The management of auricular defect using retroauricular flap

Management of auricular defect is still a challenge for reconstructive plastic surgeons. The complexity of anatomy and shape will make the reconstruction complicated. It is also inevitable that choosing the right donor to close the defect that resembles the original contour is one of the success indicators of any ear reconstruction. There are wide selections of techniques for the management of auricular defect. Retroauricular flap is one of the best choices in auricular reconstruction due to its vascular richness, low of failure rate, similarity of tissue contour and the ease of closing the donor-site defect primarily. This article reported three cases of auricular defect with various causes: crushed injury, human bite, and tumor excision. Two stages of surgeries were performed on all three patients. After sufficient debridement, the ear defect is planted beneath retroauriculomastoid dermis. The second stage, three weeks from the first surgery, the donor flap is separated from it host. One week follow up after the second stage surgery, all of the post-operative wounds showed no signs of infection, minimal scar formation and has satisfied aesthetic outcomes. The retroauricular flap has the advantages of simple dissection, low failure rate and has a good shape, texture, color for a very good aesthetic results. This flap may be considered as a good solution in the management of auricular defect and a flap bank for ear reconstruction.

Giant dentigerous cyst of maxillary sinus associated with impacted maxillary canine

Dentigerous cyst is a cyst that encapsulates enamel of the unerupted tooth, thus causing the tooth become unable to complete the eruption process. This cyst is defined as a developmental cyst as it generally occurs in first until the third decades of life. Dentigerous cyst commonly affect the mandibular area of the teeth. This article describes the case of a young patient with dentigerous cyst which affect maxillary canine. A 6-year-old girl was admitted to Plastic Reconstructive and Aesthetic Surgery Clinic at Mangusada Hospital Bali with facial asymmetry on her right cheek, noticed since the past one week. She got some medicines from the general physician, but there was no improvement. From the CT scan, we found a solitary mass on the size of 3 x 3.2 x 3.6 cm on the right maxillary area. Enucleation was done and the Caldwell-Luc approach was performed under general anesthesia. The cyst revealed to have an ectopic maxillary canine inside. The cyst and ectopic tooth were extracted from the pathological site and the incisional specimens were sent for histopathological examination. The result revealed a cyst lined by non-keratinized stratified squamous epithelium without any malignancy. She had antibiotics therapy post-surgery, and her symptoms were resolved within a week. In one month follow up, there was no sign of recurrence.

The characteristics and patterns of maxillofacial fractures at Mangusada general hospital, Badung-Bali

Background: Trauma is one of the leading causes of death among people under 40 years of age and approximately 10 percent of the cases have been maxillofacial trauma. There was limited number of studies on maxillofacial fractures in Indonesia. Thus, this research attempted to investigate the characteristics and patterns of maxillofacial fractures at Mangusada General Hospital in Badung-Bali.Methods: This research was a cross-sectional descriptive study which conducted at Mangusada General Hospital in the period of 1 January 2016 - 31 December 2017. The 127 samples selected using non-probability sampling. The inclusive criteria involved all maxillofacial trauma cases and the exclusive criteria focused on maxillofacial fractures that received intervention or with incomplete medical records. Each data was collected from the medical records and then analysed descriptively.Results: From 127 samples, male dominated the sample on the gender-based criteria (70.1%) and the highest frequency of all age groups is 21-30 years old on the age group based criteria (23.6%). Maxillary fractures are the most occurring maxillofacial cases, which took up 33.6%. The main cause of the cases is traffic accidents (89.0%).Conclusions: Maxillary fractures are the highest maxillofacial cases at Mangusada General Hospital on 1 January 2016 - 31 December 2016 period of time. The productive male age groups are the most affected groups due to traffic accidents.