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All Journal BALI MEDICAL JOURNAL (BMJ) Buletin Udayana Mengabdi E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Plastik Rekonstruksi Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Cermin Dunia Kedokteran
I Wayan Niryana
Bagian SMF Ilmu Bedah RSUP Sanglah Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Journal : Neurologico Spinale Medico Chirurgico

 1 
Open suturectomy management in craniosynostosis of bilateral coronal and metopic suture Marthinson Andrew Tombeng; I Wayan Niryana
Neurologico Spinale Medico Chirurgico Vol 4 No 1 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i1.145

Abstract

Craniosynostosis is a cranial deformation that is characterized by the premature fusion of one or more of the cranial sutures. Synostosis of multiple suture is a rare case and can be treated with open suturectomy procedure which is one of the surgical management by removing the fused suture with the purpose to allow the constricted area to expand with the growing brain. We present a case of a 2-month-old male infant with abnormal head shape since birth with a non-contrast 3D computed tomography (CT) scan of the head confirmed closure of the bilateral coronal and metopic suture. Open suturectomy was performed with no post operative complications. Open suturectomy technique can be performed in the management of multisutural craniosynostosis as indicated. The diagnosis of which suture are affected, the timing of surgery, and the prevention of surgical complication such as excessive blood loss are the important factors need to be considered.
RISK FACTORS OF HIGH INTRACRANIAL PRESSURE AND THE RELATED OUTCOMES IN SUBJECTS WITH SEVERE HEAD INJURY IN SANGLAH GENERAL HOSPITAL DENPASAR Wayan Niryana
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (187.687 KB)

Abstract

Background: Severe head injury management target is to prevent the secondary brain injury characterized by deterioration in the outcome. High intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) could cause unfavourable outcomes which is influenced by many factors, such as hypoxia and haemorrhage lesions pictured on head CT scan. This study analyzes various risk factors that can lead to increased ICP and the influence of high ICP on the outcome. Methods: This study is a prospective cohort, involving 42 consecutive subjects with severe head injury patients from June to October 2016. The subjects underwent examination for blood pressure, blood gas analysis, and head CT scan. ICP monitoring was then performed and the outcome was assessed using the Glasgow Outcome Scale score when the patient was discharged. In this study, risk factors such as hypoxia, hypotension, and subarachnoid haemorrhage (SAH) were analyzed. Statistical analysis was performed with SPSS 27 with a confidence interval of 95%. Result: There were two risk factors that significantly influenced the increase of ICP, which were hypotension (RR 0.27; 95CI 0.095-0.775; p<0.001) and hypoxia (RR 0.125; 95CI 0.034-0.457; p<0.001). High ICP value ≥ 20 mmHg was associated with an unfavourable outcome (RR 2.28; 95CI 1.31-3.98; p<0.001). Conclusion: Hypoxia and hypotension were two risk factors that significantly influenced the increase of ICP, where high ICP caused the unfavourable outcome.
PEDIATRIC CRANIOFACIAL DISFIGUREMENT WITH AUTOLOGOUS RIBS BONE GRAFT RECONSTRUCTION Anne Saputra; Wayan Niryana; Made Suka Adnyana
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2706.899 KB)

Abstract

Pediatric reconstruction of the cranial defect is a challenging task, the standard reconstruction method has been bone grafting. The reconstruction of complex facial defects should satisfy both aesthetic and functional requirements. In the case of large defects, the use of craniofacial prostheses using autogenous bone is the material of choice because of its potential for revascularization and its osteoconductive properties. A 3-year-old patient has facial disfgurement as result from bone defciency following anterior skull base tumour resection. To minimize the associated functional and cosmetic problems, a number of reconstructive options are available to the surgeon including the use of autogenous and alloplastic implants. A computed tomography (CT) 3-dimensional reconstruction scan showed a large craniofacial defect as residual radical skull base tumour resection. A transcranial approach by a neurosurgeon and plastic surgery was performed to reconstruct the defect using autologous rib bone graft. Six months after the reconstruction surgery, a defect of the craniofacial was narrowing without cranial nerve defcits.Complex reconstructions of extensive defects in craniofacial area can be achieved using autologous bone grafts. They yield reasonable functional and aesthetic outcomes and noticeably improves the qualityof life.
Co-Authors A.A Davyn Anantha Ade-Chandra - Agung Aditya Arnaya Agung Bagus S. Satyarsa Agus Roy Hamid Agus Roy Rusly Hariantana Hamid Anne Saputra D.P.W. Wardhana Dewa Ayu Wahyu Diantari Dewa Ngurah Suprapta Dewa Putu Wisnu Wardhana Dwijo Anargha Sindhughosa Ellintang Charisma Dewi Gitari, Ni Made Gusti Ngurah Agung Adi Paramartha Hendra Sanjaya I Gde Made Satya Wangsa Satya Wangsa I Gede Sutawan I Gede Suwedagatha I Gusti Agung Bagus Krisna Wibawa I Gusti Lanang Ngurah Agung Artha Wiguna I Gusti Ngurah Purnomo I Gusti Putu Hendra Sanjaya I Made Bagus Wirawan I Made Jawi I Made Suka Adnyana I Made Sukarya I Nyoman Semadi I Putu Eka Widyadharma I Putu Gede Cahya Giartha Putra I Putu Yuda Prabawa Ida Bagus Yudha Prasista J Sasongko K.K. Putra Kevin Kristian Putra Koerniawan, Heru Sutanto Loelita Marcelia Lumintang Made Agus Dwianthara Sueta Made Favian Budi Gunawan Made Indra Erlangga Prathiwindya Made Suka Adnyana Marthinson Andrew Tombeng Melissa Krisanty Moses Kharisma Setyawan Mumtazah Mardliyah Ni Luh Putu Julita Yanti Ni Putu Ayu Pande Arista Dewi Ni Putu Sri Wulandari Nyoman Golden Nyoman Siska Ananda Putu Anda Tusta Adiputra Putu Ayu Indra Shanti Wardani Putu Chandra Wibawa Putu Diahpradnya Oka Partini Putu Eka Mardhika Raka-Sudewi A. A. S. Awyono Sanjaya, Feliani Sianny Herawati Sri Maliawan Tham Hong Yuan Thomas Eko Purwata Tjokorda Gde Bagus Mahadewa