Articles
<![CDATA[Management of Traumatic Undiagnosed Condyle Fracture in Children ]]>
<![CDATA[Rizal, Syamsul]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.104
<![CDATA[Background: Condyle trauma is considered to be the major cause of TMJ ankylosis but it is also the most neglected and under-managed problem in children. ?TMJ ankylosis leads to be malocclusion and facial disfigurement. The aim of early treatment is to restore the mandibular mobility and to enhance further growth in order to reduce the possibility of future facial asymmetry. Patients and Methods: We report two patients with inability to open mouth few months following injury. They most probably suffered missed diagnosis condyle fracture by the previous physician. The latest physical examination and radiological finding shows the mandible was micrognathic and unilateral TMJ ankylosis was confirmed. A sequential protocol of TMJ ankylosis management based on aggressive resection of ankylotic mass was performed and followed withphysiotherapy.Result: In 2 month-follow up, both patients showed significant improvement in mouth opening and the mastication function was restored, accompanied with physical therapy to gain maximum mouth opening for at least a year.Summary: A detail history, clinical and functional examination, radiographic examination facilitating correct diagnosis followed by immediate surgical intervention, and physiotherapy can help us to restore physical, psychological, and emotional health of the child patient.]]>
<![CDATA[Traumatic Palatal Defect Closure With Prosthesis Post Surgical Reconstruction: A Team Approach ]]>
<![CDATA[Martina, Nungki Ratna]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.106
<![CDATA[Background: Palatal defect may be a result of congenital malformations, trauma or tumors. In most maxillopalatal trauma, surgical reconstruction is required to restore the function and appearance. Any palatal defect caused by maxillopalatal loss that cannot be achieved with surgical reconstruction needs special and comprehensive treatment. This can be done by prosthodontist prosthesis rehabilitation.Patients and Methods: A 20-year-old man underwent open reduction and internal fixation for severe maxillopalatal fracture and palatal loss. Intraoperative, the palatal defect could not be approximated due to palatal loss. In 3-month-follow up, there was a palatal defect and slight malocclusion due to anterior dental loss. Instead of performing complicated surgical procedures, we collaborate with the prosthodontist to assemble prosthesis with dental prosthesis that accommodate the closure of defect and improve appearance aesthetically. Result: The use of prosthesis improves functional and psychological wellbeing. It does not only close the palatal defect, but it also fills the anterior dental loss thus overcoming the malocclusion. Satisfying functional and aesthetic outcome was achieved. Summary: Rehabilitation of maxillopalatal defect has been well defined for prosthodontists and surgeons. A successful prosthetic design for functional restoration of the palatal defect utilizes the remaining palate and dentition to maximize the support, stability and appearance. In this case,prosthodontist and dentition prosthesis was used as modalities that offer simple solution to close the palatal defect compared to a more complicated surgical intervention.]]>
<![CDATA[Changing of Condylar Fracture Approach in Cipto Mangunkusumo Hospital ]]>
<![CDATA[Susanto, Imam]]>;
<![CDATA[Bangun, Kristaninta]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Kreshanti, Prasetyanugrahni]]>;
<![CDATA[Hapsari, Nathania Pudya]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 6 (2012): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i6.120
<![CDATA[Management of condylar fracture draws controversy for over three decades. Previously, closed reduction with intermaxillary !xation (IMF) had been predominant for many surgeons, considering shorter length of procedure, ability to achieve preinjury occlusion with acceptable adjustment, and low cost of procedure. Introduction of osteosynthesis material rigid internal !xation (RIF) and adaptive miniplate !xation marked technology development in condylar fracture management and became popular in term of the applicability and outcome results. Over period time, several studies proposed vary classi!cation system and selection patient criteria for surgical treatment on the basis of age, location of fracture, degree of communition, direction of proximal fragment displacement, location of condylar head, concomitant medical illness or associated trauma, and patient’s preferences to achieve optimum goal. This review focuses on the shifting of condylar fracture management at Cipto Mangunkusumo Hospital from 2004-2012.]]>
<![CDATA[Reconstruction of Traumatic Partial Ear Amputations Using Two-Stage Skin Flap Pocket Technique ]]>
<![CDATA[Hakim, Intan Friscilla]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i1.123
<![CDATA[Background: Various reconstructive techniques for partial traumatic ear amputations have been reported. The choice of technique is based on the missing ear components and the availability of tissue for defect coverage. The goal is to obtain an aesthetically acceptable ear. The authors report a two-stage skin flap pocket technique for the reconstruction of traumatic ear amputations. Patient and Method: Three cases of partial traumatic ear amputation due to bite is reported. After sufficient debridement, skin flap pocket was created on the retroauriculomastoid area. Conchal cartilage graft was used to replace cartilage defect in one case. The other 2 cases utilized their amputated cartilage graft, deepithelialized and then resutured to the remaining cartilage. All three cases underwent second stage surgeries for flap division, three weeks after the pocketing. Result: In 2 months follow-up, all of 3 cases showed no signs of infection. Normal dimension of the ears were achieved and aesthetic appearances were perceived as acceptable to the patients and other viewers. One case was able to be followed one year post surgery with acceptable aesthetics, and no sign of cartilage resorption. Summary: The technique used in these cases provided acceptable results in reconstructing the size and shape of the partially amputated ears. Cartilage grafts implanted in the pockets retained their shape with no infection or resorption.]]>
<![CDATA[Pericranial Hinged Flap for Congenital Posterior Meningoencephalocele Closure ]]>
<![CDATA[Atmaja, Tessa Miranda]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i1.124
<![CDATA[Background: Posterior meningoencephalocele is a complicated case that requires adequate method for closure of the defect. Congenital meningoencephalocele is a rare incidence estimated at 1:3000 to 10000 live births; with occipital encephaloceles are the most common. The method for closure should prevent leakage of cerebrospinal fluid (CSF) and coverage for the calvarial bone. Meningoencephalocele are treated by excising the non-functional brain tissue and closed the defect using thick connective tissue graft, alloplastic material and local flaps. The problems with closure are continuous leakage of cerebrospinal fluid and infection, especially when alloplastic material is used. In this case report, a pericranial flap is used to close the dura. Patient and Method: A neonate with occipital meningoencephalocele was consulted to the Plastic Surgery Department with wound dehiscence and recurrent herniation of brain tissue after undergoing first surgery by the neurosurgery team. On the second operation, a premilene mesh was placed which was later infected and causing wound dehiscence. We then close the defect using pericranial hinged flap and primary closure of the skin and subcutaneous tissue. Result: After the closure using pericranial hinged flap, there were no signs of infection and no CSF leakage. In 4 month follow up, the defect has completely healed. Summary: Closure of calvarial bone defect with pericranial-hinged flap provides a tight closure of the intracranial space, without increased risk of infection. Pericranial hinged flap should be considered as a method of choice for closure of intracranial defect, preventing leakage of cerebrospinal fluid and reducing risk of infection.]]>
<![CDATA[The Versatility of Temporalis Muscle Flap in Reconstruction of Maxillofacial Region ]]>
<![CDATA[Harsono, Anastasia Dessy]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i1.125
<![CDATA[Background: The temporalis muscle !ap (TMF) is a very versatile and valuable axial flap, which could be used in various reconstructive procedures in and around the maxillofacial region. The surgical anatomy, vascular pattern and technique of elevation of the flap are described, associated with our experience in different reconstructive situations. Patient and Method: There were two patients, one case of TMJ ankylosis and one case of facial paralysis. The TMF was used as an interpositional arthroplasty for TMJ ankylosis, as a dynamic facial reanimation for facial paralysis. Result: In the first patient, he was able to open his mouth 4 cm in 2 weeks following the surgery. There was no pain or other complication complained. In second patient, in two weeks follow up after the surgery, we found the edema was decrease gradually. The contraction on the right nasolabial sulcus was slightly seen. Summary: These report described the reliability, versatility and reproducibility of temporalis muscle flap. The rich vascularized tissue and its proximity to the reconstruction site make this flap reliable. TMF should be taken into consideration before deciding on more extensive reconstructive procedures.]]>
<![CDATA[Incomplete Cleft Palate in Cornelia de Lange Syndrome ]]>
<![CDATA[Fortuna, Fory]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i1.126
<![CDATA[Background: Cornelia de Lange Syndrome (CdLS) is a rare congenital anomaly inheritance syndrome. The prevalence is 1.6-2.2/100.000 of 8,558,346 births in Europe. Cleft palate is less frequent malformation of this syndrome (21,7%) than other associated malformations. The diagnosis can be obtained clinically based on CdLS diagnostic criteria by USA CdLS Foundation. This is the first case in our hospital. Patient and Method: A case of a 4-year-old girl who came to our attention at Cleft and Craniofacial Center Cipto Mangunkusumo National General Hospital for incomplete cleft palate. Parents’ major concerns was feeding problem. The clinical investigations showed that the child met diagnostic criteria for CdLS as described in literatures. We manage this case in collaboration with paediatric department and other related specialists, including radiologist and craniofacial orthodontist. We performed Veau-Wardill-Kilner’s palataoplasty for the incomplete cleft palate. Paediatric department arranged provision of dietary. Result: This patient with incomplete cleft palate whom we treated by palatoplasty was moderately involved by CdLS (severity score 17). After 3 weeks follow-up, we have overcome feeding problem and body weight gained. Summary: Patient with CdLS needs early multidisciplinary team approach management for maximum outcome, because variety of associated malformations may present and life-threatening. Diagnostic criteria by USA CdLS Foundation assist health care personnel recognize this syndrome early.]]>
<![CDATA[Distraction Osteogenesis for Micrognathia in Cipto Mangunkusumo Hospital : A Case Series ]]>
<![CDATA[Boaz, Grace]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i1.127
<![CDATA[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.]]>
<![CDATA[Lip And Palate Reconstruction On Median Cerebrofacial Malformation Patient ]]>
<![CDATA[Anindhawati, Nur]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i2.148
<![CDATA[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]]>
<![CDATA[Revision of Bilateral Celft Lip Deformity Using Abbe Flap ]]>
<![CDATA[Djaprie, Shelly M]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v2i2.150
<![CDATA[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.]]>
