IntroductionAdenoids are part of the ring of waldeyer and have a role in the body's defense function. 1,2) Symptoms of adenoid hypertrophy include rinolalia occlusal, mouth open to breathe, adenoid face, nasal aprosexia, headache, runny nose, chronic cough, decreased appetite, and reduced hearing. The adenoids become hypertrophied in pathological conditions that often occur in children, which can cause complications in nasal obstruction, snoring, sleep apnea, otitis media, and affect the craniofacial shape. Adenoid hypertrophy management with medication or requires an adenoidectomy. Indications for adenoidectomy include chronic infection and obstructive airways caused. 3,4) The choice to undergo adenoidectomy should be carefully, even if the consequences of post-adenoidectomy on

The COVID 19 pandemic impacts the early detection of hearing impairment. Socialization is needed in the form of early detection education of hearing loss in the era of the COVID 19 pandemic to health workers in the front line. The purpose of educational activities is to improve the knowledge and skills of health workers to conduct early detection of hearing impairment in the era of the COVID 19 pandemic. The condition of the COVID 19 pandemic changed the interaction pattern between people, including in education and training activities in the field of health. Education with on line means is becoming a common thing to do today. This training activity is conducted on line and off line methods with limited participants. The training for health workers was carried out using an off line method and was attended by 39 participants. The average result of the pre test was 45.20 (+ 15.69), and the average post test was 80.67 (+ 22.73). Comparison of the pre test and post test results with the t-test, the results were significantly different (p < 0.0001). The training with the on line method was attended by 1,145 participants. The results of the average pre test score were 55.30 (+15.61), and the post test average score was 72.82 (+21.61). Comparison of the pre test and post test scores with the t-test results was significantly different (p < 0.0001). On line and off line methods in training activities provide significant results in increasing the knowledge of health workers so that the pandemic does not hinder the implementation of training activities to increase the knowledge of health workers in an effort to improve the quality of life of the community, in this case, hearing.

Effective communication is a pillar of excellent service in the healthcare unit. Communication among health workers, hearing impaired and speech impaired will cause obstacles to services. Sign language skills need to be possessed by health workers in communicating with people who are deaf and speech impaired. Socializing sign language and developing sign language skills for health workers in health services. After participating in the training, health workers are expected to know and have sign language skills. Community service activities in the form of sign language training for health workers in health services are carried out with lectures, quiz, discussions and practice of sign language skills. Activities are carried out through online method. The activity was attended by 1,593 participants. The most participants were midwives (570 participants-35.8%), nurses (518 participants -32.5%) and doctors (191 participants -12%). A total of 1,333 participants (83.7%) experienced communication problems with the hearing impaired and speech impaired. The training was felt to be useful by 1,215 participants (76.3%). The average result of the pre-test quiz was 33.54 (+13.11) and the average post-test quiz was 61.23 (+10.41). Comparison of pre-test and post-test results of hearing health education obtained statistically significant differences (p < 0.0001). The benefits of training activities are felt to be useful and needs to be intensified to improve the quality of services and the quality of life for people who are hearing impaired and speech impaired.