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All Journal Jurnal Plastik Rekonstruksi

Bangun, Kristaninta

Division Of Plastic, Reconstructive, And Aesthetic Surgery, Department Of Surgery, Faculty Of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital

Author-ID : 1015944

Civil Engineering, Building, Construction & Architecture Other

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Distraction Osteogenesis for Micrognathia in Cipto Mangunkusumo Hospital : A Case Series Boaz, Grace; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Micrognathia is usually associated with genetic syndromes, characterized by mandibular hypoplasia causing a receding chin. The overall incidence of micrognathia was 1 per 1600 births, makes it a rare case. Severe micrognathia can be a neonatal emergency due to airway obstruction by the tongue in the small oral cavity. One method for correcting micrognathia is distraction osteogenesis. Lack of experience due to rare incidence of case, expensive cost of distraction device and technical complexity of the operation can be obstacles to this management. Patient and Method: We report two cases of micrognathia corrected with distraction osteogenesis conducted in Cipto Mangunkusumo Hospital from 2011-2012. The method consists of implantation of bilateral distraction device to the inferior border of the mandibular body. The patients then followed postoperatively. Result: Mandibular lengthening by gradual distraction is a proper method for young patients with micrognathia. Despite our minimal experience and intricate kind of method, we are trying to improve our skill in the future. Summary: Distraction osteogenesis is one method for correcting congenital mandibular hypoplasia.

Lip And Palate Reconstruction On Median Cerebrofacial Malformation Patient Anindhawati, Nur; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Median cerebrofacial malformations are developmental anomalies of the midline brain and facial structures. The clinical manifestations ranges from holoprosencephaly with agenesis of central facial structures, to those seen in median facial dysplasia. Patients who survive are usually born with severe functional limitation and die during infancy. Nowadays, with improved perinatal care, patient with severe midline craniofacial abnormalities can be expected to live longer. The purpose of this paper is to show how reconstruction of the lip and palate on patient with median cerebrofacial malformation is done. Patient and Method: Reporting 2 cases of child with cleft median cerebrofacial malformations. First case was a 2 year-old child with complete median cleft lip and palate. Clinical examinations and CT scan revealed a holoprosencephaly. She was also diagnosed with laryngomalacia. The second case was a 4 month-old patient with median cleft lip and palate also microcephaly. We performed labioplasty in both patients and did the palatoplasty in the first patient. Result: Both cases showed no sign of complication after the operation. They both discharged one day after the operation. The first patient reported dead 1 week after the surgery at home. The cause was unknown. 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. Summary: With proper perinatal care and holistic teamwork that expand the survival rate we expect those with the best prognosis deserve to appear as normal as possible. Keywords: Holoprosencephaly, median facial dysplasia, median cleft lip and palate

Revision of Bilateral Celft Lip Deformity Using Abbe Flap Djaprie, Shelly M; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Most primary repair of bilateral complete cleft lip does not show satisfying result due to several deformities caused by inappropriate use of the hypoplastic prolabial tissue, failure to advance the lateral lip elements to the midline for primary repair of the orbicularis, and scarring. The Abbe flap is the accepted procedure for the correction of severe secondary deformity of a bilateral cleft lip. By introducing an adequate amount of lip tissue, it relieves the tightness of the upper lip and also corrects the depressions of the tip of the nose. Symmetry between the two lip is also achieved Patient and Method: Three patients with tight lip deformity underwent this procedure. The Abbe flap, which was taken from the central portion of the lower lip vermilion, was designed to repair the vermilion tubercle and the Cupid’s bow. A tiny portion of skin was included to facilitate closure of the donor site. The pedicle was divided 3 weeks after operation. Results: Each patients showed a more natural contour of the vermilion tubercle and the Cupid’s bow. The scarring of the donor site was inconspicuous. Summary: The Abbe flap can be considered as a choice for revision of bilateral cleft lip deformity. The disadvantages of this flap include patient’s discomfort and the need for multiple procedures.

Bullet Penetration In The Face Caused By Accidental Gunshot: A Case Report Sastrasupena, Aditya Herwandar; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Clinical and radiological examinations are used to predict the location of the bullet in bullet penetration injury. The maxillofacial region had a variety of structure which could make the bullet deviate from its normal trajectories. Patient and Methods: A rare case of bullet penetration in the face caused by accidental gunshot is described. A 32 year-old male was hit by a bullet in the face with entrance wound on the left temporal region. Radiologic examination showed a bullet in the left inferior orbita. Treatment was exploration and extraction of the bullet. In this case we observe the difference between the clinical examination, radiological diagnosis and intraoperative findings Result: The patient underwent an explorative operation based on the prediction of location of the bullet from the clinical and radiological examination. The bullet was found in the inferior rectus muscle which the location is out of the prediction of clinical examination and radiologic findings. Summary: Clinical and radiological examination do not always give the accurate prediction regarding the location of bullet in penetrating bullet injury of the face because the face has a variety of bone, muscle and soft tissue structure.

Incidence of Palatal Fistula after One-Stage Palatoplasty and Factors Influencing the Fistula Occurrence Vityadewi, Nurardhilah; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 4 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Cleft palate repair may be compromised by a number of complications, most commonly the development of a fistula. Fistulas are related to an increased rate of hypernasal speech, articulation problems, and food or liquid regurgitation from the nose. Fistulas also tend to recur after a secondary repair to address the fistulas. This study reviews the rate of fistula in our craniofacial center after a onestage cleft palate repair; and to determine whether, cleft type, age at repair, type of cleft repair, hemoglobin level presurgery, and patients nutritional state influence the risk of fistula occurence. Patient and Method: A retrospective analysis was performed on medical records of 93 patients who underwent palate repair between January 2012 to October 2013. All consecutive cleft (lip and) palate patients are included. Bivariate analysis was performed to identify the predictors of fistula formation. Result: Ninety-three patients (50 male and 43 female) underwent one-stage palatoplasty. Cleft palate fistulas occured in 19 of 93 patients (20,4%). The age of the patients at the time of repair ranged from 9 to 144 months (mode 18 months). All palate repairs were done in one stage, using either the two flap (N=66), Wardill-Kilner (N=24), Furlow (N=2), and Langenback (N=1) techniques. No significant influence was found related between age at the time of repair (p 0.789), body weight (p 0.725), Hemoglobin value (p 0.295), and type of cleft (p 0.249) to the rate of fistula occurrence. Summary: This study found no association between , body weight, preoperative hemoglobin value, and the type of cleft to the rate of fistula following cleft palate surgery.

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): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

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): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

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): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

Computer Aided Volume Measurement Using Osirix, A Free 3D-Rendering Software, In Preplanned Correction Of Enophthalmos With Diced Cartilage Graft Kreshanti, Prasetyanugraheni; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Autologous costal diced cartilage graft is an option for replenishment of the volume deficit in residual enophthalmos following orbito-zygomatic trauma. However, in published journals referring this treatment option, quantitative volume measurement of the graft needed has not been established. Two patients with orbito-zygomatic fractures resulted from motorcycle accidents, presented with dystopia, entrapment of the eyeball, diplopia, and depressed malar eminence on the affected side. CT scans demonstrated orbital-floor disruption and herniation of the intra-orbital content into the maxillary sinus. Using OsiriX®, a free and open source medical imaging software, we calculated the volume discrepancy of the affected orbit. On coronal slices, the segmentation of the bony orbital region of interest of each single slice was performed and grouped to compute the volume. At surgery, diced cartilage grafts were inserted to the orbital cavity according to the calculated volume, to promote forwards shift of the eye globe position after releasing the entrapment and replacing the orbital floor. In both patients, good position of the eye globe was achieved. The aesthetic appearance was perceived as quite acceptable to the patients and other viewers. Transient diplopia settled within 3 months. We considered OsiriX® as a reliable tool for accurate quantitative measurement of diced cartilage graft volume in enophthalmos correction.

Modified Two-Flap Palatoplasty With Leaving Lateral Periosteum and Application of Honey Pack : A Preliminary Study Bangun, Kristaninta; Sudjatmiko, Gentur; Mahandaru, Danu
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

According to our experience in Ciptomangunkusumo hospital, most cleft palate patients has wide gap. It makes the epithelialization of the lateral defect takes longer time ( 3- 4 weeks). In this study, the authors propose a modified technique to the two-flap palatoplasty by not elevating the lateral part of the periosteum with the flap, and then apply honey packs to cover the lateral defects. The technique modification and additional honey-soaked dressing are expected to hasten the epithelialization rate. Twelve consecutive patients with non-syndromic cleft palate (with or without cleft lip) are included in the study. They undergo the modified two-flap palatoplasty with the lateral periosteum left behind, covering the palatal bone and the utilization of Honey pack. The rate of epithelialization is then observed every 2 days after operation until full healing is achieved. Complete epithelialization was attained within 5 days in one patient ( 2,8 mm/day), within 7 days in 8 patients (2-2,5mm/day), and within 9 days in 3 patients (2,2-2,7mm/day). There were no surgical complications, such as hemorrhage or wound infection. The fistula of the palate was not found until the defect closed. Our technique hasten the rate of epithelialization. It may prevent the maxillary growth disturbances in the future because faster healing reduces scar formation and wound contraction.

Co-Authors A., Nur Agatha Novell Harsanto, Agatha Novell Amaliah, Rizky Anindhawati, Nur Arvin Pramudita, Arvin Atmaja, Tessa Miranda Atmodiwirjo, Parintosa Basuki, Adi Boaz, Grace Chen, Zung Chung Diah, Enrina Djamaloeddin, Chaula Djaprie, Shelly M Djoenaedi, Intania Evie Lamtiur Pakpahan Evie Lamtiur, Evie Fortuna, Fory Hakim, Intan Friscilla Halim, Jessica Hapsari, Nathania Pudya Harsono, Anastasia Dessy Imam Susanto Irwansyah, Denny Jesica Putri Sudarman Kamayana, Jenisa Amanda Sandiarini Kesuma, Ayu Diah Kreshanti, Prasetyanugraheni Kreshanti, Prasetyanugrahni Kusumastuti, Nadia Lestari, Puri Ambar Luh Karunia Wahyuni, Luh Karunia Mahandaru, Danu Martina, Nungki Ratna Maulana, Muhammad Iqbal Mendy Hatibie Menna, Clara Mulyadi Mulyadi Nahdiyat, Nur Eulis Pujiastuti Nangingtuari, Irinawati Nindita, Eliza Olivia, Andria Pancawati, Julieta Permana, Lucky Prawoto, Pujisriyani Primadian, Akmal Putra, Teuku Nanda Putri, Nandita Melati Rayeni, Natasha Ratna Sandhi, Afriyanti Sastrasupena, Aditya Herwandar Simamora, Huntal Siti Handayani Soetjipto Soepodo, Fernita Leo Sudjatmiko, Gentur Sudjatmiko, Gentur Sukasah, Chaula Luthfia Syamsul Rizal Tania, Vika Teuku Fadli Nazwan Sani Tiza, Melina Vityadewi, Nurardhilah Widayanti, Nurina

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