Makalah Bedah Mulut IV Labioplasty

MAKALAH BEDAH MULUT IV MAKALAH BEDAH MULUT IV

 LABIOSCHISIS

 LABIOSCHISIS DAN

DAN LABIOPLASTY 

 LABIOPLASTY 

Disusun Oleh : KELOMPOK 1

Disusun Oleh : KELOMPOK 1 (GENAP)(GENAP)

FAKUL

FAKULTTAS KEDOKTERAS KEDOKTERAN AN GIGIGIGI UNIVERSITAS GADJAH MADA UNIVERSITAS GADJAH MADA

OGAKARTA OGAKARTA

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KATA PENGANTAR  KATA PENGANTAR 

Se'%l% 3u?i %$i 3%n?%%n eh%4i&% Tuh%n ME 5%n' el%h $e$>e&i%n Se'%l% 3u?i %$i 3%n?%%n eh%4i&% Tuh%n ME 5%n' el%h $e$>e&i%n &%h$% 4%n hi4%5%hBN5% sehin''% %$i 4%3% $en5eles%i%n $%%l%h

&%h$% 4%n hi4%5%hBN5% sehin''% %$i 4%3% $en5eles%i%n $%%l%h Labochisis Labochisis 4%n 4%n  Labioplasty

 Labioplasty $%%  $%% uli%uli%h 0e4%h h 0e4%h Mulu IV ini 4en'%n >%i sesu%i 4en'%n 2%u 5%n'Mulu IV ini 4en'%n >%i sesu%i 4en'%n 2%u 5%n' el%h 4ienu%n

el%h 4ienu%n Se$

Se$7'% 7'% u'u'%s %s ini 4%3% ini 4%3% >e&>e&$%n$%n8%%8%%  >%'>%'i i ii% % se$se$u% u% 4%n 4%n 4en'4en'%n %n %4%%4%n5%n5%  3en5usun%n

 3en5usun%n u'%s u'%s ini ini 4%3% 4%3% e&@%%% e&@%%% 4en'%n 4en'%n &%3i &%3i Sehin''% Sehin''% 4%3% 4%3% i% i% 3el%?%&i3el%?%&i e$>%li 4i ese$3%%n 5%n' l%in unu e3enin'%n 3&7ses >el%?%& i%C e&u%$% e$>%li 4i ese$3%%n 5%n' l%in unu e3enin'%n 3&7ses >el%?%& i%C e&u%$% 4%l%$ >i4%n' 0e4%h Mulu

4%l%$ >i4%n' 0e4%h Mulu

D%l%$ 3en5usun%n u'%s ini enu ?%uh 4%&i se$3u&n%C 7leh %&en% iu se'%l% D%l%$ 3en5usun%n u'%s ini enu ?%uh 4%&i se$3u&n%C 7leh %&en% iu se'%l% &ii

&ii  4%n s%&%n 4%n s%&%n s%n'% %$i h%&%3%n 4e$i 3e&>%i%n 4%n s%n'% %$i h%&%3%n 4e$i 3e&>%i%n 4%n 3en5e$3en5e$3u&n%%n u'%s ini3u&n%%n u'%s ini 4%n unu 3el%?%&%n >%'i i% se$u% 4%l%$ 3e$>u%%n u'%sBu'%s 5%n' l%in

4%n unu 3el%?%&%n >%'i i% se$u% 4%l%$ 3e$>u%%n u'%sBu'%s 5%n' l%in

7

7'5%%&%C - N7;e$>e& '5%%&%C - N7;e$>e& !"1#!"1# Pen5usun

BAB I

PENDAHULUAN A. Latar Belakang

Cleft $e&u3%%n su%u el%in%n 7n'eni%l 5%n' 4i%n4%i 4en'%n %4%n5% &u%n' %%u @el%h 3%4% >i>i& %%sC %l;e7lusC %%u 3%l%u$ Isil%h l%in 5%n' se&in' 4i'un%%n i%l%h cleft lipC cleft palateC 4%n cleft lip and palate.Cleft  4ie$u%n 3%4% u&%n' le>ih 1 4%&i /," el%in%nC 4%&i ?u$l%h e&se>u 1"B+" h%n5% $en'en%i  >i>i&C +#B## $en'en%i >i>i& 4%n 3%l%u$C se&% +"B-# e&>%%s 3%4%  3%l%u$ s%?%Cleft lip $e&u3%%n el%in%n 7n'eni%l 5%n' se&in' e&?%4i %&en% i4% %4%n5% 3en5%u%n se@%&% n7&$%l 4%&i >i>i& 3%4% 3&7ses e$>&i7n%l 5%n' 4%3% e&?%4i se>%'i%n %%u se$3u&n% 3%4% s%u sisi %%u 4u% sisi P&7ses e&>enun5% el%in%n ini 4i$ul%i se?% $in''uB$in''u %2%l eh%$il%n i>u Pen5e>%> 4%&i el%in%n e&se>u 5%iu 4%3% >e&u3% 7$>in%si %n%&% 8%7& 'enei 4%n 8%7&  lin'un'%nC se3e&i 7>%B7>%%nC 3en5%iC %%u in8esi 5%n' 4i4e&i% i>u s%% $en'%n4un'C 7nsu$si $inu$%n >e&%l7h7l %%u $e&77 s%% eh%$il%n Keu&%n'%n %s%$ 87l% ?u'% 4%3% $e$i@u el%in%n ini Kel%in%n ini le>ih >%n5%  4ie$u%n 3%4% 3&i% 4en'%n &%si7 !:1 Ge?%l% u%$% 4%&i @el%h >i>i& 5%iu %4%n5%  3e$>u%%n 5%n' e&lih% 3%4% >i>i& Ai>% 4%&i @el%h >i>i& 4%3% 4ie$ui 3%4% $%s%l%h $en5usuiC >e&>i@%&%C 4%n 'i'i 5%n' hil%n' e&u%$% ei% >i>i& su$>in' $elu%s e 4%e&%h 'usi >%'i%n %%s  Cleft lip 4%3% 4i7&esi 4en'%n labioplasty 5%n' $e&u3%%n in4%%n 3e$>e4%h%n unu $enuu3 @el%h 3%4% >i>i& Re7ns&usi 4%&i @el%h >i>i& e&se>u 4ih%&%3%n 4%3% $en'e$>%li%n >enu%n %7$i 5%n' sen7&$%l $un'in

B. Rumusan Masalah

1 A3% 5%n' 4i$%su4 4en'%n labioschisis ! A3%%h ei7l7'i 4%&i labioschisis

+ 0%'%i$%n% 3%78isil7'i labioschisis 4. A3%s%?% l%si8i%si labioschisis? # A3%s%?% 7$3li%si labioschisis? / 0%'%i$%n% 3e&%2%%n labioschisis

6 0%'%i$%n% follow up 3%sien 3%s@% 3e&%2%%n labioplasty

C. Tuuan

1 Unu $en'e%hui 3en'e&i%n 4%&i labioschisis ! Unu $en'e%hui ei7l7'i 4%&i labioschisis + Unu $en'e%hui 3%78isil7'i labioschisis 4. Unu $en'e%hui l%si8i%si labioschisis # Unu $en'e%hui 7$3li%si labioschisis / Unu $en'e%hui 3e&%2%%n labioschisis

BAB II PEMBAHA!AN A. Pengert"an

 Labioschisis %%u >i>i& su$>in' %4%l%h su%u el%in%n >%2%%n 5%n' e&?%4i  3%4% >i>i& 5%n' 4%3% 4ise&%i el%in%n 3%4% l%n'iBl%n'i %i>% '%n''u%n 3%4%  3e&u$>uh%n 2%?%h se?% e$>&i7 u$u& $in''u ee$3% Su$>in' %4%l%h 7n4isi

e&>el%h 3%4% >i>i& 5%n' 4%3% s%$3%i 3%4% l%n'iBl%n'i (L7h7C!"1+)

0i>i& su$>in' %4%l%h s%l%h s%u @%@% l%hi& 5%n' 3%lin' >%n5% 4i?u$3%i 4i 4uni% ini Insi4en  Labioschisis %%u >i>i& su$>in' se>%n5% !C1 4%l%$ 1""" el%hi&%n 3%4% enis %si%C 1:1""" 3%4% enis K%u%si%C 4%n "C-1:1""" 3%4% enis A8&i%BA$e&i% Insi4en e&in''i e&4%3% 3%4% 7&%n' Asi% 4%n e&en4%h 3%4% uli hi%$ Labioschisis le>ih se&in' e&?%4i 3%4% l%iBl%i (L7h7C!"1+)

B. Et"#l#g"

 Labiochisis e&?%4i %&en% e'%'%l%n 3e&e$>%n'%n 4%n 3en5%u%n  3&7@essus 8&7n7n%s%l 4%n 3&7@essus $%il%&is De8e ini >is% >e&si8% unil%e&%l

$%u3un >il%e&%l (Ah$%4C !"1+) Ei7l7'i labiochisis s%n'% 7$3lesC e>%n5%%n >e&si8% $uli8%7&i%l  Labiochisis 4%3% e&?%4i %&en% >e>e&%3% 8%7&C 5%ni 8%7& 'enei 4%n 8%7& lin'un'%nC se&% ine&%si %n%&% e4u% 8%7& e&se>u (An4e&ss7n 4C !"1")

1 F%7& 'enei 4ise>%>%n 7leh $u%si >%n5% 'en Genei $en?%4i 7$37nen 5%n' 3enin' 4%&i l%>i7@hisis 4%n 8%7& 5%n' e&3enin' >e&%s%l 4%&i family history F%7& 'enei $e$3en'%&uhi labiochisis se>%n5% !! (Ah$%4C !"1+ L7h7C !"1+) Menu&u An4e&s7n 4 (!"1") 4%n =7ulh%&4 4 (!""+)C 8%7& 'enei 5%n' e&li>% %4%l%h se>%'%i >e&iu :

% K&7$7s7$ 1C !C -C /C 11C 1-C16 4%n 1. 4ie%hui >e&3e&%n 3%4% e&?%4in5% labiochisis n7n sin4&7$i 

 > Mu%si 3%4% 'en IRF/ 4%n MSB1 ?u'% >e&3e&%n 3%4% l%>i7@hisis n7nB sin4&7$i

@ Mu%si 'en T0!!C FGFR1C %n4 P/+ >e&3e&%n 3%4% l%>i7@hisis sin4&7$i 4 =el%h 7&78%si%l le>ih se&in' e&?%4i 3%4% &%s $7n'7l7i4 4%&i3%4% ne'&7 ! F%7& lin'un'%n $e$3en'%&uhi labiochisis se>%n5% 6, F%7& 

lin'un'%n $e&u3%%n 8%7&B8%7& 5%n' $e$3en'%&uhi ei% 3&7ses eh%$il%n (L7h7C !"1+) Menu&u An4e&s7n 4 (!"1") 4%n =7ulh%&4 4  (!""+)C 8%7& lin'un'%n 5%n' e&li>% %4%l%h se>%'%i >e&iu :

% Ke>i%s%%n $e&77 4%n $en'7nsu$si %l7h7l 3%4% $%s% eh%$il%n  > De8isiensi %s%$ 87l% ei% $%s% 3e&i7nse3si

@ Pen''un%%n 7>%B7>%%n ?enis &ein7i4C 7&i7se&7i4 4%n %ni7n;uls%n (8eni7in 4%n %s%$ ;%l3&7%)

4 K7nsu$si 7>%B7>%%n 5%n' >e&si8% e&%7'en se$%s% eh%$il%nC se3e&i %se7s%l %%u %s3i&in

e Ke%4%%n 4i%>ees 4%n 7>esi%s 3%4% $%s% eh%$il%n ?u'% 4i%i%n 4en'%n e&?%4in5% @el%h 7&78%si%l

8 0e>e&%3% 3enelii%n ?u'% $en'%i%n hu>un'%n %n%&% in8esi ;i&us &u>ell% 4%n ;%&i@ell% 4en'%n e%4%%n @el%h 7&78%si%l

' Kele>ih%n ;i%$in A 3%4% $%s% eh%$il%n ?u'% 4i%i%n 4en'%n e&?%4in5% @el%h 7&78%si%l

+ 0e>e&%3% 8%7& 5%n' $e$3en'%&uhi l%>i7@hisis se3e&i 'e7'&%8iC &%sC ?enis el%$inC 4%n >u4%5% $e&u3%%n 8%7& 47$in%n 3%4% 3&7ses 3en5%i %%u %n7$%li sel%$% 8%se e$>&i7l7'i (L7h7C !"1+)

C. Pat#$"s"#l#g"

Se@%&% u$u$C labioschisis >is% e&?%4i %&en% :

1 Ke'%'%l%n 3en5%u%n %%u 3e&e$>%n'%n ?%&in'%n lun% 4%n %%u ul%n' sel%$% 8%se e$>&i7 3%4% &i$ese& I

! Te&>el%hn5% >i>i& 4%n %%u hi4un' %&en% e'%'%l%n 3&7ses n7s%l $e4i%l 4%n $%sil%&is unu $en5%u e&?%4i sel%$% eh%$il%n /B, $in''u

+ P%l%7sisis %4%l%h %4%n5% @el%h 3%4% '%&is en'%h 3%l%7 5%n' 4ise>%>%n 7leh e'%'%l%n 3en5%u%n susun%n 3%l%7 3%4% $%s% eh%$il%n 6B1! $in''u - Pen''%>un'%n 7$3li '%&is en'%h %%s >i>i& %n%&% 6B, $in''u $%s%

eh%$il%n

Pen5e>%> e&?%4in5% labioschisis >elu$ 4ie%hui 4en'%n 3%si Ke>%n5%%n il$u2%n >e&3en4%3% >%h2% labioschisis $un@ul se>%'%i %i>% 4%&i 7$>in%si 8%7& 'enei 4%n 8%@7&B8%7& lin'un'%n Di A$e&i% Se&i% 4%n >%'i%n >%&% E&73%C 3%&% 3enelii $el%37&%n >%h2% -" 7&%n' 5%n' $e$3un5%i &i2%5% elu%&'% labioschisis %%n $en'%l%$i labioschisis

Ke$un'in%n se7&%n' >%5i 4il%hi&%n 4en'%n labioschisis  $enin'% >il% eu&un%n '%&is 3e&%$% (i>uC %5%hC s%u4%&% %n4un') $e$3un5%i &i2%5% labioschisis I>u 5%n' $en'7nsu$si %l7h7l 4%n n%&7i%C eu&%n'%n ;i%$in (e&u%$% %s%$ 87l%) sel%$% &i$ese& 3e&%$% eh%$il%nC %%u $en4e&i% 4i%>ees %%n le>ih @en4e&un' $el%hi&%n >%5i* %n% 4en'%n labioschisis

1 Insu8isiensi <% unu u$>uh e$>%n' 7&'%n sel%$% $%s% e$>&i7n%l 4%l%$ h%l u%ni%s (3%4% '%n''u%n si&ul%si 8e7B$%e&n%l) 4%n u%li%s (4e8isiensi %s%$ 87l%C ;i%$in =C 4%n n)

! Pen''un%%n 7>% e&%7l7'iC e&$%su ?%$u 4%n 7n&%se3si h7&$7n%l + In8esiC e&u%$% 3%4% in8esi 773l%s$% 4%n l%$i4i%

- F%7& 'enei

Kel%in%n ini e&?%4i 3%4% &i$ese& 3e&%$% eh%$il%nC 3&7sesn5% %&en% i4% e&>enun5% $es74e&$ 3%4% 4%e&%h e&se>u sehin''% >%'i%n 5%n' el%h $en5%u (3&7sesus n%s%lis 4%n $%sil%&is) 3e@%h e$>%li

P%4% he2%n 3e&@7>%%n ;i%$in A 4ien%l se>%'%i e&%7'en uni;e&s%l  N%$un e$un'in%n e&%7'eni%s 3%4% $%nusi% 5%n' $en'7nsu$si su3le$en

;i%$in A $%sih 7n&7;e&si

Vi%$in 0B/ $e$ilii 3e&%n ;i%l 4%l%$ $e%>7lis$e %s%$ %$in7 De8isiensi ;i%$in 0B/ un''%l el%h e&>ui 4%3% $en5e>%>%n l%n'iBl%n'i $ulu su$>in' 4%n el%in%n 4e8e l%hi7& l%inn5% 3%4% ius 3e&@7>%%n

D. Klas"$"kas"

1 =el%h S%u Sisi %%u Unilateral Cleft Lips  %%u  Labioschisis Unilateral C ini 4i>%'i l%'i $en?%4i :

a. =el%h S%u Sisi Len'%3 %%u Complete Unilateral Cleft   %%u Labioschisis Unilateral Complete.

 > =el%h S%u Sisi Ti4% Len'%3 %%u Incomplete Unilateral Cleft Lips  %%u  Labischisis Unilateral Incomplete

! =el%h Du% Sisi %%u Bilateral Cleft Lips %%u L%>i7s@hisis 0il%e&%lC ini 4i>%'i $en?%4i:

% =el%h 4u% sisi len'%3 %%u @7$3lee >il%e&%l @7$3lee %%u l%>i7s@hisis  >il%e&%l @7$3lee

 > =el%h 4u% sisi i4% len'%3 %%u in@7$3lee >il%e&%l @le8 li3 %%u L%>i7s@hisis 0il%e&%l In@7$3lee

@ =el%h 4u% sisi 4en'%n s%u sisi len'%3 sisi 5%n' l%in i4% len'%3

E. K#m%l"kas"

1 Kesuli%n $%%nC 4i%l%$i 3%4% 3en4e&i% >i>i& su$>inn' 4%n ?i% 4iiui 4en'%n @el%h 3%l%u$

! In8esi Telin'% 4i%&en%%n i4% >e&8un'si 4en'%n >%i s%lu&%n 5%n' $en'hu>un'%n elin'% en'%h 4en'%n e&7n'7n'%nC 4%n ?i% i4% se'e&% 4i%%si $%% %%n ehil%n'%n 3en4en'%&%n

+ Kesuli%n >e&>i@%&% O7B77 unu >e&>i@%&% $en'%l%$i el%in%n 8un'si %&en% %4%n5% @el%h H%l ini ?u'% 4%3% $en''%n''u 37l% >e&>i@%&% >%h%n 4%3% $en'h%$>%n5%

- M%s%l%h 'i'i P%4% @el%h >i>i& 'i'i u$>uh i4% n7&$%l %%u >%h%n i4%  u$>uh sehin''% 3e&lu 3e&%2%%n 4%n 3en%n'%n%n husus An% 5%n' l%hi&  4en'%n labioschisis  4%n labiopalatoschisis $un'in $e$3un5%i $%s%l%h e&enu 5%n' >e&hu>un'%n 4en'%n ehil%n'%nC $%l87&$%siC 4%n $%l37sisi 4%&i 'i'i 'eli'i 3%4% %&e% 4%&i @el%h >i>i& 5%n' e&>enu (De2i 4%n N%nn5C !"1")

 Labioplasty  %%u cheiloraphy  %%u cheiloplasty  $e&u3%%n su%u in4%%n  >e4%h unu $e$3e&>%ii el%in%n >i>i& 7n'eni%l (>i>i& su$>in') %%u %&en%

&%u$% (H%&5 4C !"1!)

Cheilorrhaphy $e&u3%%n su%u in4%%n >e4%h 7&ei8 4%&i el%in%n  >enu @el%h >i>i& Isil%h ini >e&%s%l 4%&i cheiloC lipC 4%n raphy, 4is%u%n 4en'%n

4ile$%%u 4i?%hi Tin4%%n >e4%h ini se&in' 4i?%4i%n se>%'%i 3&7se4u& %2%l unu $e$3e&>%ii el%in%n ini 4%n 4il%u%n se'e&% $un'in ei% el%in%n ini 4ie$u%n (Pee&s7n 4C !""+)

1 Pe&%2%%n L%>i7s@hisis 3%4% 0%5i

Pen%%l%s%n%%n l%>i7s@hisis 3%4% >%5i $eli3ui >e>e&%3% %h%3 3en%n'%n%n 5%iu:

% T%h%3 3&%B73e&%si

P%4% %h%3 3&%B73e&%si 3e&lu 3e&si%3%n e&h%4%3 e%h%n%n u>uh >%5i $ene&i$% in4%%n 73e&%si 4%n %su3%n 'i<i 5%n' @uu3 4ilih% 4%&i esei$>%n'%n >e&% >%4%n 5%n' 4i@%3%i 4%n usi% 5%n' $e$%4%i S5%&%  3e$>e4%h%n $en'%@u 3%4% The Rule of TensC 5%iu >e&% >%5i $en@%3%i

1" 37un4 (-C# ')C ?u$l%h leu7si 4i>%2%h 1""""* $$+_{C nil%i he$7'l7>in}

$ini$u$ %4%l%h 1" 4L*$'C 4%n u$u& 4i %%s 1" $in''u (Gun%&7 4%n P&ih%&inin'sihC !"", Pe4e&senC 1../)

 > T%h%3 73e&%si

A4% >e>e&%3% $e74e 5%n' >is% 4i'un%%n unu 73e&%si @el%h >i>i&   >il%e&%l 5%iu  Barsy, !trai"ht Line Clossure, #illard, #anchester 

Pe$ilih%n $e74e ini 4i 4%s%&%n 3%4% 7n4isi el%in%n @el%h >i>i& 3%4% $%sin'B$%sin' 3%sien (Gun%&7 4%n P&ih%&inin'sihC !"",)

O3e&%si labioschisis  se@%&% >e4%h >i%s%n5% 4il%u%n seel%h u$u& !  >ul%nC ei% %n% el%h $enun?u%n en%i%n >e&% >%4%n 5%n'

$e$u%s%n 4%n >e>%s 4%&i in8esi 7&%lC s%lu&%n n%3%sC %%u sise$i Usi% 73i$%l unu $el%u%n 73e&%si %4%l%h usi% + >ul%nC $en'in'%  3en'u@%3%n >%h%s% >i>i& 4i$ul%i 3%4% usi% #B/ >ul%n sehin''% ?i% 7&esi  3%4% >i>i& le>ih 4%&i usi% e&se>u $%% 3en'u@%3%n hu&u8 >i>i& su4%h

e&l%n?u& s%l%h 4%n %3%>il% 4il%u%n 73e&%si $%% 3en'u@%3%n hu&u8 >i>i&  e%3 u&%n' se$3u&n% (Gun%&7 4%n P&ih%&inin'sihC !"",)

O3e&%si 3l%si @%&%B %4%l%h eni 5%n' 3%lin' se&in' 4i'un%%n G%&is ?%hi%n 5%n' 4i%i& >e&'un% unu $e$3e&e@il %i >i>i& %i>% &e&%si ?%&in'%n 3%&u (0eh&$%n 4C 1../)

(Mil7&7 4C!""-) @ T%h%3 3%s@%B73e&%si

Tu?u%n 3e&%2%%n 3%s@%B73e&%si %4%l%h 3e&>%i%n 5%n' e&4i&i 4%&i: (1) $en@e'%h %n% 4%&i $en%n'is >e&le>ih%nC 4i$%n% 4%3% $en5e>%>%n e'%n'%n 3%4% '%&is suu&%C (!) $e$37sisi%n 4en'%n h%iBh%i (?%n'%n  3e&n%h 3%4% %>47$en) unu $en@e'%h in?u&i 3%4% e$3% 73e&%siC (+) $e$>e&sih%n '%&is suu&% unu $en@e'%h 3e$>enu%n &us% 5%n' 4%3% $en5e>%>%n e&>enu%n s@%&C (-) $e$%s%n'%n restraints  unu  $en@e'%h in?u&i 3%4% e$3% 73e&%si 4%n $en''u%n butterfly strip  %%u  Lo"an bow $bar% (unu $en'u&%n'i ee'%n'%n 3%4% '%&is suu&%)C 4%n (#) $e$>e&i 3elu%n 4%n >e&>%'%i >enu %8esi unu $e$>e&i%n e>uuh%n e$7si7n%l 3%4% >%5i H%l e&%hi& $e&u3%%n h%l 5%n' 3%lin' 3enin' %&en% >%5i i4% $%$3u unu $en4%3%%n e3u%s%%%n 4%&i $enel%n (P&i@e 4C !"1-)

Ke@u&i'%%n in8esi $e&u3%%n 7n&%in4i%si 73e&%si Ji% e%4%%n 'i<i %n% >%iC @%i&%n 4%n ele&7li sei$>%n'C 3e$>e&i%n $%%n 4%3% 4ii<in%n  3%4% h%&i eB/ 3%s@% >e4%h Sel%$% 2%u 5%n' sin'% 4%l%$ $%s% 3%s@%  >e4%hC 3e&%2%%n husus s%n'% 4i3e&lu%n Die @%i& %%u seen'%h @%i& 

4i3e&%h%n%n sel%$% + $in''u 4%n 3e$>e&i%n $%%n%n 4il%u%n $el%lui ees%n %%u sen47 (0eh&$%n 4C 1../)

Pe&%2%%n '%&is suu&% $un'in $eli>%%n %3li%si ointment  %ni>%e&iC e&'%nun' 3%4% ins&usi %hli >e4%h Cotton&tipped applicators h%&us 4ihin4%&i unu $en@e'%h in?u&i 3%4% e$3% 73e&%si Te$3% 73e&%si $un'in 4i@u@i 4en'%n l%&u%n  saline  se&il 0%5i $en4%3%%n $%%n%n 4en'%n $%%n%n husus s%$3%i lu% se$>uh 7%l (1 s%$3%i ! $in''u) (P&i@e 4C !"1-)

! Pe&%2%%n labiochisis 3%4% 7&%n' 4e2%s%

Pe&%2%%n 3%4% 3%sien 4e2%s% 4en'%n labioschisis le>ih >e&87us  3%4% 3en%$3il%n 4%&i >i>i& 4%n hi4un' se&% e$%$3u%n unu >e&>i@%&%

4en'%n ?el%s 4%n $e$3e&>%ii 37sisi 'i'i 'eli'i 5%n' $%l37sisi O3e&%si 5%n' 4il%u%n sesu4%h usi% ! %hun h%&us 4iiui 4en'%n in4%%n speech teraphy %&en% ?i% i4%C seel%h 73e&%si su%&% sen'%u 3%4% s%% >i@%&% e%3 e&?%4i %&en% %n% su4%h e&>i%s% $el%8%l%n su%&% 5%n' s%l%hC su4%h %4% $e%nis$e 7$3ens%si $e$37sisi%n li4%h 3%4% 37sisi 5%n' s%l%h (An7ni$C !"1")

0%n5%n5% 3en4e&i% >i>i& su$>in' 5%n' 4%%n' ei% usi% su4%h $ele>ihi >%%s usi% 73i$%l unu 73e&%si $e$>u% 73e&%si h%n5% unu  e3e&lu%n 7s$ei% s%?% se4%n'%n se@%&% 8isi7l7'is i4% e&@%3%iC 8un'si  >i@%&% e%3 e&'%n''u se3e&i sen'%u 4%n 3el%8%l%n >e>e&%3% hu&u8 e%3 i4% 

se$3u&n%C in4%%n speech teraphy 3un i4% >%n5% >e&$%n8%% (An7ni$C !"1")

1 Al%

Menu&u  'ssociation of !ur"ical Technolo"ist  (!"1!)C %l%B%l% 5%n' 4i3e&lu%n 3%4% 3&7se4u& labioplasty %4%l%h se>%'%i >e&iu:

% Me?% O3e&%si

Me&u3%%n e$3% unu $el%u%n 3&7se4u& 73e&%si 3%4%  3%sien

 > ESU ( (lectrosur"ical ) >i37l%& 4en'%n forceps >%57ne >i37l%& 

Me&u3%%n 87&@e3 >i57ne 5%n' e&hu>un' 4en'%n %l% electrosur"ery bipolar. Fun'sin5% %4%l%h unu $e$e'%n' ?%&in'%n

@ Se )lastic Instrument 

Me&u3%%n 3e&len'%3%n 4%s%& 5%n' 4i'un%%n 3%4% e47e&%n 'i'i P%4% in4%%n >e4%hC 4%3% 4i'un%%n se>%'%i ele;%7& 3e&i7se%l

d. Bea*er +nife andle

e  Bea*er blades /- /# : unu $e$77n' ?%&in'%n

 f. oment Retractor 

Unu $e$is%h%n ?%&in'%n 5%n' el%h 4iinsisi

'  Lip Clamps unu $e$>%nu $en?%'% >i>i& e%3 e&>u%

h J%n'% S7&7n' 4%n Pen''%&is

Unu $en'uu& 3%n?%n' 4%e&%h 5%n' h%&us 4i insisi 4%n 4i&e%%n

i Pul3en * M%&e&* #ethylen Blue

 ? 0l%4e 11 4%n 1# : unu $e$>u% '%&is insisi

11 1#

  Lo"an/s bow

K%2%  stainless steel  unu $e$>%nu $e&e%%n >i>i& 3%s@% labioplasty

! 0%h%n

0%h%nB >%h%n 5%n' 4i3e&lu%n 3%4% 3&7se4u& labioplasty  %4%l%h se>%'%i >e&iu :

% 0%h%n %nesesi

0%h%n %nesesi 5%n' 4i'un%%n 4%3% >e&u3% %nesesi l7%l $%u3un 'ene&%l Ji% $en''un%%n %nesesi l7%lC >%h%n 5%n'

4i'un%%n %4%l%h li47@%ine 1 4en'%n ;%s77ns&i7& (M%l%$e4C !"1-)

0%h%n %nesesi 'ene&%l se&in' 4i'un%%n 3%4% 3%sien >%5i 0%h%n %nesesi 5%n' 4i'un%%n %4%l%h e%$in 4en'%n 47sis /B1" $'*'  >e&% >%4%n 3%sien 4%n 4iin4usi%n se@%&% in&%$usul%& Ji% $el%lui

@%&% in&%;en%C $%% 47sis 5%n' 4i3e&lu%n %4%%h ! $'*' >e&%  >%4%n N%$un ?i% 3en''un%%n %nesesi se@%&% 3%&ene&%l i4% >is% 4il%u%nC $%% 4%3% $en''un%%n $e74e inh%l%si 4en'%n >%h%n '%s NO! (0iss7nneeC !"11)

 > 0%h%n suu&in' 3%s@% 73e&%si

Pen?%hi%n 3%4% 77 $en''un%%n >en%n' ?%hi absorbableC se4%n'%n 3en?%hi%n 3%4% uli $en''un%%n >en%n' ?%hi non& absorbable (0in'  S7$$e&l%n4C !"1#) 0en%n' >e&?enis nil7n $7n78il%$en n7 #B" 5%n' e&%i 3%4% ?%&u$ % >e&$%% $eyeless needles%.

@ 0%h%n l%in

Ji% 4i3e&lu%nC %l;e7l%& bone "raft 4%3% 4i%3li%si%n ?i%  3%sien su4%h >e&usi% $ini$%l . %hunC se>%'%i e$3% unu 'i'i u$>uh sesu%i 4en'%n e$3%n5% Desin8e%n (l7&in "C#) 4%n %3%s* %s% se&il 4i3e&lu%n unu $en'us%3 %l% se>elu$ 4i'un%%n e$>%li (0in' S7$$e&l%n4C !"1#)

). Tekn"k (an Pr#se(ur Be(ah Labioplasty

1 Teni labioplasty unu %sus @el%h >i>i& >il%e&%l : % 0%&s5

Me74e 0%&s5 4i'un%%n unu @el%h >i>i& >il%e&%l 4en'%n  3&7l%>iu$ 5%n' 3en4eC 4en'%n $e74e ini >is% $e$3e&3%n?%n'  3&7l%>iu$

 > S&%i'h Line =l7ssu&e

S&%i'h Line =l7ssu&e 4i'un%%n unu @el%h >i>i& >il%e&%l 7$3li 4en'%n 3&7l%>iu$ 5%n' 3%n?%n'

@ Mill%&4

Me74e Mill%&4 4i'un%%n unu @el%h >i>i& >il%e&%l 7$3li $%u3un in7$3liC 4%3% 4i'un%%n unu $e$3e&3%n?%n' 3&7l%>iu$ 4 M%n@hese& 

Me74e Men@hese& 4i'un%%n unu @el%h >i>i& >il%e&%l in'% &in'%nC se4%n' s%$3%i >e&% Keunun'%nn5% 5%iu: #ucocutan  0unction 4%3% 4i3e&%h%n%nC >enu &e7ns&usi >i>i& sesu%i

%n%7$iC 4%n?%&in'%n 3%&u 5%n' e&>enu s%n'% $ini$Cn%$un eu&%n'%n 4%&i $e74e ini 5%iu: i4% >is% $en%$>%h 3%n?%n' 3%4% %sus @el%h >i>i& >il%e&%l 4en'%n 3&7l%>iu$ 5%n' 3en4e

(=7&%nC !"1!)

! Teni labioplasty unu %sus @el%h >i>i& unil%e&%l : a. #illiard rotation&ad*ancement 

Teni ini 4i'un%%n %&en% %4%n5% eu&%n'%n ?%&in'%n 4i $e4i%l @el%h Unu $e$>%nu $e$3e&7leh ?%&in'%n 5%n' %4eu% %'%&  @7@7 4en'%n sisi 7n&%l%e&%l (non&cleft side) 4%3% 4il%u%n 4en'%n $e$u%& (rotation) 3hil&u$ 5%n' e&sis% e>%2%hC e$u4i%n 4en'%n $e$%?u%n (ad*ancement ) ?%&in'%n l%e&%l %%n $en'7ns&usi 3hil&u$ 5%n' e&en% H%l e&se>u %%n $en'h%sil%n 7ninui%s >i>i&

Teni Mill%&4 $e&u3%%n eni 5%n' 3%lin' se&in' 4il%lu%n 4%l%$ 3e&%2%%n labioplasty P&7se4u& 73e&%si Teni Mill%&4 $enu&u 0is7n7 (!""+)C %4%l%h se>%'%i >e&iu :

1 Sisi l%e&%l $u7s% 4%&i 77 7&>iul%&is7&is 4iu3%s Ke$u4i%n uli 4%n su>uis 4i>e>%s%n 4%&i 77 7&>iul%&is 7&is s%$3%i i&%Bi&% 4%e&%h sulus n%s7l%>i%lis

! Le3%s%n $u7s% >i>i& 4%&i &%h%n' Sel%n?un5% 77 4i>e>%s%n 4%&i $u7s% hin''% e&>enu + l%3is 8l%3 5%iu $u7s%C 77C 4%n uli P%4% sisi $e4i%lC $u7s% 4ile3%s%n 4%&i 77C e$u4i%n 4i>u% 8l%3 =

+ L%u%n insisi se4%l%$ ! $$ 3%4% 3in''i& %%3 lu>%n' hi4un'C  >e>%s%n uli 4%&i $u7s% 4%n ul%n' &%2%nalae  $en''un%%n 'unin' h%lus 5%n' $elen'un' Le% ul%n' &%2%n alae 4i3e&>%ii 4en'%n %&i%n ?%hi%n 5%n' 4i3%s%n'%n e uli Seel%h ?%hi%n e&3%s%n'C leu %%3 4%n len'un' %%s %%3 lu>%n' hi4un' le>ih si$e&is

- K7lu$el% 4en'%n &%n'% ul%n' &%2%n 4%n ;7$e& 5%n' $i&in' 4%&i 4e3%n e >el%%n' suli 4i3e&>%iC sehin''% $%sih $i&in' M%% 4%&i iuC lu% 3%4% 3in''i& %%3 n%&es 4i?%hi Ke$u4i%n ?%hi $u7s% 7&%l $ul%i 4%&i &%ni%l unu $en'hu>un'%n sulus 'in'i;7l%>i%lis J%hi%n 4ie&us%n e %u4%l s%$3%i 4e% >i>i&C seel%h iu 77 4i?%hi l%3is 4e$i l%3is

# J%hi%n uli 4i$ul%i 4%&i ii 5%n' 3e&lu 4i3e&e$u%n 5%iu u?un'  >usu& =u3i47 Sel%?un5%C 4ie&us%n e %%s 4%n e $u7s% >i>i&

J%&in'%n uli %%u $u7s% 5%n' >e&le>ih%n 4%3% 4i>u%n'

/ Se>%in5% lu% 73e&%si 4iuu3 4en'%n tule 5%n' $en'%n4un'  >%h%n

 3en@e'%h 3e&len'e%n 4%n %s% le$>%> sel%$%1 h%&iC unu $en5 e&%3 &e$>es%n 4%&%h %%u se&u$ 5%n' $%sih elu%& S%u h%&i sesu4%hn5% lu% 4i&%2% 4en'%n 3e$>e&i%n s%le3 %ni>i7i

 > T&i%n'ul%& Fl%3 (Tennison repair )

P%n?%n' >i>i& 4i3e&7leh 4en'%n $e$>u% se>u%h trian"ular flap  3%4% sisi l%e&%l (cleft side)C 5%n' e$u4i%n 4isisi3%n e 4%l%$

 377n'%n $e4i%l (non&cleft side% H%l e&se>u %%n $en'h%sil%n  ?%&in'%n %$>%h%n unu in''i >i>i& 5%n' sesu%i (De$e 4%n T%u$C

!"11 Gun%&7C !"", Ri4enC 1..,)

Pe$ilih%n $e74e ini 4i 4%s%&%n 3%4% 7n4isi el%in%n @el%h >i>i&   3%4% $%sin'B$%sin' 3%sien

G. Pera'atan Pas*a Labioplasty +Follow Up,

1 P%sien 4i3e&>7leh%n 3ul%n' 1 %%u ! h%&i 3%s@% 73e&%si P%sien %%n 4i$in% 4%%n' # s%$3%i 6 h%&i 3%s@% 73e&%si unu $ele3%s >e%s ?%hi%n P%sien  >i%s%n5% %%n $e&%s%%n s%i 4%n i4% n5%$%n sehin''% 3e&lu 4i&ese3%n

%n%l'esi $is%ln5% 3%&%se%$7l %%u i>u3&78en ! Men?%'% 4%e&%h >e%s 73e&%si :

• D%e&%h >e%s 73e&%si h%&us sel%lu 4i?%'% e>e&sih%nn5% 4en'%n @%&% 4ius%3

 3e&l%h%n $en''un%%n %3%s

• D7e& $e&ese3%n s%le3 %ni>i7i unu $en?%'% 4%e&%h >e%s 73e&%si

4%&i in8esi

• Unu $en'hin4%&i %n% $en5enuh 4%e&%h >e%s 73e&%siC 4i3e&lu%n

 3e$%s%n'%n arm splints Sei4%n5% 1" h%&i 3%s@% 73e&%si %'%&   3en5e$>uh%n 4%3% >e&l%n'sun' >%i 4%n >e%s lu% i4% e&l%lu %$3% 

(222nl$nih'7;*$e4line3lus*en@5*3%ienins&u@i7ns*"""""-h$) + P%sien 4ihi$>%u unu se'e&% $en'hu>un'i 47e& ?i% e&4%3% e%4%%n :

• Te&4%3% %n4% in8esi se3e&i e$e&%h%n %%u %4% 3us • J%hi%n e&le3%s 4%n >e%s 73e&%si e&>u%

• Te&?%4i 4e$%$ !B+ h%&i

• P%sien $en'%l%$i 4ehi4&%si %&en% esuli%n $%%n

BAB III KE!IMPULAN

1  Labioschisis %%u >i>i& su$>in' %4%l%h su%u el%in%n >%2%%n 5%n' e&?%4i 3%4%  >i>i& 4i$%n% 7n4isi >i>i& e&>el%h 5%n' 4%3% 4ise&%i el%in%n 3%4% l%n'iBl%n'i Kel%in%n ini e&?%4i %i>% '%n''u%n 3%4% 3e&u$>uh%n 2%?%h se?% e$>&i7 5%iu e'%'%l%n 3e&e$>%n'%n 4%n 3en5%u%n 3&7@essus 8&7n7n%s%l 4%n 3&7@essus $%il%&is Ei7l7'in5% s%n'% 7$3lesC 5%iu 8%7& 'eneiC 8%7& lin'un'%nC 4%n ine&%si %n%&% e4u% 8%7& e&se>u

! Kl%si8i%si Labioschisis 4i%n%&%n5% :

% =el%h S%u Sisi %%u Unilateral Cleft Lips %%u L%>i7s@hisis Unil%e&%lC ini 4i>%'i l%'i $en?%4i :

• =el%h S%u sisi len'%3 %%u complete unilateral cleft  %%u Labioschisis

Unilateral Complete

• =el%h s%u sisi i4% len'%3 %%u incomplete unilateral cleft lips  %%u

 Labioschisis Unilateral Incomplete.

 > =el%h Du% Sisi %%u 0il%e&%l =le8 Li3s %%u L%>i7s@hisis 0il%e&%lC ini 4i>%'i $en?%4i

• =el%h 4u% sisi len'%3 %%u complete bilateral cleft lips %%u Labioschisis

bilateral complete.

• =el%h 4u% sisi i4% len'%3 %%u incomplete bilateral cleft lips  %%u

 Labioschisis Bilateral Incomplete.

• =el%h 4u% sisi 4en'%n s%u sisi len'%3 4%n sisi 5%n' l%in i4% len'%3

+ K7$3li%si  Labioschisis  %%n $eni$>ul%%n esuli%n $%%nC In8esi Telin'% Kesuli%n >e&>i@%&% 4%n M%s%l%h 'i'i

- Pe&%2%%n labioschisis 4%3% 4il%u%n 4en'%n in4%%n >e4%h C in4%%n >e4%h 5%n' 73i$%l 4il%u%n %4%l%h s%% 3%sien >e&u$u& + >ul%nC in4%%n >e4%h 5%n' 4il%u%n seel%h 3%sien >e&u$u& ! %hun h%&us 4ise&%i in4%%n speech teraphy

DA&TAR PU!TAKA

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De2iC L 4%n N%nn5C VC !"1"C  'suhan 7eonatus Bayi dan 'na Balita S%le$>% Me4i%C J%%&%

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Mu&h5C JC !"".C M%n%'e$en 78 @le8 li3 %n4 3%l%e in A4uls Indian 9 )last !ur", V7l -!(Su33l): S11/B!!

 Nels7nC !"""C Celah Bibir dan )alatumC EG=C J%%&%

Pee&s7nC LJC EllisC EC Hu33C JR 4%n Tu@e&C MRC !""+C Contemporary 2ral and  #a1illofacial !ur"eryC E4-C M7s>5C Miss7u&iC H%l /++

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