Garuda - Garba Rujukan Digital

PENANGANAN MIKROTIA BILATERAL: LAPORAN KASUS BERBASIS BUKTI Widodo, Dini Widiarni; Priyono, Harim; Suryati, Irma
Oto Rhino Laryngologica Indonesiana Vol 44, No 1 (2014): Volume 44, No. 1 January - June 2014
Publisher : PERHATI-KL

Latar Belakang: Mikrotia didefinisikan sebagai daun telinga berukuran kecil dengan insiden sekitar 1 dari 7000-8000 ribu kelahiran, dengan insiden pada satu telinga sekitar empat kali lipat lebih banyak dibanding dua telinga. Rekonstruksi mikrotia merupakan salah satu prosedur cukup sulit pada bidang plastik rekonstruksi. Saat ini, penggunaan tandur tulang rawan iga autologus masih menjadi baku emas untuk rekonstruksi mikrotia. Tujuan: mengingatkan kembali para ahli THT tentang pertimbangan pemilihan rekonstruksi bersamaan pada kasus mikrotia bilateral dengan pencarian literatur berbasis bukti. Kasus: dilaporkan satu kasus mikrotia bilateral derajat 3, dengan hantaran tulang telinga kanan 60 dB, dan hantaran tulang telinga kiri 72,5 dB. Dengan pertimbangan memilih rekonstruksi bersamaan atau bertahap pada kedua telinga dan mengetahui prediksi perbaikan fungsi pendengarannya. Penatalaksanaan: aurikuloplasti tahap 1 dilakukan bersamaan pada kedua telinga. Skor Jahrsdoefer kedua telinga masing-masing 3 dan karena keterbatasan ekonomi dianjurkan menggunakan alat bantu dengar bukan BAHA untuk mengatasi hambatan komunikasi. Kesimpulan: penatalaksanaan mikrotia bilateral di bidang THT tidak hanya mencakup aspek rekonstruksi bentuk namun menekankan fungsi telinga sebagai alat berkomunikasi yang optimal. Kata kunci: mikrotia bilateral, ambang pendengaran, aurikuloplasti. ABSTRACTBackground:Microtia is defined as small sized ear with incidence approximately 1 in 7000-8000 births, which incidents in one ear is 4 times more compared to bilateral ear. Microtia reconstruction is one of difficult procedures in plastic reconstruction field. Recently, the use of rib cartilage autograft is still the gold standard for ear reconstruction. Purpose: to inform otorhinolaryngologist concerning simultaneous ear reconstruction in bilateral microtia case with evidence based method. Case: a third grade bilateral microtia, with the result of bone conduction are 60 dB for right ear dan 72,5 dB for left ear, the consideration to reconstruct both ear simultaneously or gradually, and how to predict the hearing improvement Management: first step of auriculoplasty was done in both ears, with Jahrsdoefer score is 3 for each ear, BAHA is adviceable but due to economic limitation the patients chose hearing aids. Conclusion: Bilateral microtia management in otorhinolaryngology does not only emphasize on ear reconstruction aspects but also to restore ear function as a means of optimal communicating.Keywords: bilateral microtia, hearing thresholds, auriculoplasty.

Surgical management of preauricular based on plastic-reconstructive algorithm Dini Widiarni Widodo; Hemastia Manuhara Harba'i
Oto Rhino Laryngologica Indonesiana Vol 49, No 1 (2019): Volume 49, No. 1 January-June 2019
Publisher : PERHATI-KL

Background: Preauricular fistula is a congenital malformation of the six auditory hillocks during the development of auricle, when an imperfect fusion of the first arch tuberculum to other tuberculums occurred and generated a tract. It is characterized by a nodule or a dent located adjacent to the external ear. An infection will create a swollen area in front of ear auricles with pain and suppuration. Fistula extirpation should be carried out after the acute infection subsides. Purpose: To evaluate surgery techniques with the lowest complication and recurrence rate. Case report: Reporting 4 surgical cases of prearicular fistula treated by Plastic-Reconstructive ENT Head and Neck surgery, among 26 cases of preauricular fistula diagnosed between 2015 to 2017 in Cipto Mangunkusumo General Hospital. Methods: Searching literature through Pubmed, Wiley, Proquest and Google Schoolar with keywords of “Preauricular fistula AND surgical treatment”. Further selection through clinical questions. Results: One journal presented a systematic review on the surgical outcome of preauricular sinus excision techniques. Reporting 4 cases treated by plastic-reconstructive surgery based on the systematic review above mentioned. Conclusion: The supra auricular approach could be recommended as a good technique for preauricular fistula, in particular for the infected and/or the recurrent cases. Latar belakang: Fistel preaurikula adalah suatu kelainan malformasi kongenital, dimana tuberkulum arkus brakialis pertama tidak menyatu dengan tuberkulum lainnya, sehingga terbentuk sebuah traktus (saluran). Fistel preaurikula ditandai oleh adanya nodul atau cekungan yang tampak di dekat telinga luar. Bila terjadi infeksi biasanya menyebabkan daerah di depan daun telinga bengkak dan nyeri, serta bernanah. Ekstirpasi fistel sebaiknya dilakukan setelah infeksi akut mereda. Tujuan: Mengevaluasi teknik bedah dengan tingkat komplikasi dan kekambuhan terendah. Laporan kasus: Dilaporkan 4 kasus fistel preaurikula yang ditatalaksana oleh bedah THT-KL plastik-rekonstruksi, dari sejumlah 26 kasus yang datang berobat di RSUPN Cipto Mangunkusumo, antara Januari 2015 dan April 2017. Metode: Penelitian literatur melalui Pubmed, Wiley, Proquest, dan Google Schoolar dengan kata kunci “Preauricular fistula AND surgery treatment”. Seleksi literatur lebih lanjut melalui pertanyaan klinis. Hasil: Didapati 1 jurnal yang menyajikan hasil operasi dari teknik bedah eksisi sinus preaurikular secara systematic review. Dilaporkan 4 kasus yang ditatalaksana dengan bedah plastik-rekonstruksi berdasarkan systematic review tersebut di atas. Kesimpulan: Pendekatan supra aurikula dapat direkomendasikan sebagai teknik bedah yang baik untuk penatalaksanaan fistel preaurikular, khususnya yang terinfeksi dan/atau berulang.

Fibrin glue and demineralized bone matrix effect on autologus cartilage graft in microtia reconstruction Dini Widiarni Widodo; Jenny Bashiruddin; Helmi Helmi; Alida Harahap; Nurjati Chairani Siregar
Oto Rhino Laryngologica Indonesiana Vol 45, No 1 (2015): Volume 45, No. 1 January - June 2015
Publisher : PERHATI-KL

Background: Microtia reconstruction is a challenge for ENT Head and Neck surgeons. Varioussurgical techniques using autograft cartilage have been done to perform auricular reconstruction.Knowledge of cartilage graft concerning resorption process that affected the size, form, and aestheticsubunit of the ear is mandatory. Purpose: To evaluate the success of cartilage autograft by identifyingchondrocyte apoptosis, tissue degradation based on cell character, matrix homogeneity, fibrosis,proteoglycans, collagen and Transforming Growth Factor β (TGF β) expression in application of FibrinGlue (FG) and or Demineralized Bone Matrix (DBM) after 12 weeks in microtia reconstruction by Nagatatechnique. Methods: Quasi-experiments. FG and/or DBM were applied on the rest of the 12 ear cartilageframework which was implanted on mastoid area. Apoptosis was examined by TUNEL. Safranin Ostaining and modified Mankin’s score was used to evaluate cartilage degradation and TGF β expressionby ELISA. Results: FG or DBM on cartilage graft showed significant increase in chondrocyte viabilitycompare with control group (p=0.00). Minimal fibrosis, more homogeneous extracellular matrix, decreasedproteoglycan and minimal thickening of collagen, had significant differences compared with control orFG-DBM group. Structure differences occurred among cartilage graft after 12 week implantation whereasFG showed minimal fibrous tissue, normal cell character, proteoglycan, collagen, and tissue homogeneity(p< 0.05). Conclusion: FG is highly recommended to reduce degradation of cartilage graft in microtiareconstruction. DBM can be still used to maintain chondrocyte viability, proteoglycans, and collagen. Keywords: cartilage graft, fibrin glue, demineralized bone matrix, transforming growth factor β, Mankinscore.ABSTRAK Latar belakang: Rekonstruksi mikrotia merupakan tantangan bagi ahli bedah THT-KL. Berbagaiteknik operasi menggunakan rangka telinga dengan tandur kartilago autologus telah dilakukan untukrekonstruksi mikrotia. Pengetahuan mengenai tandur kartilago sangat diperlukan, mengingat tandurdapat mengalami resorpsi dengan berjalannya waktu, sehingga mempengaruhi ukuran, bentuk, dan detilestetik subunit daun telinga. Tujuan: Mengetahui viabilitas kondrosit, degradasi jaringan berdasarkanperubahan karakter kondrosit, fibrosis, homogenitas matriks, ekspresi proteoglikan dan kolagenserta ekspresi transforming growth factor β (TGF β ) dengan atau tanpa fibrin glue (FG) dan/ataudemineralized bone matrix (DBM) pada rekonstruksi mikrotia setelah 12 minggu penanduran. Metode:Quasi-eksperimen. FG dan/atau DBM digunakan pada sisa tandur autologus kartilago rangka telinga,dilanjutkan pemeriksaan apoptosis dengan TUNEL. Pewarnaan Safranin O untuk menilai degradasijaringan dengan skor modifikasi Mankin dan ekspresi TGF β dengan ELISA. Hasil: penambahan FGatau DBM pada tandur kartilago, viabilitas sel meningkat berbeda bermakna dengan tanpa perlakuanatau FG-DBM.(p=0.00), fibrosis minimal, matriks lebih homogen, penurunan proteoglikan dan penebalankolagen minimal berbeda bermakna dengan kelompok tanpa perlakuan dan campuran FG-DBM. Terjadiperbedaan struktur jaringan setelah 12 minggu, FG mempunyai nilai fibrosis yang terendah, karaktersel normal, proteoglikan, kolagen, dan homogenitas jaringan (p<0,05). Kesimpulan: Penggunaan FGsangat dianjurkan untuk mengurangi degradasi tandur kartilago autologus pada rekonstruksi mikrotia. Dalam keadaan tidak memungkinkan dapat digunakan DBM karena masih baik dalam mempertahankanviabilitas kondrosit, proteoglikan dan kolagen. Kata kunci: tandur kartilago, fibrin glue, demineralized bone matrix (DBM), transforming growth factorβ (TGF β), Mankin score.

Tatalaksana komprehensif prosedur Millard modifikasi dengan nasoalveolar molding pada labiognatopalatoskizis komplit bilateral Dini Widiarni Widodo; Raden Ayu Anatriera; Taty Zubaidah Cornain
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Latar belakang: Bibir sumbing dengan celah palatum merupakan suatu kelainan kongenital denganberbagai macam presentasi klinis, bersifat multifactoral inheritance dimana terdapat bakat genetikataupun kontribusi dari faktor lingkungan. Pasien cleft lip palate (CLP) membutuhkan penangananmultidisiplin untuk mengoptimalkan hasil. Penanganan sebelum dan pasca tindakan pembedahan yangkomprehensif diperlukan untuk menghasilkan outcome dan prognosis yang baik. Tujuan: Melaporkankasus labiognatopalatoskizis komplit bilateral dengan pilihan teknik labioplasti modifikasi Millard untukkoreksi primer celah bibir, disertai penggunaan nasoalveolar molding (NAM) sebelum pembedahan.Laporan kasus: Bayi laki-laki berusia 6 bulan datang dengan keluhan terdapat celah pada bibir danpalatum disertai adanya kelainan kongenital multipel sejak lahir. Hasil pemeriksaan fisik didapatkan celahpada bagian atas bibir komplit bilateral, gusi atas, serta palatum. Kavum nasi kedua hidung tampak defekpada bagian dasar hidung. Pada pasien dipasang NAM sejak usia 3 bulan agar dapat membantu asupanmenyusui. Kemudian pasien menjalani tindakan labioplasti menggunakan teknik Millard untuk koreksiprimer celah bibir. Metode: Penelitian literatur dengan mencari melalui Pubmed, Google Scholar, danClinicalKey sesuai pertanyaan klinis dalam beberapa tahun terakhir. Setelah penyaringan dengan kriteriainklusi dan eksklusi, diperoleh 1 jurnal yang relevan, selanjutnya jurnal ini dilakukan pengkajian kritis.Hasil: Dalam jurnal tersebut menyatakan bahwa penggunaan teknik modifikasi Millard dengan penggunaanNAM mempunyai outcome yang baik terhadap perbaikan bentuk bibir dan hidung pasien celah bibirkomplit bilateral. Kesimpulan: Penggunaan nasoalveolar molding sebelum pembedahan dapat bergunamenghasilkan perbaikan bentuk bibir dan hidung serta memperbaiki outcome dan prognosis pasien. ABSTRACTBackground: Cleft lip with cleft palate is either a non-syndromic disorder or a manifestation ofanother syndrome, with a variety of clinical presentations. Non-syndromic cleft lip is a multifactorialinheritance disorder in which there is a genetic tendency in the family, or being contributed byenvironmental factors. Cleft lip and cleft palate (CLP) patients need multidisciplinary managementto optimize results. A comprehensive prior and post surgery treatment are required to produce betteroutcome and prognosis. Objective: Reporting a case of complete bilateral labiognatopalatoschizis withMillard modified labioplasty approach for primary correction and the use of nasoalveolar molding(NAM) prior to surgery. Case Report: A 6-months-old male baby came with a complete bilateral cleftlip and palate, accompanied by multiple congenital abnormalities at birth. Physical examination showedcomplete bilateral cleft along lips, gums, hard and soft palate. There was also a defect at the base of thenose. In this patient, NAM was inserted since 3 months of age to assist breastfeeding intake. The patientunderwent a labioplasty procedure using Millard technique for primary correction of cleft lip. Method:Literature searching through Pubmed, Google Scholar, and ClinicalKey according to clinical questions.After screening with the inclusion and exclusion criteria, one relevant journal was obtained, then criticallyappraised. Result: The journal stated labioplasty procedure with NAM had a good outcome for lip andnose repair in a bilateral complete cleft lip. Conclusion: The use of NAM before surgery could be usefulin improving patient’s outcome and prognosis.

Fat graft augmentation rhinoplasty compared to costal cartilage graft in saddle nose panfacial fractures Dini Widiarni Widodo; Satria Dipo Putra Asmoro; Raden Ayu Anatriera
Oto Rhino Laryngologica Indonesiana Vol 51, No 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.449

ABSTRACTBackground: Panfacial fracture can cause nasal function and esthetics alterations, one of which is saddle nose deformity. Post-traumatic saddle nose could be treated with augmentation rhinoplasty to correct the nasal structure and function. It can use autologous material such as fat graft and cartilage graft. Purpose: To report the effect of fat graft augmentation rhinoplasty compared to costal cartilage graft on patients’ satisfaction of saddle nose panfacial fracture cases. Case report: Reporting two cases of panfacial fracture with saddle nose. The first case, a 22-years-old female with multiple facial fractures underwent plate and screw fixation and nasal fracture close reduction followed by augmentation rhinoplasty using fat graft. The second case was a 23-years-old male diagnosed as blow-out fracture treated with internal fixation and costal cartilage augmentation rhinoplasty. Clinical question: Does fat graft augmentation rhinoplasty result in a better satisfaction level than costal cartilage graft in panfacial fracture with saddle nose cases. Review method: Evidence-based literature searching was performed through Pubmed, Scopus and Proquest databases to evaluate the effect of rhinoplasty augmentation using fat graft compared to costal cartilage on patient satisfaction level. Result: One study showed patient’s high satisfaction level after fat graft augmentation procedure. Another study showed that satisfaction rates were also high in cartilage graft augmentation patients. Conclusion: The advantages of using fat graft augmentation are the more natural esthetic outcome, easy to perform and low morbidity. Rhinoplasty Outcome Evaluation (ROE) questionnaire could be used to evaluate the outcome of augmentation rhinoplasty with high sensitivity and specificity.Keywords: saddle nose, panfacial fracture, fat graft augmentation, costal cartilage graft, ROEABSTRAKLatar belakang: Fraktur panfasial dapat mengakibatkan perubahan struktur wajah disertai kelainan fungsi dan estetika hidung, salah satunya deformitas saddle nose. Saddle nose pasca trauma wajah dapat ditatalaksana dengan rinoplasti augmentasi untuk memperbaiki struktur dan fungsi hidung. Rinoplasti augmentasi dapat menggunakan material tandur autologous misalnya tandur lemak dan kartilago. Tujuan: Melaporkan hasil augmentasi tandur lemak dibandingkan tandur kartilago iga terhadap tingkat kepuasan pasien kasus saddle nose fraktur panfasial. Laporan kasus: Dua kasus fraktur panfasial disertai saddle nose. Kasus pertama, perempuan 22 tahun dengan fraktur wajah multipel, dilakukan fiksasi internal menggunakan plate and screw dan reduksi tertutup fraktur nasal, dilanjutkan rinoplasti augmentasi tandur lemak untuk memperbaiki saddle nose. Kasus kedua, laki-laki 23 tahun dengan fraktur blow-out ditatalaksana dengan fiksasi internal dilanjutkan rinoplasti augmentasi tandur kartilago iga. Pertanyaan klinis: Apakah rinoplasti augmentasi tandur lemak menghasilkan tingkat kepuasaan pasien lebih baik dibandingkan tandur kartilago iga pada kasus saddle nose pada fraktur panfasial? Telaah literatur: Pencarian literatur mengenai pengaruh augmentasi tandur lemak dibanding tandur kartilago iga terhadap tingkat kepuasan pasien fraktur panfasial dalam database Pubmed, Scopus dan Proquest. Hasil: Satu artikel menunjukkan tingkat kepuasan pasien pasca rinoplasti augmentasi tandur lemak yang tinggi dengan tingkat morbiditas rendah. Artikel lain menunjukkan tingkat kepuasan yang juga tinggi pada pasien augmentasi tandur kartilago tanpa komplikasi mayor. Kesimpulan: Keuntungan penggunaan tandur lemak pada rinoplasti adalah terlihat lebih alami, lebih mudah dilakukan dengan morbiditas rendah, akan tetapi dengan tingkat resorpsi tinggi. Kuesioner Rhinoplasty Outcome Evaluation (ROE) dapat menjadi alat untuk menilai outcome dari rinoplasti augmentasi dengan sensitivitas dan spesifitas cukup tinggi.Kata kunci: saddle nose, fraktur panfasial, augmentasi tandur lemak, tandur kartilago iga, ROE

Outcomes of Autologous Reconstruction in Comparison with Alloplastic in Microtia Patients Dini Widiarni Widodo; Irfan Irfan; Eka Dian Safitri; Mirta Hediyati Reksodiputro
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.178.258-64

Background: Microtia is a congenital abnormality of the auricle. One of the important comprehensive management of microtia is ear reconstruction. Reconstruction using an auricle framework from autologous material originating from the rib cartilages is still the gold standard. However, currently, some surgeons prefer alloplastic materials which are claimed to reduce morbidity and can be performed at a younger age. Objective: Report a case of a microtia patient who underwent autologous reconstruction followed by a literature search comparing the outcomes of autologous and alloplastic reconstruction. Case: An 11-year-old with grade 3 unilateral microtia who underwent autologous reconstruction surgery using materials from the rib cartilages. Later he complained of pain at the rib grafting site, more than at the surgical wound in the ear. Methods: A literature search based on the clinical question was done in PubMed, EBSCOhost, Cochrane Library, and by hand searching. Results: Three relevant articles that fit the clinical question were included. Autologous reconstruction causes fewer complications, while alloplastic reconstruction is better aesthetically. Further research is needed regarding the quality of life. Conclusion: Auricular reconstruction using autologous material remains the superior material of choice. Alloplastic framework can be an alternative choice with better aesthetic results but greater complication risk.

Accuracy of Centor scoring system in diagnosing group a-beta haemolytic streptococcal (GABHS) infection Poerbonegoro, Niken Lestari; Hanrahan, Joanna Erin; Amelia, Indira; Akbar, Viharsyah Aulia; Djohan, Raditya Putra; Mayangsari, Ika Dwi; Widodo, Dini Widiarni
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.430

ABSTRACTBackground: At present, the standard examination for diagnosing streptococcal upper respiratory tract infection is throat culture. As throat culture is time-consuming and relatively expensive, efforts are made to develop certain criteria that will still lead to proper diagnosis and rational use of antibiotics, that is Centor score. Even so, the accuracy of Centor score is still debatable. Purpose: To provide evidence on the accuracy of Centor scoring system compared to throat culture in diagnosing GABHS upper respiratory tract infection. Case Report: A 25-years old male came to primary health care with primary complain of sore throat. Centor score was used to diagnose GABHS infection and as a guide to give antibiotics. Clinical question: “In patients with sore throat, how accurate is the Centor score compared to throat culture in diagnosing Group A Beta-Haemolytic Streptococcal (GABHS) Infection?” Methods: Literature searching was conducted through 4 databases. Critical appraisal based on the Centre of Evidence-Based Medicine (CEBM)-University of Oxford University, Diagnostic Critical Appraisal Sheet and Systematic Review Sheet. Results: All the selected studies were considered valid. They revealed a high specificity, low sensitivity, high negative predictive value (NPV), and low positive predictive value (PPV) in the importance aspect assessment. The Centor scoring system was applicable to our patient. It was available, affordable, and accurate in adult patients, yet less accurate in children. Conclusion: In conclusion,Patient with sore throat and suspicion of GABHS infection could be diagnosed with Centor scoring system as the first line diagnosis in primary care and as a guide to whether to give giving antibiotics or not.ABSTRAKLatar belakang: Saat ini, kultur tenggorok merupakan pemeriksaan baku emas yang digunakan untukmendiagnosis infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus. Namun, kulturtenggorok merupakan pemeriksaan yang mahal dan hasilnya memakan waktu yang lama, sehinggaberbagai kriteria dikeluarkan untuk dapat dipakai sebagai alat diagnostik dan sebagai panduanpenggunaan antibiotik yang rasional pada kasus infeksi saluran napas atas. Salah satunya yaitu Centorscore, tetapi akurasinya masih kontroversial. Tujuan: Menyediakan laporan kasus berbasis buktiterhadap akurasi dari Centor score sebagai alat diagnostik infeksi saluran napas atas yang disebabkanoleh bakteri Streptococcus dibandingkan dengan pemeriksaan kultur tenggorok. Laporan kasus: Seorang laki-laki berusia 25 tahun datang ke fasilitas kesehatan tingkat pertama dengan keluhan utama nyeri tenggorokan. Centor score digunakan untuk mendiagnosis pasien ini dan sebagai panduan pemberian antibiotik. Pertanyaan klinis: Pada pasien dengan radang tenggorok,seberapa akurat Centor score dibandingkan dengan kultur tenggorok dalam diagnosis GABHS? Metode: Pencarian literatur dilakukan melalui 4 database dan telaah kritis literatur menggunakan tilikan dari CEBM, University of Oxford University. Hasil: Seluruh studi yang ditelaah valid. Seluruh studi menunjukkan spesifisitas dan negative predictive value (NPV) yang tinggi, serta sensitivitas dan positive predictive value (PPV) yang rendah. Centor score dapat diaplikasikan untuk pasien pada skenario klinis karena bersifat mudah digunakan, biaya yang dikeluarkan terjangkau, dan akurat khususnya pada pasien dewasa. Kesimpulan: Pasien dengan nyeri tenggorok yang dicurigai memiliki infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus dapat ditegakkan diagnosisnya melalui penilaian Centor score di fasilitas layanan tingkat pertama, serta dapat menjadi panduan dalam pemberian antibiotik.

Reconstruction of medial upper lip defect with Abbe flap Widodo, Dini Widiarni; Gustria, Wulan Mega
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 2 (2022): VOLUME 52, NO. 2 JULY - DECEMBER 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i2.579

ABSTRACTBackground: Reconstruction of upper lip defect is challenging, because the upper lip is formed by two lateral nasolabial subunits and one philtrum subunit. The most effective reconstruction approach for upper lip deformities is still being debated. Purpose: To report a case of upper lip defect, and review the Abbe flap and Estlander flap methods for upper lip reconstruction. Case report: A 62 years old female subject with full thickness defect of two third of the upper lip, repaired by Abbe flap. Clinical question: What is the best surgical preference for upper lip defect reconstruction? Review method: A systematic literature search based on clinical questions, inclusion, and exclusion criteria in the PubMed, ProQuest, EBSCO databases, Scopus and hand searching using keywords. Result: No eligible studies were pertinent to answer the clinical question. Conclusion: Reconstruction options of upper lip defect were based on thickness, size and the defect in the structure involved. The Abbe flap can be used to reconstruct the full thickness medial upper lip, one-third up to two-thirds of the defect area. Lateral defects and commissure involvement can be repaired by Estlander flap. ABSTRAKLatar belakang: Rekonstruksi defek bibir atas lebih sulit, karena dibentuk oleh dua subunit nasolabial lateral dan satu subunit filtrum. Pendekatan rekonstruksi yang paling efektif untuk kelainan bentuk bibir atas masih diperdebatkan. Tujuan: Untuk menyajikan kasus defek bibir atas, pilihan terapi untuk pasien ini dan meninjau pilihan metode operasi dengan jabir Abbe dan Jabir Estlander untuk rekonstruksi bibir atas. Laporan kasus: Seorang wanita 62 tahun dengan defek dua pertiga bibir atas dengan ketebalan penuh, yang direkonstruksi dengan jabir Abbe. Pertanyaan klinis: Apakah pilihan bedah rekonstruksi terbaik untuk defek bibir atas? Telaah literatur: Pencarian literatur sistematis berdasarkan pertanyaan klinis, kriteria inklusi dan eksklusi di database PubMed, ProQuest, EBSCO host dan pencarian tangan menggunakan kata kunci. Hasil: Tidak didapati studi yang memenuhi syarat untuk menjawab pertanyaan klinis. Kesimpulan: Pilihan rekonstruksi untuk defek bibir atas adalah berdasarkan ketebalan, luas, dan kecacatan pada struktur yang terlibat. Jabir Abbe dapat digunakan untuk rekonstruksi medial bibir atas dengan ketebalan penuh sepertiga hingga dua pertiga dari area defek. Defek lateral dan keterlibatan komisura dapat diperbaiki dengan jabir Estlander.

Eksisi Intralesi sebagai Strategi Tatalaksana Keloid: Laporan Kasus Berbasis Bukti Trmartani; Widodo, Dini Widiarni; Ranakusuma, Respati Wulansari; M, Mesiwisani; Putri, Annisa; Reksodiputro, Mirta Hediyati
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 1 (2024): VOLUME 54, NO. 1 JANUARY - JUNE 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i1.646

Background: Several therapeutic modalities exist for keloids, but management them remains a challenge due to high recurrence rates. These case series discussed surgical therapy using intralesional excision. Purpose: To compare the effect of intralesional excision with extra-lesional excision followed by post-operative triamcinolone injection, on the recurrence rates of auricular keloids. Case reports: Three patients with keloids treated with intralesional excision were presented. The first patient, a 20-year- old male, had keloids on both ears, nose, hands, and feet following burnt injury. The second patient, a 19-year-old female, had a keloid lump on the left auricle. The patient had a history of bilateral microtia and had undergone stage 1 auriculoplasty with rib grafting on both ears. The third patient, a 36-year-old woman with complaints of a keloid appearing for 3 years in the helix of her right ear, and underwent surgical excision followed by triamcinolone injection. Clinical question: How does the recurrence in patients with auricular keloid undergoing intralesional excision and postoperative triamcinolone injection, compared to extra-lesional excision and triamcinolone injection? Method: A systematic literature search was conducted using PubMed, Cochrane Library, Scopus, and ClinicalKey with relevant keywords: “intralesional excision”, AND “keloid”. Result: A total of 192 articles were found, and 3 articles met the eligibility criteria. Conclusion: The literature search revealed no difference in the recurrence rates between intralesional and extra-lesional excision with triamcinolone injection. Further research on this topic is needed. Keywords: intralesional excision, keloid, recurrence

The Auricular Elevation Stage in Microtia Reconstruction Widodo, Dini Widiarni; Trimartani, Trimartani; Shabrina, Febby; Ranakusuma, Respati Wulansari
eJournal Kedokteran Indonesia Vol. 12 No. 2 (2024): Vol. 12 No. 2 - Agustus 2024
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Microtia is a congenital hypoplastic malformation of the pinna that can cause hearing impairment, cosmetic, and psychosocial problems. The auricular elevation in stage two is one of the most challenging procedures of autologous ear reconstruction. This article aims to determine whether the use of posterosuperior auricular fascia flap (PSFF), temporoparietal fascia flap (TPF), or retroauricular fascia flap (RFF) in stage 2 auricle reconstruction. A literature search was conducted in public databases and registries (PubMed/Medline, EBSCOhost, ProQuest, CENTRAL, ICTRP, Clinicaltrial.gov). Patients with unilateral or bilateral microtia were included in this study. The validity rating was assessed using the guideline from CEBM Oxford University. All these studies were analyzed for the systematic review of outcome studies of each surgical technique. PSFF is superior by reducing surgical time compared to RFF (p<0.01) with less risk of scarring (p=0.03) and less incidence of partial skin graft necrosis (p= 0.01). RFF offered superior aesthetic results compared to TPF. PSFF is a preferable technique for stage two reconstruction surgery in congenital microtia due to its ease of use, shorter operating time, and reduced complications compared to RFF. RFF may still be considered for better aesthetic outcomes, while TPF can be a suitable option in challenging cases.

Title

Found 11 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 11 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 11 Documents
Search