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All Journal Jurnal Rekonstruksi dan Estetik Journal of Social Research
Arista, Timotius Hansen
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Humanities Computer Science & IT Economics, Econometrics & Finance Education Medicine & Pharmacology Social Sciences

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SUCCESSFUL PHARYNGOPLASTY AFTER LE FORT I ADVANCEMENT IN A SEVERELY NEGLECTED CLEFT LIP AND PALATE PATIENT Arista, Timotius Hansen; Hutagalung, Magda Rosalina
Jurnal Rekonstruksi dan Estetik Vol. 4 No. 1 (2019): Jurnal Rekonstruksi dan Estetik, June 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (236.371 KB) | DOI: 10.20473/jre.v4i1.24351

Abstract

Highlights: In a seriously neglected case, pharyngoplasty to a certain extent as a correction treatment of VPI was reliable. A posterior pharyngeal flap was seccessful to recover significant speech capacity. Abstract: Introduction: When indicated, velopharyngeal insufficiency (VPI) is treated with pharyngoplasty with consideration of patient's age. Several studies have evaluated the relationship between age at surgery and speech outcome. The best results regarding reduction of open nasality were obtained when surgeries were performed around age of 5 to 6 years and operative complications were also less frequent in the younger age group than in older patients. Pre-operative assessment such as nasopharyngoscopy and/or videofluoroscopy gives surgeons a chance to estimate flap dimension to correct the defect causing the VPI. Moreover, velopharyngoplasty proceeded with speech therapy yields better recovery. Case Illustration: A seriously neglected case of cleft lip and palate was reported. A 24 years old female underwent two palatorrhaphy at age 13 and 14 years old, which were far beyond the recommended age of 10 –12 months. The resulting hypernasality was further worsened by absence of speech therapy which should have been followed from age 1–4 years old. On presentation, this patient requested to have immediate orthognatic surgery to repair his severe type 3 facial profile and malocclusion, a procedure which he underwent worsening the VPI. We decided to surgically correct the VPI. Discussion: Nasoendoscopic assessment revealed he had an antero-posterior velopharyngeal closure problem which indicated a pharyngoplasty using a superiorly- based pharyngeal flap. Three months post-operatively his speech was re-evaluated by a speech therapist and nasoendoscopically. Despite imperfectness, significant improvement was achieved. Conclusions: Pharyngoplasty could still be reliable to a certain extent as a correction treatment of VPI in a seriously neglected case. A posterior pharyngeal flap helped this patient to recover significant speech capacity.
Pre-Surgical Planning Using Virtual And 3D Printing Model as Guidance for SECONDARY Mandible Reconstruction with Bone Graft: A Case Report Tanto, Christabela Dwiutami; Arista, Timotius Hansen; Dhiparedja, Rionaldo; Wicaksono, Bambang
Journal of Social Research Vol. 3 No. 11 (2024): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v3i11.2294

Abstract

Reconstruction of mandibular defects due to trauma or tumor resection is a significant challenge for surgeons, given the unique and variable shape of the mandible in terms of curvature, length, and height. Numerous techniques have been developed to achieve both aesthetic and functional outcomes. This case report presents a 28-year-old patient with mandibular irregularity following ameloblastoma dissection, which was reconstructed with non-vascularized bone grafts (NBGs) from the left iliac crest approximately 10 years ago. Prior to our procedure, virtual planning and 3D modeling were employed to accurately assess the bone defect. After debridement, a 5 cm defect was identified, and NBGs were harvested from the right iliac crest for reconstruction. NBGs are commonly used for small mandibular defects (<6 cm), non-continuity defects, and benign pathologies, and they can be performed in centers without microsurgical expertise. The use of virtual planning and 3D printing enables the surgical team to thoroughly study the case, anticipate potential issues, and improve precision, resulting in better outcomes and reduced operative time. NBGs, guided by virtual planning and 3D modeling, prove to be an effective technique in reducing surgical time and minimizing the risk of failure during the postoperative recovery period.
Co-Authors Dhiparedja, Rionaldo Hutagalung, Magda Rosalina Tanto, Christabela Dwiutami WICAKSONO, BAMBANG