Pustaka Ilmiah Universitas Padjadjaran

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Metode Tumpang Padu Otot Bibir Lingkar Atas Dan Tengah Pada Keberhasilan Kesimetrisan Anatomi Hidung Dan Bibir Atas Pascalabioplasti Unilateral

Ketidak jelasan dan ketidak pastian mengenai faktor penyebab dan mekanisme proses terbentuknya sisa deformitas belum dapat dijelaskan dengan baik. Berbagai penelitian menunjukkan bahwa metode labiorhinoplasti primer yang dipraktikkan selama ini masih menyisakan sisa deformitas hidung dan bibir, sehingga dibutuhkan tindakan rhinoplasti sekunder. Tumpang-padu otot bibir lingkar atas dan tengah dalam penelitian ini merupakan pengembangan berbagaitemuan penelitian, dan kajian-kajian relevan lainnya yang dapat memperbaiki kesimetrisan anatomi hidung dan bibir atas pascalabioplasti unilateral. Penelitian ini bertujuan untuk menganalisis ukuran antropometri nasolabial sebelum dan sesudah labioplasti unilateral melalui tumpang-padu otot bibir lingkar atas dan tengah dan membandingkan ukuran kesimetrisan nasolabial hasil bedah dengan ukuran bayi normal. Penelitian dilakukan di R,S. dr Hasan Sadikin dan rumah sakit jejaring. Ukuran sampel minimal adalah 10 pasien (pada taraf kepercayaan 95% dan power test 95%). Peneliti menetapkan variabel tumpang padu otot bibir lingkar atas dan tengah sebagai variabel independen, dan nasolabial antropometri terdiri atas 10 variabel dependen. Metode penelitian berupa quasi experimental melalui nonrandommized control group time series. Penarikan sampel dilakukan berdasarkan waktu masuk rumah sakit (consecutive admission to the hospital) pada subjek penelitian pasien celah bibir dan langit unilateral komplit nonsindroma, berusia . 6 bulan. Mistar dan jangka standar dipakai sebagai instrumen untuk mengukur titik antropometri prabedah dan pascabedah selama kurun waktu tiga bulan operasi atau sampai usia 9-10 bulan. Hasil analisis statistik diambil dari 10 variabel nasolabial dalam kurun waktu pemeriksaan pascabedah tiga bulan. Secara garis besar, uji hipotesis terhadap delapan variabel memperlihatkan adanya kesimetrisan secara bermakna (pada taraf kepercayaan 95%) dengan bayi normal, sedangkan dua variabel lainnya yaitu puncak hidung dan titik tengah kolumela memperlihatkan deformitas. Namun demikian kedua variabel ini sejajar dengan garis tengah wajah. Secara khusus, pada usia 9.10 bulan, berdasarkan jenis kelamin, laki-laki memperlihatkan kesimetrisan dengan bayi normal, kecuali titik ujung hidung dan tengah kolumela pada posisi tegak lurus. Pada perempuan kesepuluh variabel simetris terhadap bayi normal. Penelitian menyimpulkan bahwa penerapan metoda tumpang-padu otot bibir lingkar atas dan tengah dapat memperbaiki kesimetrisan anatomi hidung dan bibir atas pascalabioplasti unilateral.

The unclear and uncertain caused factors and the mechanism of residual deformities formation has not been well explained yet. Studies showed that primary labiorhinoplasty resulted to residual nose and lip secondary deformities, therefore necessary followed by secondary rhinoplasty.The overlapping of the upper and middle ring lip muscles in this study was developed from the previous studies and other relevant studies which able to achieve the symmetrical anatomy of nose and upper lip in unilateral post labioplasty. The objective of the study is to analyze anthropometric measurement of the nasolabial both pre and post unilateral labioplasty through the overlapping of the upper and middle ring lip muscles and to compare the symmetrical measurement of nasolabial as result of the operation ith the measurement of the normal baby. The study was conducted in dr. Hasan Sadikin Hospital in Bandung and network hospital . A minimal sample size of 10 was obtained under the 95% degree of freedom and power test. The control group was compared to the study group. The overlapping of the upper and middle ring lip muscles was chosen as the independent variable, where as the nasolabial antrhopometric which consist of 10 variables were selected as the dependent variables. The study approached used was the quasi experimental with non randommized control group time series. Sample taken based on consecutive admission to the hospital from patients . six months age nonsyndromic cleft lip and palate subjects. Standardized ruler and caliper were used as the instruments to measure the anthropometry points in pre and post operation during the three months time series or up to 9-10 months of age as indicated above. The statistical analysis were taken from the 10 nasolabial variables in series of time up to three months postoperation. In general, the hypothesis tested showed the eight variables were significant in symmetrical aspect, and the remaining tw ovariables, which were the pronasion and subnasal still remained to secondary deformities. Nevertheless, the two variables above were parallel with the true vertical face dimension. Specifically based on gender, boys ages of 9-10 months showed a symmetric appearance compared to the normal babies, except for pronasion and subnasal which were in a perpendicular position. In girls, all variables were symmetric. The study concluded that the overlapping of the upper and middle ring lip muscles method applied succeeded in improving the symmetrical anatomy of nose and upper lip in unilateral post labioplasty.

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