,3,l,ho+-,n0,nusi,8,n-4e+1,0,.,li /e.e+7,.e1i.,3i 3uni,27u-, 0e+u4,.,n o+-,n 8,n- 4e+1,0, .,li si,4 /e.e+7, 4,3, s,,1 ,.hi+,1 1e+7,3i6 M,.,4en3en-,+,n 1i3,. 4e+n,h 1i3u+ s,0, se.,li6Sesun-uhn8, 4en3en-,+,n ,3,l,h o+-,n 1u/uh 0,nusi, 8,n- 4e+1,0, .,li /e.e+7,.e1i., seo+,n- 0,nusi, l,hi+ 3i 3uni,6 M,.,2 seo+,n- /,8i .e1i., s,,1 4e+1,0, .,li l,hi+2i, /is, 0en3en-,+2 /e+/e3, 3en-,n .e3u, 0,1,6 M,.,2 seol,h All,h in-in 0en-,1,.,n.e4,3, .i1,2 1i3,. 0e+es4on?2 1i3,. 0e+,s, ,3, /,h,8, 8,n- 0en-,n9,06 Ini8,n- 4e+1,0,6Ke0u3i,n2 ,4,/il, 0,nusi, 1i3u+2 0,., se0u, o+-,n 1u/uhn8, is1i+,h,12 .e9u,li4en3en-,+,nn8,6 Ei., en-.,u in-in /,n-un 3,+i 1i3u+0u2 3,n en-.,u le1,..,n 1,n-,n0u3i 3e.,1 0,1,0u2 0,.,0,1,1e+se/u1 1i3,.,.,n0e+,s,.,nn8,6A.,n1e1,4i 7i.,,3,su,+, /e+isi. 3i 3e.,1 1elin-,0u2 0,., ,n3, ,.,n 1e+/,n-un se.e1i.,6 Ini 8,n- .e3u,6A3,4un8,n-.e1i-,2 1elin-,,3,l,h4en-hu/un-,n1,+,0,nusi,3en-,n3uni,lu,+6 All,h 1,Q,l,, .e1i., in-in 0en7,3i.,n ,shh,/ul .,h:i 1i3u+ sel,0, *0( 1,hun2 All,h /e+:i+0,n: :RSTUV? VWXY Z[\] RSTUV ^_ `SaVbc deY f\ghi_ 11 >22M,., K,0i 1u1u4 1elin-,-1elin-, 0e+e., sel,0, /e+1,hun-1,hun >sel,0, *0( 1,hun2 lih,14,3, ,8,1 2" /e+i.u1n8, -4en1? >6S6 Al-K,h:i: 11?D,+i sini2 .e1i., 1elin-, 1u1u4 sehin--, 1i3,. /is, 0en3en-,+2 0,., o+,n- ,.,n1e+1i3u+ sel,0, /e+,1us-+,1us 1,hun 1,n4, ,3, -,n--u,n6 H,l ini .,+en, -e+,.,n--e+,.,n0,nusi, 4,3, si,n- h,+i 0en-h,l,n-i 0,nusi, 3,+i 1i3u+ 4ul,s2 3,n 1en,n-n8, 0,nusi,>1,n4, ,3, ,.1i=i1,s? 4,3, 0,l,0 h,+i 0en8e/,/.,n /is, 1i3u+ 4ul,s2 3,n 1elin-, 1e1,41i3,. 1i3u+ 3,n 1i3,. l,l,i se3i.i14un6 D,n3i sini ,3, s,1uh,l 8,n-4e+lu.,0i -,+is /,5,hi2 8,i1u sesun--uhn8, All,h/e+:i+0,n 3,l,0 su+,1 'ushshil,1: :jek_? lmenop fnq Vh[rs mneot u vV lw `x\\y ZTUz {`sWme| uz `s}fkgw uz `Ton] `T[eY XS~t lw lzhxxp `x\s fqz 22 >D,n .,0u se.,li-.,li 1i3,. 3,4,1 /e+se0/un8i 3,+i 4e+s,.si,n 8,n- 3il,.u.,n oleh4en3en-,+,n0u2 0,1,-0,1, .,li,n2 3,n .uli1-.uli1 .,li,n 1e+h,3,4 .,li,n sen3i+i2 /,h.,n .,0u0en-i+, /,h5, All,h 1i3,. 0en-e1,hui .e/,n8,.,n 3,+i ,4, 8,n- .,li,n .e+7,.,n6>6S6 'ushshil,1: 22?Ken,4,.,li0,1 ,.,n l,+,n-,n ini?6< >S Al AnQ,,0 %&?E,n-,nl,h 1,.u1 ,1,u 0,lu 0enin--,l.,n 4e0/i9,+,,n 8,n- /e+isi -hi/,h2 ,4,l,-i0en8i0,.1,8,n-,n1ele=isi8,n-/e+isi -hi/,h7,0,Qi6 T,.u1 3,n 0,lul,h4,3, All,h8,n- 0,h, 0en3en-,+ 3,n 0,h, 0elih,166Telin-, 0,nusi, 1,. 4e+n,h 1e+su0/,12 1e1,4i .e4,l, 3,n isi h,1i 0e+e., 8,n- /,+,n-.,lise+in-/e+0,s,l,h6 Ki1,1,.4e+n,h/e+hen1i 0en3en-,+21,4i 0un-.inse+in-.,li ,l4,un1u. /e+4i.i+ 3,n se3i.i1 0e+enun-6 S,,1n8, /e+l,1ih2 s,,1n8, 0en-,s,h seni0en3en-,+6 S,,1n8,0en3en-,+ .eluh.es,h,n,.-,n,.2 7e+i1 .e1,.u1,n+,.8,12 su,+,-su,+, o+,n- l,4,+2 ,1,u 1e+i,.,n-1e+i,.,n .+i1is6 D,n 7u-,2 s,,1n8, 0en3en-,+.,n suarahati kita.S Al Is+,Q *%?24DA'TAR P$STAKA1. Soepardi, efaty asyad,dkk.2009. Ilmu kesehatan telinga hidung tenggorokankepala dan leher edisi keenam. Jakarta : Balai Peer!it "#$%2. Sloae, &t'el. 2003. Anatomi dan Fisiologi. Jakarta : &()3. (*a+a S(, Setia!*dy ,, -a.rialdi/20070Farmakologidan Terapiedisi5,Jakarta, Balai Peer!it "#$%46 http://www.facebook.com/note.php?note_id=8825672464!ref=mf.Di,+si4.,n 3i/,5,h: ABAMA2 A.hl,J 25