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Functional Endoscopic Orbital Decompression Surgery in Acute Rhinosinusitis with Orbital Complication : A Case Report Lekatompessy, Michael; Kirana, Amanda P
Medicinus Vol 10, No 3 (2021): June 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i1.4197

Introduction: Orbital complications secondary to acute rhinosinusitis can cause permanent vision loss and death if not treated promptly and appropriately. The prevalence of orbital complications due to rhinosinusitis is more common in children than adults, occurring in 3-4% of children with acute rhinosinusitis. Lamina papyracea in children has many dehiscences, the nasal cavity tends to be narrower and the mucosa is softer than in adults, therefore causing the spread of infection more easily from the sinuses to the eyes. Clinical presentation: a 4-year-old child presented with eye swelling and pus discharge in the right eye for 5 days before being admitted to the hospital, for which she was treated with medication and did not improve. On physical examination, there is a narrow nasal cavity, inferior turbinate edema, and hyperemia, mucopurulent discharge. CT scan and MRI revealed contrast enhancement in intraorbital with suspected intraorbital abscess with orbital cellulitis, right pansinusitis, and buccal abscess. Functional endoscopic orbital decompression was done immediately.Conclusion: Orbital complications due to acute rhinosinusitis are uncommon but potentially lead to more fatal complications. Early diagnosis and aggressive treatment of immediate functional endoscopic sinus surgery and antimicrobial therapy have a good outcome.

Modified transnasal endoscopic medial maxillectomy with inferior turbinate flap for dentigerous cyst Wardani, Retno Sulistyo; Lekatompessy, Michael; Senior, Brent Anthony
Oto Rhino Laryngologica Indonesiana Vol. 45 No. 2 (2015): Volume 45, No. 2 July - December 2015
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v45i2.119

Background: Dentigerous cyst is one of the most frequent types of odontogenic cyst that usually involving an impacted, supernumerary or ectopically erupted tooth. One of the non-dental sites for ectopiceruption is the maxillary sinus. The traditional approach under such circumstances is a Caldwell-Luc maxillotomy, but this type of procedure may result in significant long-term complications. Endoscopic transnasal medial maxillectomy (ETMM) has several advantages, such as good il lumination, as wellas clear and magnified visualization. The new modified endoscopic transnasal medial maxillectomy(METMM) can provide good visualization and more functional result by preserving the nasolacrimalduct and the inferior turbinate. Purpose: We present this case to introduce the METMM technique forextirpation of any tumor in the maxillary sinus. Case: One case of dentigerous cyst with an ectopicleft maxillary 3 molar tooth in a 27 year old woman who presented with sinusitis. Management:Surgery with a METMM technique to enucleate the cyst, combined with functional endoscopic sinussurgery (FESS) for the sinusitis. The patient then evaluated subjectively for epiphora and objectivelywith nasoendoscopic examination. Conclusion: In this case, METMM was effective in accessing themaxillary sinus allowing for tumor extirpation, while preserving the function of the inferior tubinate andnasolacrimal duct. Keywords : Dentigerous cyst, maxillary ectopic tooth eruption, transnasal medial maxillectomy ABSTRAKLatar belakang: Kista dentigerous merupakan salah satu jenis kista otontogenik yang paling sering ditemukan, biasanya berhubungan dengan gigi impaksi, supernumeri atau gigi yang tumbuhektopik. Salah satu tempat erupsi ektopik adalah sinus maksilaris. Pendekatan tradisional dalamkeadaan ini adalah operasi Caldwell-Luc, tetapi teknik operasi ini dapat mengakibatkan komplikasijangka panjang. Maksilektomi medial transnasal dengan endoskopi (MMTE) memiliki beberapakeunggulan, seperti visualisasi yang jelas dan diperbesar. Teknik maksilektomi medial transnasaldengan endoskopi yang dimodifikasi (MMTEM) dapat memberikan visualisasi yang baik dan hasillebih fungsional dengan mempertahankan duktus nasolakrimal dan konka inferior. Tujuan: makalahini diajukan untuk memperkenalkan teknik MMTEM untuk ekstrirpasi massa yang berada di dalamsinus maksila, karena teknik ini memberikan hasil yang lebih fungsional. Kasus: melaporkan satu kasuskista dentigerous dengan gigi molar 3 yang erupsi ektopik pada sinus maksila kiri pada wanita 27tahun. Penatalaksanaan: kasus ini ditatalaksana dengan teknik MMTEM untuk mengenukleasi kistadan BSEF untuk sinusitis. Pasien kemudian dievaluasi secara subjektif dengan anamnesis mengenaiadanya epifora dan objektif dengan pemeriksaan nasoendoskopi. Kesimpulan: MMTEM terbukti efektifuntuk ekstirpasi tumor yang berada di dalam sinus maksila, dan teknik ini juga memberikan hasil yanglebih fungsional dengan dipertahankannya konka inferior dan duktus nasolakrimal. Kata kunci : Kista dentigerous, erupsi gigi ektopik di maksila, transnasal maksilektomi medial

Case Report: Mediastinitis Secondary to Deep Neck Abscess, Should Sternotomy be Done? Noor, Muhammad Farhan; Lekatompessy, Michael; Dandanah, Maulidia Ayudika
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.191

A deep neck abscess is a treatable infection in the deep cervical space. The condition may have life-threatening complications. A complication that can happen secondary to the abscess is mediastinitis, and treating a patient with such a complication could be challenging. To emphasize that treatment by exploration of the abscess and insertion of a mediastinal drain could be an alternative therapy compared to sternotomy for mediastinitis secondary to deep neck abscess. A 39-year-old male came to the ER with a chief complaint of swollen and neck tenderness for the past five days, along with difficulty swallowing and chest pain. Radiographic examinations showed a retropharyngeal abscess with a widening mediastinum. The patient underwent surgery to drain the abscess. Cervical and mediastinal drains were inserted, and the patient was transported to the Intensive Care Unit for observation. The patient was extubated after three days, and both drains were removed on the fifth day. Deep neck abscess is still common in Indonesia, and mediastinitis is a complication of deep neck infections. A surgical approach is necessary when mediastinitis occurs as it is considered a medical emergency. Not all ICU units in Indonesia can provide or manage open sternotomy patients. Identifying complications, early detection, and treatment is crucial in determining the patient’s prognosis.

Clivus Chordoma: Case Report and Current Considerations on Endoscopic Endonasal Trans-Sphenoid Surgery with Neurosurgeon-Otolaryngologist Collaboration Lekatompessy, Michael; Widyakrisna, Albertus Boyke Raditya; July, Julius
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9245

Chordomas, infrequent malignancies primarily located along the craniospinal axis, showcase gradual growth and localized bone destruction, with the clival region involved in approximately 25-35% of cases. Headaches accompanied by neurological deficits are the typical clinical presentations. Complete surgical resection is the mainstay, with recent collaborative efforts between otorhinolaryngologists and neurosurgeons leading to a positive shift from traditional craniotomic procedures to endoscopic endonasal approaches, fostering minimally invasive techniques and utilizing endoscopy for primary visualization across the neuraxis. Furthermore, the concept of team surgery has been introduced, involving simultaneous contributions from ENT surgeons and Neurosurgeons at all stages of the procedure, including the approach, resection, and reconstruction phases. This report presents a series of two successful cases of clival chordomas managed using the endoscopic endonasal approach at Siloam Hospital Lippo Village This indicates its potential as a viable surgical choice, particularly within medical centers that possess the necessary specialties. Successful implementation is notably enhanced through collaborative efforts between otolaryngologists and neurosurgeons, underscoring the significance of interdisciplinary teamwork.

Functional Endoscopic Orbital Decompression Surgery in Acute Rhinosinusitis with Orbital Complication : A Case Report Lekatompessy, Michael; Kirana, Amanda P
Medicinus Vol. 10 No. 3 (2021): June 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i1.4197

Introduction: Orbital complications secondary to acute rhinosinusitis can cause permanent vision loss and death if not treated promptly and appropriately. The prevalence of orbital complications due to rhinosinusitis is more common in children than adults, occurring in 3-4% of children with acute rhinosinusitis. Lamina papyracea in children has many dehiscences, the nasal cavity tends to be narrower and the mucosa is softer than in adults, therefore causing the spread of infection more easily from the sinuses to the eyes. Clinical presentation: a 4-year-old child presented with eye swelling and pus discharge in the right eye for 5 days before being admitted to the hospital, for which she was treated with medication and did not improve. On physical examination, there is a narrow nasal cavity, inferior turbinate edema, and hyperemia, mucopurulent discharge. CT scan and MRI revealed contrast enhancement in intraorbital with suspected intraorbital abscess with orbital cellulitis, right pansinusitis, and buccal abscess. Functional endoscopic orbital decompression was done immediately.Conclusion: Orbital complications due to acute rhinosinusitis are uncommon but potentially lead to more fatal complications. Early diagnosis and aggressive treatment of immediate functional endoscopic sinus surgery and antimicrobial therapy have a good outcome.

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