Tesis

Persepsi Estetik Hasil Operasi Hidung Pasien Sumbing Dengan Tehnik “Semi –Open Modified Tajima”

Latar belakang: Tujuan studi ini adalah untuk menilai persepsi masyarakat terhadap hasil
operasi hidung pada pasien cleft menggunakan tehnik semi-open modified Tajima. Mengingat
banyak tehnik operasi yang digunakan dengan berbagai kelebihan masing – masing, kami ingin
mengetahui apakah tehnik yang sederhana, mudah dikerjakan dengan morbiditas yg rendah
hasilnya akan mendapatkan apresiasi yang berbeda oleh orang tua dan para profesional medis.
Metode: Studi cross sectional menggunakan questionnaire dengan menilai 25 foto dari hasil
operasi hidung pada pasien cleft dengan tehnik semi-open modified Tajima. Duapuluh lima orang
tua dan 25 orang pelaku medis dalam hal ini residen bedah plastik akan di perlihatkan foto, dan
kemudian mereka akan menilai hasil operasi tersebut dengan menggunakan VAS score, yaitu
berupa tanda disepanjang garis berukuran 100 mm. Data kemudian dianalisa dengan tes Chisquare.
Dan korelasi antara profesional medis dan orang tua akan dianalisa menggunakan
Spearman correlation.
Results: Dari penelitian didapatkan perbedaan yang significant dari persepsi orangtua mengenai hasil operasi
dengan professional medis sebesar -0.38 yang berarti persepsi mereka cenderung bertolak belakang. Dan terdapat
korelasi lemah antara orangtua dan medis sebesar 0. 045(lebih rendah dari 0.05).
Kesimpulan:Adanya perbedaan persepsi estetik antara orang tua dan profesional medis
memberikan informasi yang berharga mengenai harapan orangtua terhadap anak mereka. Selama
ini profesional medis dengan pengetahuan terhadap masalah pasien akan cenderung lebih mudah
tidak puas terhadap hasil operasi, karena mereka mengharapkan lebih dan lebih. Tidak semua
tehnik yang baik lepas dari resiko dan biasanya memerlukan usaha yang lebih pula,sehingga
kadang memberikan morbiditas yang lebih banyak. Persepsi estetik antara profesional medis dan
orangtua ternyata berbeda. Sebagai orang terdekat dan yang bertanggung jawab terhadap pasien,
memang sudah sewajarnya kita mendengarkan dan menelaah apa sebenarnya keinginan dan
harapan mereka.


Background: There are many technique of cleft rhinoplasty has been used worldwide. Each of it
came with their own advantage and disadvantage. Technique that has been known with simple,
easy and less morbidity are semi – open modified Tajima technique, but it always judged as a
second class compare to the open rhinoplasty, despite the higher morbidity of the open
rhinoplasty. But actually no one ever try to find if result of the semi –open rhinoplasty modified
Tajima technique are really dislike by the community. Are the medical professional communities
whom prefer sophisticated technique with exquisite result or the parents also share the same
interest? The different perception between medical profesional and parents are the thing we like
to observe.

Methods: A cross sectional research on a 25 consecutive sample for each grouup. Twenty five
photograph of a patient that has been through rhinoplasty using semi – open modified Tajima
technique are shown to 25 parents and 25 medical professional (plastic surgery resident). After
observe the photograph, parents and residents are giving their judgment on a questionnaire using
VAS score. They put a mark on a 100 mm ruler base on their judgments. After that the result was
analyzed using chi square, and correlation between parents and residents are analyzed using
Spearman correlation.

Results: The result shown that there are 12 poor perception and 13 good perception from
medical professional, while there are 13 poor perception and 12 good perception from parents.
There 6 poor perceptions by both medical professional and parents, and 6 good perceptions by
booth parents and medical professional. A kappa value from this research is – 0.38, which means
the two observers classify slightly the opposite of each other. If one observer says excellent, the
other might says poor. Nevertheless the kappa value < 0.4 (0.38) are considered poor. There are
weak correlation between the medical professional perception and parent perception show in
correlation coefficient that is 0.045 which is lower than 0.5.
.
Conclusion: There are a significant differences in perception between medical professional and
parents according to result of the rhinoplasty using semi-open modified Tajima technique.
Therefore what being judge as a poor result by the medical professional not assured that parents
are also has the same perception. We have to clarify the expectation of parents due their child
condition, and having a good conversation between medical professional and parents in such
manner their having an understanding that satisfied both.