Penatalaksanaan emergensi pada trauma oromaksilofasial disertai fraktur basis kranii anterior

https://doi.org/10.22146/majkedgiind.12606

Agus Dwi Sastrawan(1*), Endang Sjamsudin(2), Ahmad Faried(3)

(1) Program Pendidikan Dokter Gigi Spesialis Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Padjadjaran, Bandung, Jawa Barat
(2) Departemen Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Padjadjaran, Bandung, Jawa Barat
(3) Departemen Bedah Saraf, Fakultas Kedokteran, Universitas Padjadjaran, Bandung, Jawa Barat
(*) Corresponding Author

Abstract


Emergency management of oromaxillofacial trauma with anterior cranial base fracture. Oromaxillofacial trauma with cranial base fracture is a case that is quite commonly found in the ER of Oral and Maxillofacial Surgery Department at Dr. Hasan Sadikin General Hospital Bandung. Emergency management aims to take any appropriate action, prevent complications, and consult to other departments involved. A man aged 28 years came with bleeding from the mouth due to a motorcycle accident approximately 6 hours before admission to the hospital. Physical examination showed facial asymmetry, bilateral periorbital edema and hematoma, rhinorrhea, and stitches in labiomental area. Intraoral examination showed maxillary, palatal, parasymphisis, dentoalveolar fractures, lacerated wound on the upper lip, lower lip, palate, gingival, difficulty in opening the mouth, and malocclusion of the teeth. Immediate and rapid surgical and maxillofacial surgical emergency was performed with minimal maxillary intervention, aiming to prevent persistent spontaneous cerebrospinal fluid leak, and prevent infection. The management of soft tissue and hard tissue injury is by reduction, fixation and immobilization of fractures, management of pain and administration of antibiotics. In conclusion, the emergency management of oromaxillofacial trauma with cranial base fracture is promptly and rapidly carried out with minimal intervention.


ABSTRAK

Trauma oromaksilofasial disertai fraktur basis kranii merupakan kasus yang cukup banyak ditemukan di Instalasi Gawat Darurat Bedah Mulut dan Maksilofasial RSUP Dr. Hasan Sadikin Bandung. Penatalaksanaan emergensi bertujuan untuk melakukan tindakan yang tepat, mencegah komplikasi, serta konsultasi kepada bagian lain yang terkait. Seorang laki- laki usia 28 tahun datang dengan keluhan perdarahan dari mulut akibat kecelakaan motor kurang lebih 6 jam sebelum masuk rumah sakit. Pemeriksaan fisik ditemukan wajah asimetris, edema dan hematoma pada regio periorbita bilateral, terdapat rhinorrhea, serta bekas jahitan pada regio labiomental. Pemeriksaan intra oral tampak fraktur pada daerah maksila, palatum, parasimfisis, fraktur dentoalveolar, vulnus laserasi pada bibir atas, bibir bawah, palatum, gingiva, kesulitan membuka mulut, dan maloklusi gigi geligi. Tindakan emergensi bedah mulut dan maksilofasial dilakukan segera dan cepat dengan minimal intervensi pada rahang atas bertujuan untuk mencegah kebocoran cairan serebro spinal persisten, dan mencegah terjadinya infeksi. Manajemen luka jaringan lunak dan jaringan keras, melakukan reduksi, fiksasi dan imobilisasi fraktur, manajemen nyeri serta pemberian antibiotik. Penatalaksanaan emergensi pada trauma oromaksilofasial disertai fraktur basis kranii dilakukan segera dan cepat dengan minimal intervensi.



Keywords


cranial base; fracture; management; oromaxillofacial

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DOI: https://doi.org/10.22146/majkedgiind.12606

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