https://www.ajhsjournal.ph/index.php/gp

Asian Journal of Health and Science

p-ISSN: 2980-4302

e-ISSN: 2980-4310

Vol. 1 No.3 December, 2022

CHARACTERISTICS OF PATIENTS OF Cleft LIP- PALATE OPERATED AT

BHAYANGKARA KEDIRI HOSPITAL & BHAYANGKARA TULUNGAGUNG

HOSPITAL

R. Mohamad Javier

(1)

, Dani Pratama Febrianto

(2)

, Hanif Azin Abada

(1)

Martin Yudi Adenanto

(3)

, Ruby Riana Asparini

(4,5)

( 1 )

Medical Profession Education, University of Muhammadiyah Malang

(2)

Profession of Doctor, University of Muhammadiyah Malang

(3)

SMF Anesthesiology & Intensive Therapy at Bhayangkara Hospital, Kediri

( 4 )

Deputy Dean for Academic Affairs, Faculty of Medicine, University of Muhammadiyah

Malang

(5)

SMF of Surgery, Division of Aesthetic Reconstructive Plastic Surgery , University of

Muhammadiyah Malang Hospital

javierbedah@webmail.umm.ac.id

(1)

danipratama4@webmail.umm.ac.id

(2)

abadaazinhanif@webmail.umm.ac.id

(1)

martin@umm.ac.id

(3)

ruby@umm.ac.id

(4,5)

Abstract

Cleft lip palate ( CLP ) is a defect resulting from a congenital deformity caused by an

abnormality in facial development during pregnancy. The aim of the study was to determine

the characteristics of CLP sufferers who were operating at Bhayangkara Kediri Hospital and

Bhayangkara Tulungagung Hospital for the period October 2021 - February 2022. The

research method used was descriptive using the cohort retrospective design method. Data

were collected from patients who underwent CLP surgery for the period October 2021 -

February 2022. Sampling was carried out by total sampling and 31 samples were obtained.

This study found that there were more males than females who suffered CLP . The conclusion

of this study is that CLP patients were dominated by men with the most age who operated less

than five years old and the most types of cleft reconstruction, were cleft palate

reconstruction.

Keywords: Cleft lip and palate, characteristics of cleft reconstruction

INTRODUCTION

Activities within the framework of the Indonesian National Police's Birthday this year

in the field of community service through Biddokkes (Medicine and Health) of the National

Police are social services for cleft lip (CB) and cleft palate (CL) surgery through the

Bhayangkara Hospital throughout Indonesia. This activity was carried out in East Java,

especially at the Kediri Regional Police carried out at the Kediri and Tulungagung

Bhayangkara Hospital (Tribratanews , 2022) . CBL 's operational social services which

coincide with the 76th Birthday of the Indonesian National Police in 2022 , is part of the Tri

https://www.ajhsjournal.ph/index.php/gp

Dharma of higher education which includes: education and teaching, research and

development, community service ( Fadholi, 2020)

CB and CL operations were carried out to reduce the psychological burden of the

sufferer later , that's why CBL surgery is usually performed at the age of infants or children.

Cleft lip or cleft lip is a defect resulting from a congenital deformity caused by an abnormal

development of the face during gestation (pregnancy). Clefts can occur in the lips, palate or

both. Cleft lip occurs when the tissues that make up the lips of a fetus don't fuse properly. The

cause is not known with certainty, but is thought to be related to the result of a combination

of genetic and environmental factors ( Saphira, 2021)

CBL defects are congenital (congenital) abnormalities, where these defects can bring

significant psychological pressure, both to themselves and their families, which can result in

disrupting a child's emotional development. CBL surgery aims to reduce psychological

pressure during the growth period. This action is a way to relieve CBL sufferers ( Saphira,

2021)

This study aims to determine the characteristics of patients with CBL palate operated

on at Bhayangkara Kediri Hospital and Bhayangkara Tulungagung Hospital for the period

October 2021 – February 2022 and to fulfill the Tri Dharma of Higher Education, especially

in the field of Community Service.

RESEARCH METHODS

This research method is an observational study using a retrospective cohort design

method . The research was conducted at the Central Surgical Installation of Bhayangkara

Kediri Hospital & Bhayangkara Tulungagung Hospital. The study started from October 2021

to February 2022. The population in this study were CBL sufferers obtained from operations

at the central surgical installation in the last few years at Bhayangkara Kediri Hospital &

Bhayangkara Tulungagung Hospital. The sample in this study were CBL sufferers obtained

from patient medical records in October 2021 - February 2022 at Bhayangkara Kediri

Hospital & Bhayangkara Tulungagung Hospital with predetermined inclusion criteria,

namely: CBL sufferers for the period October 2021 - February 2022 who were operated on at

Bhayangkara Kediri Hospital & Bhayangkara Tulungagung Hospital, male -men & women

with an age limit of <2 months and> 26 years, and the patient's condition before surgery .

Data presentation and analysis techniques obtained descriptively, presented using diagrams.

RESULTS AND DISCUSSION

This research is a type of descriptive survey research that was carried out at

Bhayangkara Kediri Hospital and Bhayangkara Tulungagung Hospital in October 2021 –

February 2022 . The sample in this study were CBL patients who underwent surgery at

Bhayangkara Kediri Hospital and Bhayangkara Tulungagung Hospital during January-

November 2022. Data collection in this study was taken from data on patients who underwent

CBL surgery at Bhayangkara Kediri Hospital and Bhayangkara Tulungagung Hospital.

Samples obtained at Bhayangkara Kediri Hospital were 22 patients and 9 patients at

Bhayangkara Tulungagung Hospital, with a total of 31 patients. The results of the research

obtained are presented as follows.

https://www.ajhsjournal.ph/index.php/gp

Diagram 1. Distribution CBL at Bhayangkara Hospital Kediri by Gender

The results obtained in diagram 1 show the distribution of CBL in Bhayangkara

Hospital Kediri based on gender. CBL sufferers 55% of those undergoing surgery at

Bhayangkara Hospital were male (12 patients) and 45% female (10 patients).

Diagram 2 shows the same thing, namely the distribution of CBL in Bhayangkara

Tulungagung Hospital based on gender. Total patients included in this study were 9 patients.

Five patients were male (56%) and 4 patients were female (44%).

Diagram 2. Distribution of CBL d i Bhayangkara Tulungagung Hospital by Gender

Comparison of the results obtained in table 1 and diagram 3 below, it can be seen that

the distribution of CBL at Bhayangkara Kediri Hospital based on age was 15 patients aged <5

years (68.2%), 2 patients aged 6-10 years (9.1%), 2 patients aged 16-20 years (9.1%), 2

patients aged 20-25 years (9.1%), and 1 patient aged >25 years (4.5%).

Table 1. Distribution of CBL at Bhayangkara Hospital Kediri by age

Age

Frequency (f)

Percentage (%)

<5 years

68.2%

6-10 years

9.1%

11-15 years

16-20 years

9.1%

20-25 years

9.1%

>25 years

4.5%

Amount

100%

https://www.ajhsjournal.ph/index.php/gp

Diagram 3. Distribution of CBL in Bhayangkara Hospital, Kediri by Age

Table 2. Distribution of CBL in Bhayangkara Tulungagung Hospital by Age

Age

Frequency (f)

Percentage (%)

<5 years

66.7%

6-10 years

11.1%

11-15 years

11.1%

16-20 years

11.1%

20-25 years

>25 years

Amount

100%

Diagram 4. Distribution of CBL at Bhayangkara Tulungagung Hospital by age

Distribution of CBLs at Bhayangkara Tulungagung Hospital by age are shown in

table 2 and diagram 4. The number of patients included in this study were 9 patients. A total

of 6 patients aged <5 years (66.7%), 1 patient aged 6-10 years (11.1%), 1 patient aged 11-15

https://www.ajhsjournal.ph/index.php/gp

years (11.1%), and 1 patient aged 16-20 years (11.1%).

Diagram 5. Distribution of CBL reconstructions d i Bhayangkara Hospital Kediri by Type

The operations carried out based on the type are divided into 3, namely CB

reconstruction, CL reconstruction and CBL reconstruction . Diagram 5 shows the distribution

of operations at Bhayangkara Kediri Hospital by type. A total of 6 patients underwent CB

reconstruction (27.3%), 12 CL reconstructions (54.5%), and CBL reconstruction 4 patients

(18.2%).

The operation results are described in diagram 6 below, it can be seen the distribution

of CBL sufferers at Bhayangkara Tulungagung Hospital by type , namely: CB reconstruction,

CL reconstruction and CBL reconstruction . The results showed that 9 patients, 1 patient

underwent CB reconstruction (11.1%), 7 patients underwent CL reconstruction (77.8%), and

1 patient underwent CBL reconstruction (11.1%).

Diagram 6. Distribution of CBL reconstruction at Bhayangkara Tulungagung Hospital by

Type

The results of the study were based on gender, it was found that there were more male

patients than women. This is in accordance with the literature which explains that gender and

type of abnormality, the disability rate consists of 55.95% male sufferers and 44.05% female

sufferers. Cause why CBL it is more common in males is not known with certainty,

presumably due to differences in embryological processes in males and females (Elfiah, et al.,

2021).

Celah bibir

Celah langit-langit

Celah bibir dan langit-langit

https://www.ajhsjournal.ph/index.php/gp

Types of CBL reconstruction Most of this study was CL reconstruction , namely

54.5% of CBL reconstruction at Bhayangkara Kediri Hospital and 77.8% of CBL

reconstruction at Bhayangkara Tulungagung Hospital. This is due to operations performed

according to the CBL surgery algorithm ( time table ), or CBL patients who have undergone

lip surgery before, and indications for palate surgery.

The results of this study indicate that the most age of patients undergoing CBL surgery

is <5 years old, both at Bhayangkara Kediri Hospital (68.2%) and Bhayangkara Tulungagung

Hospital (66.7%). This is in accordance with the Rule of Ten criteria which is used as a

guideline for children with CB who will be operated on, namely age > 10 weeks (3 months),

body weight > 10 pounds (4.5 kg), and hemoglobin > 10 g% (Sjamsuhidajat , 2017). The

results of the study have found several patients who underwent surgery at the age of their

teens or older. The effect of the results of surgery on CBL treatment is a multidisciplinary

treatment that takes years (Supandi, 2014).

CONCLUSION

Cleft lip is a defect resulting from a congenital deformity caused by an abnormality in

facial development during gestation. Based on the descriptive analysis that has been carried

out, it shows that there are more CB patients in this study, the male sex group is more than

female. This is in accordance with research (Asparini, et al . 2021) which states that the male

group is dominated by CB sufferers. Most of those aged less than 5 years perform CB

operations. The most common type of gap reconstruction in this study was CL reconstruction

BIBLIOGRAPHY

Allori AC., Maera JG., Mulliken JB., Shusterman S. The Cleft Palate-Craniofacial Journal.

2015. Classification of Cleft Lip/Palate : Then and Now : PubMed.54(2).

Asparini, Ruby Riana. Perdanakusuma, David. Handayani, Retno. 2021. Distribution of Cleft

Lip and Palate at Cleft Lip and Palate Center Medical Faculty, Universitas

Muhammadiyah Malang, Indonesia. India : Indian Journal of Forensic Medicine &

Toxicology. Vol. 15. No.3

Chandra, D., Lw, H. Y. and Agustin, D. 2014. Hubungan Antara Protein EGFR( Epidermal

Growth Factor Receptor ) dan ERK-1( Extracellular S-ignal-Regulated Protein Kinase-

1 ) pada Kejadian Celah bibir Ras Protomalayid di Provinsi Nusa Tenggara Timur.

Majalah Kesehatan FKUB. Vol.1:pp.69–73.

Elfiah, Ulfa., Kushariyadi., Wahyudi, Septa. 2021. Analisis Kejadian Sumbing Bibir dan

Langit: Studi Deskriptif Berdasarkan Tinjauan Geografis. Jurnal Rekonstruksi dan

Estetik. Jember. Vol.6(01). Pp. 34-43

Fadholi, M. 2020. Apa itu Tri Dharma Perguruan Tinggi? Mahasiswa Wajib Tahu.

https://maukuliah.id/blog/apa-itu-tri-dharma-perguruan-tinggi-mahasiswa-wajib-tahu/

( Diakses pada 17 November 2021).

Fortuna, Fory. 2019. Cleft Lip and Palate. Padang : RS Universitas Andalas, Jurnal

Rekonstruksi dan Estetika Departemen Ilmu Bedah UNAND. Vol. 12 (2), Pg 1-3

Hasyim, Inayatullah. 2011. Hukum Operasi Plastik.

https://www.dakwatuna.com/2011/12/27/17689/hukum-operasi-plastik/amp/(Diakses

pada 17 November 2021).

Kati, Firas Abd. 2018. Cleft Lip and Palate:Review Article. Indian Pediatrics.

Vol.19(11):pp.937–942.

https://www.ajhsjournal.ph/index.php/gp

Kawalec A, Nelke K, Pawlas K, Gerber H. Risk factors involved in orofacial cleft

predisposition-review. Open Med. 2015;10(1):163–75

Novelino, Andry. 2021. Sejarah Berdirinya Polri, Berawal dari Masa Majapahit": ( Diakses

pada 17 November 2021)

Saphira, Chairani Fitri. 2021. Operasi Celah bibir untuk Perbaikan Celah Bibir dan Langit.

https://rs-soewandhi.surabaya.go.id/operasi-perbaikan-bagi-penderita-bibir-

sumbing/(Diakses pada 17 November 2021)

Sjamsuhidajat, R. 2017. Buku Ajar Ilmu Bedah Sjamsuhidajat-De Jong. 4th ed. Jakarta:

Penerbit Buku Kedokteran EGC

Shaye, D., Liu, C. C. and Tollefson, T. T. 2015. Cleft Lip and Palate. An Evidence-Based

Review. Facial Plastic Surgery Clinics of North America. Elsevier Inc.

Vol.23(3):pp.357–372. doi: 10.1016/j.fsc.2015.04.008.

Stuppia, L. et al. 2011. Genetics of Syndromic and Nonsyndromic Cleft Lip and Palate.

Journal of Craniofacial Surgery. Vol.22(5):pp.1722–1726. doi:

10.1097/SCS.0b013e31822e5e4d

Supandi, A., 2014. Angka Kejadian Sumbing Bibir Di Rsup Prof. Dr. Rd Kandou Manado

Periode 2011-2013. e-CliniC, 2(2).

Tribratanews. 2022. Puncak Hari Bakti Kesehatan Polri dalam rangka menyambut Hari

Bhayangkara ke 76 tahun 2022.https://tribratanews.polri.go.id/info-kita/puncak-hari-

bakti-kesehatan-polri-dalam-rangka-menyambut-hari-bhayangkara-ke-76-tahun-2022-

54 (Diakses pada 17 November 2021)

Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh HP. Cleft of lip and palate: A review. J

Family Med Prim Care. 2020 Jun 30;9(6):2621-2625. doi:

10.4103/jfmpc.jfmpc_472_20. PMID: 32984097; PMCID: PMC7491837.

Worley, M. L., Patel, K. G. and Kilpatrick, L. A. 2018. Cleft Lip and Palate. Clinics in

Perinatology. Elsevier Inc. Vol.45(4):pp.661–678. doi: 10.1016/j.clp.2018.07.006