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Kista Celah Brankial Kedua: Sebuah Laporan Kasus ferryansyah, ferryansyah; Hafiz, Al; Novialdi, Novialdi; Novianti, Hera; Handayani, Tuti
Majalah Kedokteran Andalas Vol. 48 No. 2 (2025): MKA April 2025
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v48.i2.p239-251.2025

Pendahuluan: Kista celah brankial adalah malformasi kongenital yang timbul akibat involusi yang tidak sempurna dari sisa-sisa aparatus brankial. Kista celah brankial kedua biasanya berupa massa yang mobile, fluktuatif, tidak nyeri, yang terletak di sepanjang batas anterior otot sternokleidomastoideus. Pemeriksaan ultrasonografi, magnetic resonance imaging dan histologi dapat membantu dalam menegakkan suatu diagnosis kista brankial dan menyingkirkan diagnosis banding lainnya. Penatalaksanaan pada kasus kista brankial adalah dengan tindakan eksisi kista. Laporan Kasus: Dilaporkan satu kasus anak laki-laki usia 1 tahun 3 bulan dengan keluhan benjolan pada leher sisi kanan. Pada pemeriksaan regio colli dekstra didapatkan massa kistik pada level IV, mobile, fluktuatif, tidak nyeri. Dilakukan tindakan eksisi kista dengan hasil histopatologi berupa kista brankial. Kesimpulan: Kista celah brankial kedua perlu dipikirkan pada kondisi pembengkakan leher bagian luar/ lateral. Kista celah brankial kedua berupa massa yang mobile, fluktuatif, tidak nyeri, yang terletak di sepanjang anterior otot sternokleidomastoideus, biasanya bersifat unilateral. Tatalaksana kista brankial berupa eksisi lengkap kista dan traktus sinus.Kata kunci: : kista celah brankial; aparatus brankial; kista celah brankial kedua; eksisi kista Â

Hubungan Alel Human Leukocyte Antigen A*11 dengan Kejadian Karsinoma Nasofaring pada Etnik Minangkabau di RSUP Dr. M. Djamil Padang Tri Yuspitasari, Jenny; Rahman, Sukri; Hafiz, Al
Jurnal Otorinolaringologi Kepala dan Leher Indonesia Vol. 2 No. 1 (2023)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jokli.v2i1.19

Latar Belakang : Karsinoma nasofaring (KNF) merupakan keganasan sel skuamosa nasofaring yang etiologi dan epidemiologinya dipengaruhi oleh etnik di dunia. Etiologi KNF bersifat multifaktorial yaitu interaksi antara infeksi virus Epstein-Barr (EBV), faktor lingkungan dan faktor genetik. Human Leukocyte Antigen (HLA) merupakan alel yang berperan penting dalam presentasi antigen virus yang menentukan dampak respon imun terhadap infeksi EBV. HLA bersifat polimorfisme dan sangat bervariasi pada etnik yang berbeda. Hal ini dapat dilihat dengan ditemukannya hubungan antara alel HLA dengan kejadian KNF. HLA-A*11 diduga berhubungan dengan insiden KNF yang rendah karena kemampuan alel tersebut memicu sistem imun dalam melawan virus. Tujuan : Mengetahui hubungan antara HLA-A*11 dengan kejadian KNF pada etnik Minangkabau di RSUP Dr. M. Djamil Padang. Metode : Penelitian analitik dengan menggunakan desain potong lintang (cross sectional), dilakukan terhadap 18 pasien KNF etnik Minangkabau dan 18 orang sehat etnik Minangkabau sebagai kontrol. Pada responden dilakukan pemeriksaan molekuler untuk melihat ekspresi HLA-A*11 dengan metode PCR-SSP (Polymerase Chain Reaction-Sequence Spesific Primer). Data dianalisis secara statistik dengan program komputer dan dinyatakan bermakna jika p <0.05. Hasil : Pada penelitian ini frekuensi HLA-A*11 ditemukan lebih banyak pada pasien kontrol (77,8%) dibandingkan dengan pasien KNF (66,7%), akan tetapi secara statistik tidak bermakna (p>0.05) Kesimpulan : Tidak terdapat hubungan Alel HLA-A*11 dengan kejadian karsinoma nasofaring pada etnik Minangkabau.

Modified supraauricular approach in recurrent preauricular sinus: A case report Hafiz, Al; Julianda, Wahyu
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 1, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss1.art14

The preauricular sinus (PAS) also known as the fossa fistula sac or depression is located near the external auricle at the posterior end of the stalk of the ascending helix. Most cases of PAS are asymptomatic and do not require treatment. Surgery is performed if there are signs of infection or recurrence. Incomplete PAS resection is the most common cause of recurrence. The real problem with surgical resection of PAS is the high recurrence rate after sinusectomy. We report the case of a 22-year-old woman who complained of a mass in her left ear that was enlarging for the past 3 months. The patient had previously undergone two operations at the same site but they were recurrent. Physical examination revealed a non-hyperemic painful cystic mass. A few days after the operation the patient recovered and the pain in front of his left ear disappeared. The patient can close his eyes and lift his forehead symmetrically and show no signs of infection. A follow-up examination 1-2 weeks after surgery in the Department of Ear Nose Throat Head and Neck Surgery (ENT-HNS) showed that the general condition of the patient was good and there were no signs of infection. After 6 months the patients ears returned to normal and there was no recurrence 6 months after surgery. There is a scar along the leading edge of the helix. The patient was diagnosed with a recurrent PAS complicated by a preauricular cyst and treated with sinusectomy using a modified supraauricular approach and resection of the preauricular cyst. Sinusectomy with a modified supraauricular approach is an effective technique and is superior to simple sinusectomy due to its low recurrence rate with minimal complications and superior aesthetic appearance. This modified supraauricular approach achieved excellent functional and aesthetic results in this patient.

Clinical characteristics of maxillofacial fracture patients in Dr. M. Djamil General Hospital Padang Hafiz, Al; Maidatuz Zahra, Agnesia; Mulyani, Henny; Huriyati, Effy; Revilla, Gusti; Zhuhra, Rahma Tsania
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 2 (2024): VOLUME 54, NO. 2 JULY - DECEMBER 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i2.661

Background: Maxillofacial fracture consists of several types of fractures depending on their location. Traffic accidents are the most common cause of these cases. The choice of management given in maxillofacial fractures is divided into immediate and planned delayed management, depending on the condition of the injured tissue. Purpose: To describe the clinical characteristics of maxillofacial fracture in the Department of Otorhinolaryngology Faculty of Medicine Universitas Andalas/Dr. M. Djamil General Hospital Padang, in 2020 to 2022. Method: A descriptive study with retrospective approach. The study was conducted by collecting data from the medical record section by using a total sampling technique (59 patients) from 2020 to 2022. Result: The highest cause was traffic accidents (49.2%), the most common findings were nasal bone fracture (44.1%), with operative management (82.4%). Conclusion: Maxillofacial fractures were most commonly experienced by the young age group and caused by traffic accidents, therefore driving safety and driver compliance should be more emphasized. Keywords: maxillofacial fracture, ORIF (Open Reduction Internal Fixation), septorhinoplasty, septoplasty, rhinoplasty ABSTRAK Latar belakang: Fraktur maksilofasial terdiri dari beberapa jenis fraktur tergantung lokasinya. Kecelakaan lalu lintas menjadi penyebab tersering dari kasus ini. Pemilihan tatalaksana yang diberikan pada fraktur maksilofasial dibagi menjadi tatalaksana segera dan tatalaksana lanjutan terencana, tergantung dari kondisi jaringan yang terluka. Tujuan: Untuk mengetahui karakteristik klinis pasien fraktur maksilofasial di Departemen THT-BKL FK Unand/RSUP Dr. M. Djamil Padang, dari 2020 sampai 2022. Metode: Penelitian ini bersifat deskriptif dengan pendekatan retrospektif. Penelitian dilakukan dengan pengambilan data di bagian rekam medik dengan teknik total sampling dan didapatkan sampel sebanyak 59 pasien pada tahun 2020 sampai 2022. Hasil: kelompok usia paling sering adalah 16-30 tahun (54.2%), dengan jenis kelamin terbanyak adalah laki-laki (76.3%), penyebab tersering adalah kecelakaan lalu lintas (4.2%), jenis fraktur tersering adalah fraktur tulang hidung (44.1%), dan tatalaksana paling sering adalah tatalaksana operatif (82.4%) Kesimpulan: Fraktur maksilofasial paling sering dialami oleh kelompok usia remaja dan disebabkan kecelakaan lalu lintas, oleh karena itu keselamatan dan kepatuhan berkendara perlu lebih diperhatikan dan ditingkatkan. Kata kunci: fraktur maksilofasial, ORIF (Open Reduction Internal Fixation), septorinoplasti, septoplasti, rinoplasti

Primary Furlow Palatoplasty for Delayed Repair of Veau Type I Cleft Palate in an Adolescent: Surgical Challenges and Bio-functional Outcomes Al Hafiz; Hazazi Nur Adli Aroli; Emilia Nissa Khairani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1530

Background: Cleft palate is a pervasive congenital craniofacial anomaly characterized by the failure of palatal shelf fusion, resulting in a persistent communication between the oral and nasal cavities. While developed healthcare systems mandate repair between 9 and 12 months, delayed presentation in adolescence remains a distinct clinical entity in developing regions. These cases are surgically complex due to maxillary skeletal maturity, tissue fibrosis, and wider cleft gaps compared to infant cases. The primary surgical objective is to seal the defect and restore the velopharyngeal sphincter to prevent hypernasality. This study evaluates the efficacy and physiological advantages of the Furlow double opposing Z-plasty technique in a high-risk delayed primary repair scenario. Case presentation: We report the management of a 14-year-old male presenting with an uncorrected non-syndromic incomplete cleft palate. Preoperative assessment revealed severe hypernasality and audible nasal air emission. Clinical examination confirmed a Veau Type I defect confined to the soft palate with a bifid uvula. Primary palatoplasty was executed using the Furlow technique. The procedure successfully recruited lateral tissue for palatal lengthening and achieved transverse muscle reorientation without the need for lateral relaxing incisions. Conclusion: The intervention resulted in complete anatomical closure with no evidence of wound dehiscence, hemorrhage, or oronasal fistula formation. The Furlow technique proved to be a feasible and safe modality for Veau Type I defects in adolescents, effectively addressing the vertical pharyngeal gap and restoring the sphincter mechanism's anatomy.

Functional Restoration of the Superior Auriculocephalic Sulcus in Cryptotia: A Case Report Validating the Twin Compression Theory via an Extended Sub-Galeal Advancement Flap Stevani Irwan; Al Hafiz
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1541

Background: Cryptotia, characterized by the invagination of the superior helix beneath the temporal skin, presents significant functional challenges regarding the retention of eyewear and protective masks. While prevalent in East Asian populations, data from the Indonesian archipelago is scarce. This study aims to document the functional and aesthetic outcomes of a modified surgical technique in a monozygotic twin, addressing the twin compression etiological hypothesis. Case presentation: A 7-year-old male monozygotic twin presented with Type I Cryptotia of the right ear, with a superior helix-to-mastoid distance of 0 mm. The co-twin exhibited normal auricular morphology. The patient underwent a partial otoplasty combined with a modified posterior auricular advancement flap. The specific modification involved extended sub-galeal undermining to recruit maximum tissue elasticity. Cartilage reshaping was performed using non-absorbable horizontal mattress sutures. Postoperative evaluation at 3 months revealed a superior helix-mastoid distance increase to 12 mm and an auriculocephalic angle restoration to 30 degrees. Patient-Reported Outcome Measures via a validated Visual Analog Scale showed an improvement from 2 to 9 out of 10. No immediate recurrence or hypertrophic scarring was observed. Conclusion: The extended sub-galeal advancement flap offers a promising solution for sulcus restoration, prioritizing vascularity and tissue recruitment over skin grafting. This case supports the intrauterine mechanical compression theory as a viable etiology for sporadic cryptotia. Short-term results are robust, though long-term surveillance is required to monitor cartilage memory.

From Nasal Vestibulitis to Maxillofacial Abscess: Reconstruction of Extensive MRSA-Induced Defects in a Diabetic Patient Clarissa Fiolly Refieska; Al Hafiz
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1556

Background: Nasal vestibulitis is frequently regarded as a benign localized infection. However, in immunocompromised hosts, specifically those with uncontrolled diabetes mellitus, it can rapidly escalate into a life-threatening maxillofacial abscess involving the danger triangle of the face. The synergistic destructive potential of Methicillin-resistant Staphylococcus aureus (MRSA) and hyperglycemia poses a formidable challenge for reconstructive surgery due to extensive tissue necrosis and compromised microvasculature. This study evaluates the efficacy of a dual-flap approach—combining Rotation and V-Y Advancement flaps—for restoring extensive midfacial defects. Case presentation: A 51-year-old male with uncontrolled Type 2 Diabetes presented with a massive, ruptured maxillofacial abscess originating from neglected nasal vestibulitis exacerbated by rhinotillexomania. The infection resulted in extensive necrosis spanning the nasal dorsum, infraorbital regions, and forehead. Microbiological analysis confirmed MRSA. Laboratory markers indicated severe sepsis with leukocytosis of 34,840 /mm³ and hyperglycemia of 328 mg/dL. Following acute stabilization and surgical debridement, the patient sustained a complex soft-tissue defect crossing multiple aesthetic subunits. A staged reconstruction was performed three weeks post-debridement. A V-Y advancement flap was utilized for the infraorbital and medial cheek defects to minimize ectropion risk, while a rotation flap was designed for the glabella and nasal dorsum to recruit forehead tissue. Conclusion: The combination of V-Y advancement and rotation flaps provides a robust, anatomically adaptable, and aesthetically superior solution for complex midfacial defects where skin laxity is compromised. This approach allows for tension-free closure in the aesthetic subunits of the face, even in patients with compromised perfusion due to diabetes. Early recognition of MRSA in diabetic vestibulitis is critical to preventing catastrophic tissue loss.

Primary Furlow Palatoplasty for Delayed Repair of Veau Type I Cleft Palate in an Adolescent: Surgical Challenges and Bio-functional Outcomes Al Hafiz; Hazazi Nur Adli Aroli; Emilia Nissa Khairani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1530

Background: Cleft palate is a pervasive congenital craniofacial anomaly characterized by the failure of palatal shelf fusion, resulting in a persistent communication between the oral and nasal cavities. While developed healthcare systems mandate repair between 9 and 12 months, delayed presentation in adolescence remains a distinct clinical entity in developing regions. These cases are surgically complex due to maxillary skeletal maturity, tissue fibrosis, and wider cleft gaps compared to infant cases. The primary surgical objective is to seal the defect and restore the velopharyngeal sphincter to prevent hypernasality. This study evaluates the efficacy and physiological advantages of the Furlow double opposing Z-plasty technique in a high-risk delayed primary repair scenario. Case presentation: We report the management of a 14-year-old male presenting with an uncorrected non-syndromic incomplete cleft palate. Preoperative assessment revealed severe hypernasality and audible nasal air emission. Clinical examination confirmed a Veau Type I defect confined to the soft palate with a bifid uvula. Primary palatoplasty was executed using the Furlow technique. The procedure successfully recruited lateral tissue for palatal lengthening and achieved transverse muscle reorientation without the need for lateral relaxing incisions. Conclusion: The intervention resulted in complete anatomical closure with no evidence of wound dehiscence, hemorrhage, or oronasal fistula formation. The Furlow technique proved to be a feasible and safe modality for Veau Type I defects in adolescents, effectively addressing the vertical pharyngeal gap and restoring the sphincter mechanism's anatomy.

Functional Restoration of the Superior Auriculocephalic Sulcus in Cryptotia: A Case Report Validating the Twin Compression Theory via an Extended Sub-Galeal Advancement Flap Stevani Irwan; Al Hafiz
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1541

Background: Cryptotia, characterized by the invagination of the superior helix beneath the temporal skin, presents significant functional challenges regarding the retention of eyewear and protective masks. While prevalent in East Asian populations, data from the Indonesian archipelago is scarce. This study aims to document the functional and aesthetic outcomes of a modified surgical technique in a monozygotic twin, addressing the twin compression etiological hypothesis. Case presentation: A 7-year-old male monozygotic twin presented with Type I Cryptotia of the right ear, with a superior helix-to-mastoid distance of 0 mm. The co-twin exhibited normal auricular morphology. The patient underwent a partial otoplasty combined with a modified posterior auricular advancement flap. The specific modification involved extended sub-galeal undermining to recruit maximum tissue elasticity. Cartilage reshaping was performed using non-absorbable horizontal mattress sutures. Postoperative evaluation at 3 months revealed a superior helix-mastoid distance increase to 12 mm and an auriculocephalic angle restoration to 30 degrees. Patient-Reported Outcome Measures via a validated Visual Analog Scale showed an improvement from 2 to 9 out of 10. No immediate recurrence or hypertrophic scarring was observed. Conclusion: The extended sub-galeal advancement flap offers a promising solution for sulcus restoration, prioritizing vascularity and tissue recruitment over skin grafting. This case supports the intrauterine mechanical compression theory as a viable etiology for sporadic cryptotia. Short-term results are robust, though long-term surveillance is required to monitor cartilage memory.

From Nasal Vestibulitis to Maxillofacial Abscess: Reconstruction of Extensive MRSA-Induced Defects in a Diabetic Patient Clarissa Fiolly Refieska; Al Hafiz
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1556

Background: Nasal vestibulitis is frequently regarded as a benign localized infection. However, in immunocompromised hosts, specifically those with uncontrolled diabetes mellitus, it can rapidly escalate into a life-threatening maxillofacial abscess involving the danger triangle of the face. The synergistic destructive potential of Methicillin-resistant Staphylococcus aureus (MRSA) and hyperglycemia poses a formidable challenge for reconstructive surgery due to extensive tissue necrosis and compromised microvasculature. This study evaluates the efficacy of a dual-flap approach—combining Rotation and V-Y Advancement flaps—for restoring extensive midfacial defects. Case presentation: A 51-year-old male with uncontrolled Type 2 Diabetes presented with a massive, ruptured maxillofacial abscess originating from neglected nasal vestibulitis exacerbated by rhinotillexomania. The infection resulted in extensive necrosis spanning the nasal dorsum, infraorbital regions, and forehead. Microbiological analysis confirmed MRSA. Laboratory markers indicated severe sepsis with leukocytosis of 34,840 /mm³ and hyperglycemia of 328 mg/dL. Following acute stabilization and surgical debridement, the patient sustained a complex soft-tissue defect crossing multiple aesthetic subunits. A staged reconstruction was performed three weeks post-debridement. A V-Y advancement flap was utilized for the infraorbital and medial cheek defects to minimize ectropion risk, while a rotation flap was designed for the glabella and nasal dorsum to recruit forehead tissue. Conclusion: The combination of V-Y advancement and rotation flaps provides a robust, anatomically adaptable, and aesthetically superior solution for complex midfacial defects where skin laxity is compromised. This approach allows for tension-free closure in the aesthetic subunits of the face, even in patients with compromised perfusion due to diabetes. Early recognition of MRSA in diabetic vestibulitis is critical to preventing catastrophic tissue loss.

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