Penatalaksanaan Repair Palatoplasty dengan Teknik Furlow Double Opposing Z Plasty
Pingky Krisna Arindra(1*), Prihartiningsih Prihartiningsih(2), Bambang Dwi Rahardjo(3)
(1) Program Studi Bedah Mulut dan Maksilofasial, Program Pendidikan Dokter Gigi Spesialis, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Bagian Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Gadjah Mada dan anggota Staf Medik Fungsional RSUP Dr. Sardjito, Yogyakarta, Indonesia
(3) Bagian Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Gadjah Mada dan anggota Staf Medik Fungsional RSUP Dr. Sardjito, Yogyakarta, Indonesia
(*) Corresponding Author
Abstract
Kasus bibir dan lelangit sumbing merupakan salah satu kelainan deformitas yang sering terjadi. Keadaan klinis bervariasi mulai dari kasus sumbing tidak komplit sampai dengan komplit. Keadaan klinis dengan lebar celah yang bervariasi membutuhkan teknik pembedahan yang tepat. Pasien-pasien dengan bibir dan atau lelangit sumbing mungkin
sebelumnya telah menjalani beberapa intervensi pembedahan, sehingga sering memerlukan koreksi lebih lanjut untuk memperbaiki hasil operasi sebelumnya. Pasien anak laki-laki usia 4 tahun 7 bulan mengeluhkan masih terdapatnya celah di lelangit. Pasien didiagnosis dengan labiognatopalatoschisis bilateral. Sebelumnya pasein sudah menjalani 4 kali operasi penutupan celah bibir dan lelangit. Pasien menjalani 2 kali operasi bibir sumbing dengan metode lip adhesion dan metode Barsky, dan 2 kali operasi lelangit sumbing dengan metode pushback dilanjutkan dengan koreksi dengan z plasty, tetapi hasil akhir masih terdapat celah di palatum mole. Selanjutnya dilakukan operasi repair palatoplasi dengan
metode Furlow double opposing z plasty dengan kombinasi insisi lateral, dan didapatkan hasil menutupnya celah di palatum mole sampai dengan uvula. Telah dilakukan operasi repair palatoplasi dengan metode Furlow double opposing z plasty. Teknik ini dilakukan untuk menghindari insisi yang terlalu luas dikarenakan terdapatnya jaringan fibrous yang tebal pada mukosa palatum pasca operasi sebelumnya. Tujuan studi kasus adalah untuk mengetahui kemampuan teknik Furlow Double Opposing Z Plasty sebagai prosedur repair palatoplasty.
Repair Palatoplasty Management with Furlow Double Opposing Z Plasty Technique. Cases of cleft lip and palate are one of the deformity disorders that often occur. There are variety of clinical appearance ranging from incomplete to complete cases. Clinical appearance with different width requires proper surgical technique. Patients with cleft lip and palate had undergone surgical intervention, so that they needed surgical correction to repair the result or failure of the previous surgery. A Four year old boy complain there was cleft on the soft palate. The patient was diagnosed with labiognatopalatoscisis. The patient had undergone two stages of cleft lip surgery and twice of cleft palate surgery with pushback method and repair with z plasty, however the result was unsatisfactory. Further, the patient underwent repair palatoplasty surgery with Furlow double opposing z plasty method combined with lateral relaxing insicion. The result in the post surgery was the closure of cleft soft palate up to uvula. Repair palataplasty surgery has been done with Furlow double opposing z plasty method. This technique could avoid extended incision due to thick fibrous tissue on the palatum mucosa as the result of serial previous surgery. The aim of this case case study is to determine the technical capabilities of Furlow Double Opposing Z Plasty as palatoplasty repair procedure.
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DOI: https://doi.org/10.22146/majkedgiind.8856
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