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Fulltext Determinations of a safe musculofascial plication in abdominoplasty

Al-Shaham AA

Med J Malaysia, 2007 Dec;62(5):380-2.
PMID: 18705470 MyJurnal

This study was conducted to determine a safe vertical musculo-fascial plication distance in abdominoplasty operation in order to avoid the risk of developing respiratory distress during the post operative period. Abdominoplasty is a surgical procedure that removes excess abdominal skin and fat (panneculectomy), and tightens lax anterior abdominal wall muscle; in which musculo-fascial plication is a major component of abdominoplasty in patient with significant divaricating of the recti muscles. Respiratory decompensation may occur as a result of undue plication which reduces the intra abdominal volume with diaphragmatic excursion leading to abdominal compartmental syndrome. Fifty six patients for abdominoplasty were selected prospectively, during the period from June 1998 to February 2004, male to female ratio 1:13, mean age 39.5, mean weight 95.2 kilogram. To determine a safe plication distance (PD). The difference between two pre-operative measurements of the abdominal circumference was measured, before (BB) and after (AB) application of abdominal binder. The safe plication distance (PD) in centimeters = (BB) - (AB). The mean plication distance is 13.5cm. The changes in the pulmonary functions test before and after surgery were clinically insignificant. Pre-operative determination of safe plication distance is simple and convenient method which reduces the risk of developing respiratory distress in patients undergoing abdominoplasty in the post-operative period.
Cemento-ossifying fibroma of the maxilla

Al-Shaham AA, Samher AA

J Plast Surg Hand Surg, 2010 Dec;44(6):318-21.
PMID: 21446812 DOI: 10.3109/02844311003683713

Despite the fact that cemento-ossifying fibromas of the maxilla may be quite large and locally aggressive, en-bloc excision is achieved by gentle blunt dissection, with the whole tumour mass peeled out from the adjacent structures. Until recently different fibro-osseous tumours that contained cementum were classified together as "cementomas". In 1992 The World Health Organization adopted a new classification that included these fibromas as benign osseous tumours. While such tumours of the mandible are common, those of the maxilla are rare. They are growth products of periodontal membrane remnant. The triggering mechanism in the formation of cementum outside the periodontal membrane remains unclear. We present a 35-year-old woman who had a giant expanding lobular mass in the right maxilla of 5 years duration. She had visual disturbances and nasal obstruction, and was treated successfully by surgical en-bloc resection of the tumour through an infraorbital transverse incision. The differential diagnosis included fibrous dysplasia, osteoid osteoma, osteoblastoma, chronic sclerosing osteomyelitis, ameloblastoma, squamous cell carcinoma of the maxillary sinus, calcifying epithelial odontogenic tumour (Pindborg tumour) and calcifying odontogenic cyst (Gorlin cyst). Histopathological examination confirmed a cemento-ossifying fibroma.
Fulltext Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

Al-Shaham AA, Sood S

J Med Case Rep, 2010 Jun 29;4:196.
PMID: 20584337 DOI: 10.1186/1752-1947-4-196

INTRODUCTION: Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps.
CASE PRESENTATION: A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence.
CONCLUSIONS: Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

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