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All Journal Jurnal Veteriner Folia Medica Indonesiana Jurnal Rekonstruksi dan Estetik

Zarasade, Lobredia

Department Of Plastic Reconstructive And Aesthetic Surgery, Faculty Of Medicine, Universitas Airlangga, Surabaya, Indonesia

Author-ID : 1313255

Medicine & Pharmacology Veterinary Other

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SEVERE CONSTRICTED HEAD – AN EXTREME FORM OF CROUZON SYNDROME POSING CHALLENGING FRONTO-ORBITAL ADVANCEMENT: A CASE SERIES REPORTS Lupitasari, Ciptomurti; Zarasade, Lobredia; Hutagalung, Magda Rosalina
Jurnal Rekonstruksi dan Estetik Vol. 4 No. 2 (2019): Jurnal Rekonstruksi dan Estetik, December 2019
Publisher : Universitas Airlangga

Highlights: Severe Constricted Head in Crouzon Syndrome. Complex surgical interventions to address severe craniofacial abnormalities in Crouzon syndrome. Abstract: Introduction: Constricted head or cloverleaf deformity in Crouzon syndrome is a severe form of the syndrome involving trilobed coronal and lambdoid synostosis. Crouzon syndrome with acanthosis nigricans is distinct from the classic Crouzon syndrome, characterized by thick and dark skin in body folds. The major problems resulting from constricted head are related to craniostenosis, orbitostenosis developing from abnormalities of the skull base associated with progressive rise in intracranial and intraorbital pressures which could progress to hydrocephalus and cerebellar herniation. Case Illustration: Two cases with severe Crouzon syndrome were reported. The first was a five month old girl associated with acanthosis nigricans and the other was a sixteen month old boy, both whose phenotypic expressions were at the extreme severe end of the disease spectrum. On examination there was serious corneal exposure, visual loss, severely narrow head, midface hypoplasia, and beaked nose. CT scan showed typical cloverleaf skull, expanded middle cranial fossa, foreshortened anterior and posterior fossae and honeycomb appearance in the occiput involving pansutural synostosis and extensive copper beaten deformity from the high intracranial pressure . Both were complicated with hydrocephalus requiring ventricul operitoneal shunt. Discussion: This required an arduous effort in releasing the brain from the multiply punctured calvaria, avoiding excessive dural tear and bleeding and ultimately preserving the brain. Excessive bleeding was also caused by the raised ICP. Both patients are planned to undergo occipital expansion three months later. Conclusion: Severely constricted head in Crouzon syndrome is an extreme manifestation and late stage of the syndrome which not only will result in irreversible complication but will require meticulous surgical technique.

PALATE FRACTURE PROFILE IN PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY OF DR. SOETOMO GENERAL ACADEMIC HOSPITAL: JANUARY 2012- DECEMBER 2017 N., Priscilla Valentine; Budi, Agus Santoso; Zarasade, Lobredia
Jurnal Rekonstruksi dan Estetik Vol. 4 No. 1 (2019): Jurnal Rekonstruksi dan Estetik, June 2019
Publisher : Universitas Airlangga

Highlights: The demographic data of patients with palate fractures is young adult men aged 19-30 years, the most common of palatal fracture type is parasagittal type, and causes of trauma being traffic accidents. The use of transmolar wiring and plating, occlusion was achieved well. Abstract: Introduction: Palatal fractures are often associated with maxillofacial fractures and Le Fort fractures. The diagnosis and management of palatal fractures in the midface area is a challenge for a plastic surgeon in restoring function and aesthetics. With the results of this study, it is expected to be a database of maxillofacial fractures treated at SMF Reconstructive Plastic Surgery and Aesthetic Dr. Soetomo General Academic Hospital, Surabaya and gave the ability to make a fast and precise diagnosis for time and technical maxillofacial fractures. Methods: This study uses medical record data for all patients diagnosed with palatal fractures in Dr. Soetomo General Academic Hospital, Surabaya during January 2012 to December 2017. The variables studied were demographic data including sex, age, mechanism of occurrence of accidents, types of fractures, management, complications that occur and length of treatment. Discussion: There were 82 patients with palatal fractures, with traffic accidents being the most common cause of palate fracture (n=61) followed by workplace accidents and households in second place (12 and 9%). Most sufferers were men (68%), women (14%) with the highest age range of men aged 19-30 years who were followed by ages 31-45. The most were parasagittal fractures (56%), then Sagittal (15%), paraalveolar (9%), alveolar (1%), comminutive (1%). no fractures with anterior and posterolateral alveolar types, posterolateral type or transverse type fractures. Hospitalization period with plating (12 days), transmolar wiring (10.6 days), and conservative (13.8 days). Conclusions: In this study assessed the experience in the reconstruction and aesthetic plastic surgery department of Dr. Soetomo General Academic Hospital regarding palatal fractures and accompanying demographic data. The type of fracture that occurs is also related to the management performed. Incomplete medical records caused problems in this study.

Co-Authors Agus Santoso Budi, Agus Santoso Diah Mira Indramaya Hamiseno, Gifta Marshanda Qanitah Hutagalung, Magda Rosalina I Nyoman Esha Pradnyana Indri Lakhsmi Putri, Indri Lakhsmi Iswinarno Doso Saputro Lupitasari, Ciptomurti M Sjaifuddin Noer Muharram, Arif Rahmat N., Priscilla Valentine Nata’atmadja, Beta Subakti Ningrum, Laras Puspita Prasetyo, Arif Tri Putri, Nadia Tamara Revita Widya Prasanti Rifqi Kurniawan Sintaningrum, Elisabeth Prajanti Wulandari, Pratidina

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