Analisis dan Perkembangan Prinsip Teknik Rotasi pada Rekonstruksi Bibir Sumbing

(Cleft Lip) UnilateralJoshua C.Demke, Sherard A. Tatum

Oleh

◦ Annisa Muliasari (1102090011)◦ Pembimbing: dr.Rofin Syarifin

◦ Supervisor : dr. A. J. Rieuwpassa, Sp.B, Sp.BP-RE(K)Journal ReadingFebruari 2015

DIBUAT DALAM RANGKA TUGAS KEPANITERAAN KLINIKBAGIAN ILMU BEDAH FAKULTAS KEDOKTERAN

UNIVERSITAS HASANUDDINMAKASSAR

2015

Pendahuluan

Rekonstruksi bibir sumbing unilateral, selama seabad terakhir, telah menunjukkan adanya perubahan dan perbaikan dalam teknik pengerjaannya.

Kami meninjau perkembangan dari perbaikan bibir sumbing termasuk straight-line, geometric, dan rotasi/ jenis operasi yang lebih maju, namun tetap melihat dasar dari teknik rotasi dan bagaimana prinsip umum yang membedakan dari tiap teknik.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Anatomi

Teknik Rekonstruksi Bibir Sumbing Unilateral

Straight-line repairs

• Quadrangular flap• Triangle Flap

Teknik Geometrik

Rotation/advancement repairs

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Straight-line repairs

Gambar 1. Straigth-line dan teknik yang terkait : Gambar 1. (a) Rose (b) Chait (c) Pfeifer (d) Nakajima (e)Delaire

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Straight-line repairs

Teknik Straight-line repairs menunjukkan prinsip umum dari insisi curvilinear sehingga dapat dilakukan rotasi dan menambah panjang bibir dengan hasil insisi straight-line atau near vertical.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Teknik Geometrik

Gambar 2. Teknik Geometrik: (a) Le Mesurier (b)Tennison (c) Trauner

(d) Song I (e) Fernandes Z-plasty.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Teknik Geometrik

Flap dengan desain secara geometrik merupakan teknik yang umum untuk rekonstruksi bibir sumbing, secara umum sebuah teknik operasi dikatakan sebagai teknik geometrik ketika bekas luka akhir menandai kolumna vertical dari philtrum dengan bentuk zigzag.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Rotation/advancement repairs

Gambar3. Rotation/Advancement techniques: (a) Millard (b)Mohler (c) Tatum (d) Fisher (e) Song II

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Rotation/advancement repairs

• Tekhnik ini berasal dari desain insisi yang memungkinkan dilakuan rotasi tapi juga meminimalkan gangguan subunit estetika.

• Fakta 46% dari dokter bedah Amerika Utara menggunakan teknik rotasi Millard tanpa modifikasi untuk rekonstruksi bibir sumbing unilateral dan 38% dengan tambahan berbagai variasi.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

Kesimpulan

• Artikel ini meninjau perkembangan rekonstruksi bibir sumbing unilateral dengan penekanan khusus pada teknik yang memungkinkan untuk rotasi dan meningkatkan penyatuan medial cleft.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

• Merancang flap untuk mencapai rotasi yang diinginkan, dan mengoptimalisasi lebar bibir vertical dan horizontal dan meminimalisasi kerusakan philtrum dan mempertahankan estetika hidung.

Joshua C.Demke, Sherard A. TatumFacial Plastic and Reconstructive Surgery Division of Otolaryngology, Department of Surgery, Texas Tech University, School of Medicine, USADivision of Facial Plastic and Reconstructive Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

TERIMA KASIH