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All Journal Jurnal Plastik Rekonstruksi

Bangun, Kristaninta

Yayasan Lingkar Studi Bedah Plastik

Author-ID : 1015944

Civil Engineering, Building, Construction & Architecture Other

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Evaluation of Facial Trauma Severity in Cipto Mangunkusumo Hospital Using FISS Scoring System Bangun, Kristaninta; Kesuma, Ayu Diah
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Many scoring systems were introduced to search prognostic value in trauma patients. Facial trauma is a special trauma because it can cause many disabilities in facial function. There have been several reports on facial severity scoring system, such as Facial Injury Severity Score (FISS) and Maxillofacial Injury Severity Score (MFISS). Although these scoring systems have been introduced in many journals, they are not yet used by many clinicians because of their unawareness of its beneficiary. In this study, we want to introduce and apply these scoring systems in our maxillofacial data, thus it can be used for documentation system, as a research tool, and have prediction value for prognosis We retrospectively collected data on patients with facial trauma in Cipto Mangunkusumo Hospital in 2009. The data collected were age, gender, etiology, use of helmet, type of fracture and treatment given. Each patient then evaluated by FISS score to obtain their degree of severity. Using FISS score introduced by Bagheri, we found the average FISS score ini this evaluation was 3,37 ± 1,9, with minimum value 1 and maximum value 9. Most patients have FISS score 2 (24,7%). From FISS scoring system, we found that most of maxillofacial trauma in Cipto Mangunkusumo hospital in 2009 was mild trauma. In order to evaluate if FISS scoring system has predictive value for prognosis, a large sample and complete maxillofacial database are needed.

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 Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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 Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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 Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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 Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

The Correction of The Auricle in Neurofibroma with Aggressive Tumor Removal Principle and Two Stages Total Ear Reconstruction Bangun, Kristaninta; Chen, Zung Chung
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Neurofibroma is a major facial hamartoma and is one of the most destructive and debilitating disease affecting the skin, muscle, mucosa, and the skeletal systems. Involvement of the ear usually increases the dimensions of the auricular skin and underlying tissues, distorts normal architecture along with auricular malpositioning, producing an ear that is abnormal in size, shape and position. The correction of the auricle in neurofibroma and benign tumors of the head and neck has been reported, but overall favorable results appear difficult to attain. We present a case of neurofibroma of the auricle in which radical resection was performed, and reconstruction was done in a two-stage surgery with satisfactory result. Patient and Methods: A 30 years-old female presented with type-1 neurofibroma to our office, especially concerned of a large tumor growth on the right auricle. With prior experience in treating microtia cases by Nagata’s method, we performed a two-stage operation on the patient. The first operation involved excising the whole auricular mass, and fabricating as well as grafting of a three-dimensional costal cartilage framework. In the second stage, the ear was elevated.Result: Nine months after the second surgery, the result was satisfactory with good auricular definition attained, and proper elevation of the ear at the correct anatomical site. No sign of neurofibroma recurrence was found on the surrounding reconstructed auricle.Summary: In our experience, the correction Neurofibroma of the ear by using the aggressive tumor removal principle combined with Nagata’s two-stage total ear reconstruction delivered a satisfactory result.

The Non-denuded Mucoperiosteal Palatoplasty Technique in Precipitating Healing Process of Palatal Lateral Defect Irwansyah, Denny; Bangun, Kristaninta; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Conventional two-flap palatoplasty technique which is a very common technique used including in our center, will result in lateral defects without any periosteal coverage. In this conventional technique, epithelialization of lateral defect was achieved within 3-4 weeks. These denuded lateral defects are prone to contamination and infection. The wound healing process in these wound will involve wound contraction, trigger scar formation, and will result in maxillary growth impairment. In our center, the retrospective study showed that conventional two-flap palatoplasty technique resulted in a fair maxillary growth (mean Goslon score=3.5). Thus, we explore other technique, which is non-denuded mucoperiosteal palatoplasty technique. We intend not to elevate all layers of mucoperiosteal flap in order to gain lateral defect covered by a thin sub-mucosa and periosteal layer. We assume that this technique will precipitate the re-epithelialization process. Faster re-epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. Method: Total 48 patients with unilateral or bilateral cleft palate were divided into 2 groups. Twenty-four patients underwent the non-denuded mucoperiosteal technique (intervention group) and another 24 patients underwent the conventional two-flap palatoplasty technique (control group). Evaluation of lateral defect closure was done in both groups and compared statistically. Result: Faster epithelialization was significantly influenced by age, WBC count and non-denuded mucoperiosteal technique.Summary: The non-denuded mucoperiosteal technique, along with age and WBC count, significantly accelerate the process of epithelialization of lateral defect post palate repair.

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 Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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 Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

Curettage and Policresulen Tampon as A Modality Treatment in Management of Verucca Simamora, Huntal; Lestari, Puri Ambar; Bangun, Kristaninta; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Verruca, also known as warts is a skin disease characterized by epidermal growth. Verruca may occur anywhere especially on palms and soles. It appears as a rough, dark-grey colored surface and has similar features with clavus or callus, which frequently lead to inappropriate management.Patient and Method : We report two cases with verruca, one was on sole and another was on palm area treated with curettage and chemical ablation using policresulen solution. Both cases have histories of recurrences from the previous treatment, which was excision and primary closure.Results : The wound healed within seven days after treatment. There were no recurrences found after 6-month follow up.Summary : Our treatment (curettage and chemical ablation using policresulen) has two advantages: (1) it can avoid excessive tissue removal since this lesion only afect epidermal layer.

Co-Authors A., Nur Anindhawati, Nur Atmaja, Tessa Miranda Atmodiwirjo, Parintosa Boaz, Grace Chen, Zung Chung Diah, Enrina Djamaloeddin, Chaula Djaprie, Shelly M Djoenaedi, Intania Evie Lamtiur, Evie Fortuna, Fory Hakim, Intan Friscilla Hapsari, Nathania Pudya Harsono, Anastasia Dessy Imam Susanto Irwansyah, Denny Kesuma, Ayu Diah Kreshanti, Prasetyanugraheni Kreshanti, Prasetyanugrahni Kusumastuti, Nadia Lestari, Puri Ambar Luh Karunia Wahyuni, Luh Karunia Mahandaru, Danu Martina, Nungki Ratna Mendy Hatibie Mulyadi Mulyadi Nindita, Eliza Pakpahan, Evie Lamtiur Prawoto, Pujisriyani Putri, Nandita Melati Rayeni, Natasha Ratna Sandhi, Afriyanti Sastrasupena, Aditya Herwandar Simamora, Huntal Siti Handayani Soetjipto Soepodo, Fernita Leo Sudjatmiko, Gentur Syamsul Rizal Vityadewi, Nurardhilah

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