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Journal : Jurnal Plastik Rekonstruksi

Aggresive Mass Excision Through Nasolabial Fold Areain the Treatment of Facial Neurofibromatosis : Case Report Handayani, Siti; Bangun, Kristaninta; Soetjipto Soepodo, Fernita Leo
Jurnal Plastik Rekonstruksi Vol 1 No 1 (2012): January - February Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i1.32

Abstract

Neurofibromatosis type 1 is a rare disease which can manifest itself by the development of plexiform neurofibromatosis, with craniofacial deformities. In this paper, we propose special consideration in excision nasolabial fold mass to help lifting procedures in neurofibromatosis patients. We are reporting two case, both presented with von Recklinghausen’s disease, a 21 years old male patient with neurofibromatosis in his right hemifacial for which he had been operated on five times previously at other center, and a 24 years old male with neurofibromatosis in his left hemifacial. After several stages of reconstruction which started with nasolabial fold mass excision, the result was satisfactory, by using the multiple stage repair, it was done until the end result is similar to anatomical form. The mass debulking procedures for these patients, which started with Nasolabial Fold mass excisison are continued with durable lifting procedures. This method gives results a satisfactory lifting procedure.
The Results Of Two Conjoined Twin Separations From January To June 2010 : Case Series Handayani, Siti; Bangun, Kristaninta; Rayeni, Natasha Ratna
Jurnal Plastik Rekonstruksi Vol 1 No 1 (2012): January - February Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i1.2

Abstract

Conjoined twins are a rare resulting from late and incomplete division of monozygotic embryonic disk generally after 13th day of fertilization. Most cases of separation are extremely risky and life threatening. We present two successful cases of conjoined twins separations, who were admitted to Cipto Mangunkusumo Hospital, both in early 2010. Lulu-Lala, the abdominophagus conjoined twins and NaylaNabila the Abdominothorakophagus conjoined twins. The successions of this conjoined twins separation depends on the techniques, precautions and the team that works together to treat the patients. One of the separation techniques is the utilization of tissue expander to loosen the skin and so can be close primarily by primary closure. The foremost precaution is the infection control, including preparation and sterilization. Conjoined twins have a particular structural defect. Forty percent of them are stillborn and 35% survive only for one day. The mortality is increased by many causes and the most common cause is infection after surgery. All aspects in the team have to give priority to the sterility to avoid infection of those babies. The efforts to avoid the infections must have been done start from pre-surgery managements until the post-surgery.
Innervated Bilobed Radial Forearm Free Flap For Tongue Reconstruction Atmodiwirjo, Parintosa; Bangun, Kristaninta; Handayani, Siti; Djamaloeddin, Chaula; Nindita, Eliza
Jurnal Plastik Rekonstruksi Vol 1 No 1 (2012): January - February Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i1.28

Abstract

Hemiglossectomy defects need reconstructions to restore normal functions and aesthetic outcomes. It is therefore prudent that well-planned reconstructive technique is needed for a good functional substitution for the defect.This case report describes a 30 years old male who developed T2N1M0 squamous cell carcinoma of the left tongue. The patient underwent a tongue reconstruction following his hemiglossectomy involving floor of the mouth without mandibular resection.The optimum method of reconstructing a major defect such as hemiglossectomy with floor of the mouth resection is best carried out by using microvascular free tissue transfer. We conclude that the radial forearm free flap is good method for reconstructing major defects of the tongue. The radial forearm free flap is thin, can be raised without patient position change, has constant vascular anatomy, and provides an advantage in the aesthetic aspect at the donor site.
Revisited Anterolateral Thigh Free Flaps For Reconstructive Microsurgery : One Year Evaluation Atmodiwirjo, Parintosa; Handayani, Siti; Djaprie, Shelly Madona
Jurnal Plastik Rekonstruksi Vol 1 No 2 (2012): March - April Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i2.44

Abstract

Extensive soft tissue defects present a dif!cult problem to the plastic surgeon as they are usually associated with exposed important structures such as vessels, nerves, tendons, joint cavity or bone. Reconstruction of soft tissue defects have a wide range of therapeutic options. We reconstructed soft tissue defect in many areas using free anterolateral thigh flap (ALTF). From Februari 2009 - 2010, 9 cases of soft tissue defects in the face, neck, leg and foot of various etiologic factors were admitted to the plastic and reconstructive surgery unit, Cipto Mangunkusumo general hospital. Trauma is the commonest cause of soft tissue defects of the lower extremity, followed by tumours. The cruris was the commonest site (4 cases, 44,4%). Flap success rate was 66,67 %. Failure was reported 1 cases in this study due to vein compromise. In our hospital, we are quite familiar with Anterolateral thigh flap (ALTF) even though the case is limited. Anterolateral thigh flap (ALTF) is used for reconstruction of various simple and complex soft tissue defects, for big and small defects with cavity (orbita).
Speech Outcome Evaluation After Two-Flap Palatoplasty In Plastic Surgery Division Cipto Mangunkusumo Hospital: A Retrospective study Bangun, Kristaninta; Handayani, Siti; Djoenaedi, Intania; Wahyuni, Luh Karunia
Jurnal Plastik Rekonstruksi Vol 1 No 2 (2012): March - April Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i2.49

Abstract

One of the primary goal of cleft palate repair is to provide an intact mechanism for normal speech production. The purpose of this study is to evaluate the two-flap mucoperiosteal palatoplasty procedure on speech outcomes in patients undergoing surgical repair before the age of 2 years. A retrospective analysis study was done on 22 children with complete unilateral cleft palate (with or without cleft lip) who underwent two-flap palatoplasty between year 2002 to 2006 at Cipto Mangunkusumo Hospital. Evaluation was performed by a speech pathologist for pattern of articulation, hypernasality, intelligibility, and velopharyngeal competence. Palatoplasty were performed after 2 year-old in 11 patients and before 2 year-old in 11 patients. Speech of the 22 children postpalatoplasty was evaluated perceptually from standardised tape recordings. Velopharyngeal competence in patients who underwent palatoplasty before 2 year-old compared to after 2 year-old were 72.7% good, 18.2% fair and 9.1% poor versus 54,5% good, 9,1% fair and 36,4% poor respectively. Two-flaps mucoperiosteal palatoplasty performed before the age of 2 years old shows better spepolech outcome in all parameters, although the numbers are not statistically significant. Further prospective study with larger sample is needed.
Amniotic Band Sequence, Frequently Misdiagnosed in Cleft Patients Putri, Nandita Melati; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol 1 No 3 (2012): May-June Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i3.58

Abstract

Background: Amniotic band sequence (ABS) is a set of congenital malformations attributed to amniotic bands that entangle fetal parts during intrauterine life. thiopatogenesis of this sequence is still unknown. Because of such a wide spectrum of possible anomalies and many combinations of their simultaneous appearance, there are no two identical cases of ABS. This diagnosis is often missed based on the secondary major defects.Patients and Methods : There are cases of cleft patients treated in Plastic Surgery Division Cipto Mangunkusumo Hospital that has other congenital anomalies. The data is taken from the medical record and surgical photos (in our division from 2010-2011). Results : The patients presented had either facial cleft or cleft lip and palate. These patients had other congenital anomalies such as meningoencephalocele and constriction ring syndrome or other defects on the extremities.Summary : This diagnosis may not be often established because we often only see the secondary major defects such as meningoencephalocele or facial cleft. With this paper we hope that we could make this diagnosis known so we can make a multidisciplinary approach to this sequence.
Maxillary Growth Evaluation After Cleft Palate Repair Using Goslon Criteria: Preliminary Study Simamora, Huntal; Lamtiur, Evie; A., Nur; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol 1 No 3 (2012): May-June Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i3.67

Abstract

Background: The goal of palatoplasty is to achieve normal maxillofacial growth, normal speech, and prevent hearing loss. Disturbance of maxillary growth may occur in cleft lip palate patients after palatoplasty. To determine how many patients later developed a disrupted maxillary growth following operations, a retrospective study was designed to evaluate patients with complete unilateral cleft lip and palate who have undergone two-flap palatoplasty.Methods:A retrospective analytic study evaluated the maxillary growth of 15 consecutive unilateral cleft lip and palate patient aged around 8-year-old treated in the Division of Plastic Surgery Cipto Mangunkusumo Hospital, Jakarta. Cephalogram and dental study models were used to assess growth. Cleft lip and palate repair were performed to all patients without alveolar bone graft or any orthodontic treatment. Result: The cephalogram shows that 53,3% of the patients developed maxillary hypoplasia post palatoplasty. Mean value of the Goslon Yardstick was 3,53 (intermediate category by Goslon criteria).No patient fell into the Goslon 1 or 5 categories. Discussion: Disturbed maxillary growth is postulated to be caused by the manipulation and suturing of the maxillary vomer, and scarring of the dentoalveoli post-surgery. Another contributing factor is the intrinsic tissue deficiency. Conclusion: Maxillary hypoplasia is a possible complication following two !ap palatopasty, affecting either anteroposterior, transversal and vertical maxillary growth. This finding needs to be proven especially after the process of growth ceased. It is highly probable that maxillary disruption is higher when the two flap palatoplasty technique leaves lateral areas of denuded bone on the maxillary tuberosity.
Multidisciplinary Approach in Treating Undiagnosed Severe Temporo Mandibular Joint Ankylosis : A Case Report Sandhi, Afriyanti; Pakpahan, Evie Lamtiur; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol 1 No 3 (2012): May-June Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i3.68

Abstract

Background: Temporo Mandibular Joint (TMJ) ankylosis refers to bone or fibrous adhesion of the anatomic joint component and the ensuing loss of their function. The TMJ forms the very cornerstone of craniofacial integrity and hence its ankylosis in growing children adversely affects the growth and development of the jaws and occlusion. Difficulty in mouth opening and mastication, poor oral hygiene and rampant caries pose a severe physical and psychological burden in the tender minds of children. Patient and Method: Bony ankylosis on the right TMJ in a female patient was not diagnosed until the patient reached her early teens, at which the condition was treated by bony fusion release on the right condyle. We managed the patient for further orthognathic surgery (Le Fort I Ostoeotomy and Bilateral Sagittal Split Osteotomy) to correct the skeletal deformity. Result: In collaboration with the Orthodontist for pre-surgery and post-surgery orthodontic treatment, and Physiotherapist for mouth opening and masticatory muscles exercises, a good functional and aesthetic result was achieved. Summary: Multidisciplinary approach in treating severe TMJ ankylosis is mandatory to achieve the optimum results. Awareness among all plastic surgeon and dentist involved in the treatment of craniofacial pathologies in children must be build to allow early diagnosis and treatment.
Maxillary Growth and Speech Outcome in Patient with Cleft Lip and Palate after Two-Stage Palate Repair: A Systematic Review Mulyadi, Mulyadi; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol 1 No 4 (2012): July-August Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i4.84

Abstract

Background: The management of patients with cleft lip and palate is complex, where the treatment outcome is judged on the balance between aesthetics, speech, and maxillary growth. Up to now, there is no generally accepted treatment protocol. Every center must find the best-suited protocol treatment for their population. Methods: A systematic review through literature search was conducted for English-language studies in PubMed. This search was conducted in September 2011 using EndNote X3 with keywords: Two-stage Palate Repair and Maxillary Growth and Two-stage Palate Repair and Speech Outcome. Both retrospective and prospective studies on maxillary growth and speech outcome in patient with cleft lip and palate after two-stage palate repair published from 2001 to 2012 were included. Result: From the reviewed of 37 articles, only 14 articles fit the inclusions criteria, three articles discussed the outcome of maxillary growth and speech outcome, eight articles only discussed the maxillary growth and the rest of articles only discussed the speech outcome. Conclusion:From this review we found that most of the two-stage palate repair results in better maxillary growth, but only few of them results in good speech outcome. We will perform further study based on this review to discover a new protocol for the management of palate repair in our center.
The Experience of Using Various Modalities For Orbital Floor Fracture Reconstruction Prawoto, Pujisriyani; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol 1 No 4 (2012): July-August Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i4.87

Abstract

Background: Fractures of the orbital floor require surgical intervention in group of patients with cosmetic problems and/or vertical diplopia. The surgical management of these patients provides a great challenge to the surgeon. A variety of implant materials have been used to recreate normal bony orbital dimension or supplement deficient orbital volume which include alloplastic or autogenous materials. The purpose of this case series was to assess the aesthetic and functional outcome of orbital floor reconstruction performed with calvarial bone graft, titanium mesh, absorbable mesh and “Turkish Delight” diced cartilage graft.Patients and Methods: From 2006-2010, we treated eight patients with orbital blowout fracture using various modalities. We used titanium mesh, absorbable mesh, calvarial bone graft and “Turkish delight” diced cartilage. These various modalities were chosen based on clinical examination, patient satisfaction, radiographic investigations and the cost on managing patient.Result: Calvarial bone graft were performed in two patient, “Turkish delight” diced cartilage in one patient, absorbable mesh in one patient, and titanium mesh in four patient. All patients had satisfactory result with adequate volume correction and reduction in vertical diplopia.Summary: All four materials, calvarial graft, titanium mesh, absorbable mesh, and “Turkish delight” diced cartilage graft have the potential to be useful reconstructive materials in orbital floor blowout fractures based on holistic consideration.