Aim:The aim of this study is to determine the factors that can affect the occurrence of noise-induced hearing loss (NIHL) and the relationship between the intensity of noise with increased blood pressure on employees who work at Begerpang Palm Oil Mill PT Perusahaan (BPOMPL) Perkebunan London Sumatra Indonesia Tbk.Materials and methods: This was a cross-sectional study conducted from July to December 2013. The selected employee as the subject was 60 people. They first fill out the questionnaire and then get a clinical examination of ear nose and throat. Respondents were tested for blood pressure before and after working and also checked their hearing using a pure tone audiometer. Chi-square test was used, including the relationship of age, length of working, noise intensity, personal protective equipment to the occurrence of NIHL and the relationship between the intensity of noise with increased blood pressure. It is statistically significant if the p-value is <0.05.Results: It was found a significant relationship between the working period (p = 0.001), noise intensity (p = 0.008), and the use of personal protective equipment hearing (p = 0.001) with NIHL occurrence. There was also a significant relationship between noise intensity with increasing systolic (p=0.001) and diastolic (p = 0.001) blood pressure. Conclusion:This study proved a significant correlation between the working period, noise intensity and the use of personal protective equipment of hearing with NIHL occurrence and between noise intensity with increased systolic and diastolic blood pressure.Clinical significance : NIHL diagnosis is an important step to prevent hearing loss and increased blood pressure in workers.

<p>Foreign body of the sphenoid sinus is a rare condition and most of the documented cases are shrapnel wounds. The most cases of sinuses foreign bodies are in maxillary and frontal sinus. Very few cases have been reported of lodgment of foreign body in paranasal sinuses. Garces and Norris reported that 70% of these foreign bodies usually appeared after maxillofacial traumas and 30% appeared during or after dental procedures of maxilla.  A bullet impacted in the sphenoid sinus case in nineteen-year-old man was reported involving the anterior skull base. The bullet was safely removed with the trans-nasal endoscopic approach preserving the structures around the sphenoid sinus. Proximity of the sphenoid sinus to vital structures such as the optic nerve and internal carotid artery may render life-threatening complications. Adequate knowledge of the anatomical variations with regard to the sphenoid sinus and good preoperative planning are essential to ensure safe removal of foreign bodies, thereby avoiding catastrophic complications.</p>

<p>The incidence of fungal rhinosinusitis (FRS) has been increasing over the past decade. FRS is categorized into invasive and non-invasive based on the histopathological evidence of tissue invasion by fungi. According to Hardik Shah, among FRS, 48% were non-invasive, and 52% were invasive. Fungal ball is the most frequent cause of non-invasive FRS, and the most commonly involved sinus is the maxillary sinus, and most cases are unilateral. Nowadays, Endoscopic sinus surgery (ESS) has become the gold standard in treatment of non-invasive FRS, due to its low morbidity and the easy access to the affected paranasal sinus. However, removal of maxillary sinus fungal ball (MSFB) may be long and difficult. Therefore, it is important to keep a sufficient field of view in order to remove the fungal debris completely. Good handling of endoscopic is needed, and furthermore, although the risk of complication of ESS for FRS is low, it is important to understand the potential complications.</p>