Publications by authors named "Yunia Irawati"

6 Publications

  • Page 1 of 1

Evaluation of 3 and 2-point internal fixation in the management of zygomaticomaxillary complex fractures: Case report.

Ann Med Surg (Lond) 2021 Jul 3;67:102539. Epub 2021 Jul 3.

Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Introduction: The ZMC has a prominent shape compared to other parts in the midfacial region, thus small injuries will generate fractures in the ZMC. The management of ZMC fracture depends on the fracture deformity and the surgeon's considerations. Various studies have revealed the success of ZMC reconstruction with one fixation point to 4 fixation points fitting to the tetrapod shape.

Case Report: We report two cases of ZMC fractures which comparing the efficacy of 3- and 2-point internal fixations for improving clinical outcomes The first patient underwent ORIF which placed at 2 fixation points, the first point in the left ZF suture and the second point in the left ZMB. The second patient underwent ORIF reconstruction at 3 fixation points, the first point in the right inferior orbital rim, the second point in the right ZF suture, and the third point in the right ZMB.

Discussion: The most common surgical approach for ZMC fractures is through a gingivobuccal groin incision. This approach is for body exposure of the ZMB, which is the main buttress. The 3-point internal fixation improved the postoperative clinical outcome of fracture fragment stability compared to two-point fixation, but the mean malar height projection, vertical dystopia, and enophthalmos were not different between the two fixation methods

Conclusion: Three-point internal fixation can improve the clinical outcome of fracture fragment stability compared to 2-point fixation; however, it has a mean operative duration 22.2 minutes longer than 2-point fixation, so its application must be considered during the COVID-19 pandemic.
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http://dx.doi.org/10.1016/j.amsu.2021.102539DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271108PMC
July 2021

Spontaneous Retrobulbar Hemorrhage in a Previously Healthy Infant.

J Pediatr Hematol Oncol 2021 May 31. Epub 2021 May 31.

Department of Ophthalmology, Division of Plastic and Reconstructive Surgery Department of Ophthalmology, Division of Pediatric and Strabismus Department of Child Health, Division of Pediatric Hematology-Oncology Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Dr Cipto Mangunkusumo Hospital Department of Ophthalmology, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Spontaneous retrobulbar hemorrhage is a rare yet vision-threatening condition. We reported a 5-month-old male infant with sudden onset of left eye proptosis with no prior history of getting vitamin K injection after birth. Head computed tomography scan revealed retrobulbar and intracranial hemorrhages. Laboratory results showed anemia, prolonged prothrombin and activated partial thromboplastin time, supporting the diagnosis of vitamin K deficiency bleeding. After the bleeding and clotting profile were stabilized, lateral canthotomy and cantholysis; and drainage following orbital decompression were successfully performed, yielded in a completely resolved proptosis. The right timing for surgery with the goal of releasing intraorbital pressure represent the merit of this paper. Our case also led to a crucial emphasis on vitamin K prophylaxis at birth.
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http://dx.doi.org/10.1097/MPH.0000000000002218DOI Listing
May 2021

A case report of reconstruction of ocular and complete upper eyelid avulsion with severe facial soft tissue injuries using anterolateral thigh free flap.

Int J Surg Case Rep 2021 May 1;82:105856. Epub 2021 Apr 1.

Reconstructive Microsurgery Section, Division of Plastic Surgery, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.

Introduction And Importance: Ocular injury is second mostly caused by motor vehicle accident (MVA) and often leads to severe ocular injury even to visual loss and various aesthetic problems. The outcome is determined by the magnitude of the initial damage and treatment availability. Treating ocular and facial injury due to MVA is challenging given the scope of the damage and may result in various outcomes.

Case Presentation: This case presented a 22-years old woman with a history of car accident assessed with total upper eyelid avulsion with corneal perforation and involvement of multiple facial fractures on the left side. The visual function is irreparable due to the extensive corneal defect from exposure and secondary infection, and possible optic nerve damage.

Clinical Discussion: This case presented a complete upper eyelid avulsion with severe facial tissue injury. Therefore, the reconstructive procedure main objectives are to maintain appropriate prosthetic position and to improve cosmetic function. This case used anterolateral thigh free flap as the reconstructive surgery method because it is convenient for large defects and the donor scar is not visible. After completing the surgery and several follow-up procedures, the patient recovered without any significant complications.

Conclusion: Despite visual loss due to the extent damage of the eye, it is important to restore the facial damages. Visual function is as crucial as cosmetic function in determining the patient's quality of life.
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http://dx.doi.org/10.1016/j.ijscr.2021.105856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056434PMC
May 2021

Multiple Approaches for Managing Complex Ophthalmic Blunt Trauma: A Case Report.

Int Med Case Rep J 2021 31;14:205-210. Epub 2021 Mar 31.

Division of Plastic Reconstruction, Department of Ear, Nose and Throat, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Introduction: Ophthalmic trauma is defined as injuries affecting the ocular structures, including the globe, eyelid, lacrimal system, and surrounding orbital walls. Blunt trauma acts as the leading cause of injury and it may affect both the anterior and posterior parts of the globe. Prompt diagnosis, early management, and sustained follow-up are mandatory for an optimal outcome.

Purpose: This report presents a one-step surgery management process for an intricate case of blunt facial trauma with complex ophthalmic and nasal injury.

Patients And Methods: A 45-year-old male with blunt force trauma of the left eye from a wooden block, suffered from naso-orbital-ethmoidal fractures, eyelid laceration with canalicular, close-globe injuries of traumatic cataract and vitreous hemorrhage with retinal detachment. A simultaneous one-step surgery was performed by a trauma team of ophthalmological and ENT surgeons during the height of the COVID-19 pandemic to lessen the risk of cross-transmission. After ruling out the possibility of open-globe rupture, traumatic cataract extraction, retinal detachment surgery, the repair of an eyelid laceration with canalicular involvement, and septorhinoplasty were performed on concomitantly.

Results: Anatomical success was achieved for the repair of the nasoorbitoethmoidal (NOE) type II fracture and close-globe injuries, including the anatomical reattachment of the retina. However, the functional outcome remained unsatisfactory. Visual acuity failed to show further improvement at a later follow-up. Traumatic optic neuropathy was, at the final follow-up, considered to be the cause of the suboptimal visual acuity.

Conclusion: A single-step multi-procedure for a complex ophthalmic blunt trauma, as demonstrated in this case, may be beneficial for reducing the complications that might arise due to treatment delay. The complex nature of the injury, however, creates the higher possibility for residual post-operative complications. Risks of residual functional impairment should be considered in such complex trauma prior to surgery, to determine the surgical prognostic value and provide appropriate consent to the patient.
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http://dx.doi.org/10.2147/IMCRJ.S304193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020129PMC
March 2021

Orbital Compressed Air and Diesel Explosion Injury Resembling Orbital Cellulitis: An Unusual Case.

Am J Case Rep 2021 Feb 21;22:e929671. Epub 2021 Feb 21.

Research Assistant, Department of Ophthalmology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

BACKGROUND In this observational case report, we describe a case of orbital cellulitis caused by blunt trauma from an orbital compressed air and diesel explosion injury. CASE REPORT A 44-year-old man presented to our emergency department with a marked clinical worsening of right upper eyelid swelling, accompanied by pain, fever, and redness. Four days prior, the patient's right eye was struck by a pressurized diesel engine explosion. He sought treatment at another hospital, where an initial examination was conducted and a small laceration was found and immediately treated with irrigation and medication. The wound became progressively worse, and on examination at our hospital, we diagnosed orbital cellulitis, multiple abscesses, and pneumo-orbital formations. There was no indication of infection from the ears, nose, throat, and oral cavity, which usually causes orbital cellulitis. Drainage, debridement, incision, and necrotomy with orbital decompression (canthotomy and cantholysis procedure) was then performed on the patient. CONCLUSIONS Diesel explosion injury can cause orbital cellulitis which can appear to be a simple case at first but has a poor prognosis. Therefore, evaluating the patient's trauma history, computed tomography scan, and histopathological examination are essential in establishing the diagnosis. As early as possible, a diagnosis should be made to prevent tissue damage due to inflammation. Surgical debridement and the administration of a corticosteroid and antibiotic were key to managing the presented case.
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http://dx.doi.org/10.12659/AJCR.929671DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7904534PMC
February 2021

Successful management of bilateral periorbital necrotising fasciitis with ocular involvement.

BMJ Case Rep 2018 Mar 15;2018. Epub 2018 Mar 15.

RSCM, Jakarta, Indonesia.

A 4-year-old girl had suffered from multiple pustules and severely swollen eyelids for a week which led to difficulties in opening her eyes. The pustules burst 2 days prior to admission, causing blood and pus to come out. As a result, the evaluation of eye movement, visual acuity and intraocular pressure was hindered. Eyelids were spasming, hyperaemic, warm and of soft consistency on palpation. Crust and necrotic tissues were also observed. The patient had a history of fever with cough and nasal congestion. CT scan revealed soft tissue thickening on bilateral anterolateral periorbital region. She also underwent debridement in both eyelids, followed by partial periosteal graft on the left eye due to corneal perforation. During follow-up after 1.5 months, she also underwent excision of the periosteal graft and synechiolysis, followed by cataract extraction of the left eye.
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http://dx.doi.org/10.1136/bcr-2017-223457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878336PMC
March 2018
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