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Versatility of Local Skin Flaps in Facial Reconstruction after Resection of Malignant Cutaneous Tumors

Research Abstract

Abstract
Background: The most prevalent malignant tumors of the human face are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma.  BCC constitutes more than three quarters of skin cancers of the face and the rest primarily consist of SCC.
Objectives: The aim of our study is  to describe different  types of local cutaneous flaps that are versatile and reliable in reconstruction of post-oncological facial defects.
Patients and methods: This prospective study was conducted on patients admitted to the Plastic Surgery Department, Qena Faculty of Medicine, South Valley University from May 2019 to May 2020 (one-year duration). A total of fifty patients with malignant tumors of facial skin were included in  our study.
Results: Twenty nine patients had reconstructed their defects by local random flaps, while 21 patients had reconstructed their defects by local axial flaps. The most random flap applied was rhomboid flap in 14 (28%) patients  The most axial flap applied was forehead flap in 6 (12%)  patients and nasolabial flap in 6 (12%)  patients .
Conclusion: The reconstruction of post ablative face defects, using local flaps, is a real challenge from the perspective of surgical techniques, considering the difficulties determined by the restoring of three dimensional structures and the complexity of reconstructive methods.

Research Authors
Basma M. Ali* 1; Ahmed A.A. Ali1; Asmaa Gaber R2; Samia M. A. Saied3
Research Date
Research Department
Research File
Research Journal
SVU-International Journal of Medical Sciences
Research Member
Research Pages
17-26
Research Publisher
Qena University, Faculty of Medicine
Research Vol
2
Research Website
https://journals.ekb.eg/article_156494.html
Research Year
2022

Comparative Study between Mohler (Modified Millard) and Fisher Techniques in Unilateral Cleft Lip Repair

Research Abstract

Abstract
Background: Cleft lip & palate are among most common congenital craniofacial malformations, with global incidence of 1/1000 live births.  Goal of surgical repair is to enhance function & aesthetic presence of lip while providing appropriate anatomical reconstruction. Over time, numerous methods for cleft lip repair have been characterized.  Ideal lip repair has symmetrical nasolabial folds & alae of nose on sides, natural-looking philtrum & Cupid's bow in both static & dynamic states, & hidden scar.
Objectives: The purpose of this study is to compare esthetic results between Mohler & Fisher technique in unilateral cleft lip healing.
Patients and methods: Prospective, randomized controlled research of 30 studied cases with unilateral cleft lip & palate was performed; divided into two groups (Mohler and Fisher groups), admitted to Plastic Surgery Department; Qena University Hospital from May 2021 to April 2022 (one year duration). Studied cases with microform cleft lip, syndromic cases, & non- compliant studied cases for photography and follow up were excluded. Anthropometric measurements were taken manually and valuation of quality of cleft lip repair was performed based on Steffensen's grading criteria.
Results: Anthropometric measurements were taken postoperatively from patients photos and compared with the preoperative measurements taken manually and these measurements were compared between the two groups. Lip height and vermilion height were higher in Fisher group likened to Mohler group; however, there is no significant lip width and alar base length. Outcomes between the two groups were compared according to Steffensen's criteria, it showed that good outcomes were more frequent in Fisher group compared to Mohler group but without statistically significant difference. Assessment of patient satisfaction was compared between the two groups; it was more excellent score in Fisher's group than in Mohler's group.
Conclusion: Fisher technique was more favorable than Mohler technique. This was revealed from our results according to Steffensen's grading criteria. Also, patient satisfaction from esthetic outcomes was more desirable in Fisher than Mohler repair for a long time follow up.

Research Authors
Alaa M.A. Gaber* 1; Samia M.A. Saied2; Mohamed Yousef A.3; Ahmed A.A. Ali1
Research Date
Research Department
Research Journal
SVU-International Journal of Medical Sciences
Research Member
Research Pages
435-449
Research Publisher
Qena University, Faculty of Medicine
Research Vol
6
Research Website
https://journals.ekb.eg/article_271279.html
Research Year
2023

Cleft Nasal Deformity And Rhinoplasty; Review Article

Research Abstract
Even for a highly skilled plastic surgeon, managing cleft-lip and nasal deformity is challenging.the deformity may be mostly addressed early at the time of cleft lip repair or later by secondary rhinoplasty procedure.However, it's crucial  to  remember  that  the  severity  of  the  abnormality,  the  consequences  of  growing  through  time,  and  the aftereffects  of  earlier  surgery's  scarring  might  influence  the  outcomes  of  secondary  cleft  nasal  repair.Primary, intermediate, and secondary or final repairs may be categorized according to the time of surgical intervention for correction  of  cleft  lip  nasal  deformity.  The  primary  cleft  rhinoplasty  is  commonly  performed  at  3 months of  age along with primary cheiloplasty.Intermediate rhinoplasty is referred as interventions that carried out before nose growth  is  complete,  between  definitive  lip  repair  and  secondary  rhinoplasty.  Once  the  maxillary  and  nasal development  stops,  which is  around  the  ages  of 14  to 16  for  girls  and  16  to 18  forboys,  secondary  or definitive rhinoplasty is performed.As a result, there is still no agreement on the best method, and the final aesthetics of cleft restoration are still hindered by the cleft nose. But for many, achieving total rectification of all nasal defects remains a distant dream
Research Authors
Abdelrahman K. A. Hassan1, Mahmoud A. Hifny1, Ahmed A. A. Ali, MD1, Samia Saied2
Research Date
Research Department
Research Journal
Journal of Pharmaceutical Negative Results
Research Member
Research Pages
631-639
Research Publisher
ResearchTrentz
Research Vol
14
Research Website
https://www.pnrjournal.com/index.php/home/article/view/7306
Research Year
2023

Outcome Analysis of Clinical Evaluation and Surgical Management of Different Grades of Gynecomastia

Research Abstract

Abstract
Background: : Gynecomastia (GM) is the most common breast condition in males. The clinical evaluation and surgical management of different grades of Gynecomastia are described extensively throughout several previous literatures.
Objectives: The objective of our present study is to assess the epidemiological, clinical presentation, and the preferred type of surgical intervention along with evaluation of aesthetic outcomes of each procedure.
Patients and methods: This is a prospective descriptive case series study conducted on 30 patients who was presenting with different grades of true gynecomastia admitted to the Plastic Surgery department in Qena university hospital from the outpatient clinic and seeking surgical correction.
Results: Fifty eight breasts were operated upon in 30 patients; two cases (6.67%) had  unilateral Gynecomastia and 28 cases (93.33%) had bilateral lesion.Based on surgical intervention,  periareolar excision was performed in ten cases, liposuction was performed in six cases, periareolar excision combined with liposuction was done in 4 cases. While, circumareolar excision combined with liposuction was performed in two cases and, circumareolar concentric mastopexy without liposuction was performed in four cases. Four cases of grade III gynecomastia were treated with free nipple grafts.
Conclusion: Gynecomastia is a persistent growth of breast tissue in men and the most successful course of management is surgery. Liposuction and surgical resection and/or combined procedures are three main types for surgical alternative

 

 

Research Authors
Ahmad AbdElhady Muhammad Ibrahim* 1; Samia Mohammed Ahmed Saied2; Mohammed Ahmed Omar3; Ahmed Ali Abdelrahim Ali1
Research Date
Research Department
Research File
Research Journal
SVU-International Journal of Medical Sciences
Research Member
Research Pages
630-642
Research Publisher
Qena University, Faculty of Medicine
Research Vol
7
Research Website
https://journals.ekb.eg/article_383906.html
Research Year
2024

Rhinoplasty techniques in repair of secondary cleft lip nasal deformity

Research Abstract

Background: Tissue distortion and malposition cause clefts in stillborn foetuses. Facial growth complicates the basic cleft nasal deformity into the secondary deformity.
Objectives: The aim of this study was to Evaluation of the different rhinoplasty techniques in management of secondary cleft lip nasal deformity Comparing the results of the secondary rhinoplasty in patients who had primary correction and others with no prior correction.
Patients and methods: This Prospective study was carried out in Plastic surgery department, Qena university hospital, South Valley University on 20 patients with nasal deformities.
Results: There was a significant difference between the two groups with regard to the change in hemicollumellar length and tip height between before and after surgery. In group A, there were considerable variations in preoperative and postoperative results. The Postoperative Alar width were significantly different between the two groups. Regarding the Third Aesthetic rating, there were significant differences between the two groups. In group A, there were substantial differences in preoperative and postoperative satisfaction with appearance as well as contentment with appearance among family and friends.
Conclusion: Successful adjunctive surgery, rhinoplasty, strengthens the alar margin, prevents the alar rim from collapsing, and provides supports for the cleft-side alar rim. Stopping postoperative retraction can be done as a prophylactic treatment in people with damaged lower lateral cartilage. 

Research Authors
Abdelrahman K.A. Hassan 1 Mahmoud A. Hifny 1 Ahmed A.A. Ali 1 Samia Saied 2
Research Journal
SVU-International Journal of Medical Sciences
Research Member
Research Pages
882-891
Research Publisher
Qena University, Faculty of Medicine
Research Vol
7
Research Website
https://svuijm.journals.ekb.eg/article_395659.html
Research Year
2024

Outcomes of Facial Artery Musculomucosal Flap in Repair of Post-palatoplasty Fistula - A Retrospective Study

Research Abstract

Abstract

Introduction: 

Closure of palatal fistula is difficult due to excessive scarring of the palate after previous surgery. The facial artery musculomucosal (FAMM) flap is considered a better option for palatal fistula closure due to its axial blood supply and minimal donor site morbidity. The aim of this study was to evaluate the results of harvesting FAMM flap for closure of medium and large palatal fistulas in terms of its versatility, reliability, feeding and speech assessment.

Materials and Methods: 

A retrospective analysis was performed on patients with post-palatoplasty fistula admitted to the outpatient clinics of the Department of Plastic Surgery and the Department of Maxillofacial Surgery of Assiut University Hospital from March 2022 to February 2024.

Results: 

Twenty patients aged 3–11 years, with female:male = 3:2 ratio, were included in the study. Two flaps experienced venous congestion and then partial flap necrosis. In addition, two flaps had wound dehiscence with mild infection. One patient experienced complete flap loss and then a late recurrent fistula. Most patients were able to feed well, except one patient was unable to swallow and had nasal regurgitation of fluids, that was relieved after second surgery by dorsally based tongue flap. Most patients had intelligible speech during verbal communication, only one patient had nasal tone and hypernasality and two patients were unable to communicate verbally.

Conclusion: 

The FAMM flap is suitable for closing medium and large fistulas due to its versatility and vascular reliability. It has fewer complications and sufficient functional and aesthetic results.


 

Research Authors
Ahmed AA Ali, Mohamed H Osman Hasan
Research Date
Research Department
Research Journal
Annals of Maxillofacial Surgery
Research Member
Research Pages
180-186
Research Publisher
Medknow
Research Vol
14
Research Website
https://journals.lww.com/aoms/fulltext/2024/07000/outcomes_of_facial_artery_musculomucosal_flap_in.11.aspx?context=latestarticles
Research Year
2024

Assessment of Arm Lymphedema After Once-weekly Hypofractionated Radiotherapy for Breast Cancer Patients in Qena University Hospital

Research Abstract

Abstract Background: The use of a hypofractionated 15–16 fraction radiotherapy course replaced the standard fractionated whole breast irradiation (SF–WBI) more than 10 years ago, resulting in shorter waiting lists, lighter machine loads, and more patient compliance. Objectives: Assessment of Arm Lymphedema in breast cancer patients postmastectomy treated with adjuvant single-weekly hypofractionated radiotherapy to the whole breast. Aiming to improve the lifestyle and reduce the suffering of cancer patients. Patients and ethods: Adjuvant RTH to the chest wall was given to 30 postmastectomy women who had infiltrating duct carcinoma of the breast that was histologically confirmed. The dose was 30 or 28.5 Gy in 5 fractions given once a week at a dose of 6.0 or 5.7 Gy. All patients were assessed for ipsilateral arm lymphedema by monitoring the arm circumference on both sides before radiation treatment and at 3, 12, and 24 months after radiation treatment. Results: The incidence of lymphedema grade 0 was (93.3%) in the study group before radiotherapy; at 12 and 24 months after the end of radiotherapy, it was (83.3%) and (80%), respectively (P = 0.044). Grade I was noted in 2 patients (6.66%) before RTH and in 4 patients (13.3%) at 24 months of follow-up (P = 0.682). One case (3.33%) showed grade 2 lymphedema at 3 months after radiation treatment, and 2 cases (6.66%) after 24 months of the end of RTH (P = 0.194). Conclusion: Breast cancer patients can achieve satisfactory results in terms of dosimetric parameters and lymphedema grades by receiving once-weekly whole breast irradiation

Research Authors
Alaa A. Hassan* 1; Mohammed Mostafa Wahman1; Ahmed A. A. Ali2; Eisa Mohamed Hegazy3; Mostafa Elsayed Abd Elwanis4
Research Date
Research Journal
SVU-International Journal of Medical Sciences
Research Member
Research Pages
1137-1147
Research Publisher
South Vally University, Qena Faculty of Medicine
Research Vol
8
Research Website
https://journals.ekb.eg/article_426606.html
Research Year
2025

Assessment of Nanocrystalline Hydroxyapatite Versus Autogenous Bone Grafts in Alveolar Cleft Grafting

Research Abstract

Background: 

Repair of the alveolar cleft is essential for both functional and aesthetic reasons, particularly in syndromic individuals with inherited deformities. The aim of this work was to compare the outcomes of nanocrystalline hydroxyapatite and autogenous bone grafts in alveolar cleft grafting.

Methods: 

A total of 36 patients with alveolar clefts were enrolled in the study. The patients were randomly divided into 2 groups: group A, in which an autogenous iliac bone graft was used to fill the alveolar defect, and group B, in which nanocrystalline hydroxyapatite was used to fill the alveolar defect. All patients were evaluated with cone beam computed tomography at 6 months postoperatively.

Results: 

The main findings of the present study were that there were no significant differences in the baseline or perioperative data between the 2 groups. Group A had a significantly longer duration of surgery (100 ± 21.21 versus 61.38 ± 26.05 min; P = 0.02). Both groups had comparable postoperative success scores.

Conclusions: 

Nanocrystalline hydroxyapatite, an alloplastic substitute, is a good graft material for alveolar cleft repair, reducing the risk of donor site morbidity, causing less pain, and resulting in shorter operative time and hospital stay.


 

Research Authors
Abdullah Hashim, Mohamed Abd Elrahim, Ahmed AA Ali, Mohamed NA Mohamed, Mostafa M Youssef, Muhammad Daiem, Ghulam Qadir Fayyaz, Mohamed El-Shazly
Research Date
Research Department
Research Journal
Plastic and Reconstructive Surgerym Global Open
Research Member
Research Publisher
American Society of Plastic Surgery
Research Vol
14
Research Website
https://journals.lww.com/prsgo/fulltext/2026/01000/assessment_of_nanocrystalline_hydroxyapatite.62.aspx?context=latestarticles
Research Year
2026

Use of Lateral Arm Perforator Flap in Reconstruction of Post-Burn Cubital Contracture in Children

Research Abstract

Abstract

Background: Post-burn cubital contracture is a common, debilitating complication, especially because the elbow has thin, mobile tissue and nearby neurovascular structures. Surgical reconstruction requires balancing coverage durability, recurrence risk, and early movement. Perforator flaps maintain axial blood supply while providing flexible, pliable tissue.

Objective: To evaluate functional and aesthetic outcomes of the lateral arm perforator flap (LAPF) for reconstruction of post-burn cubital contractures in children.

Patients and Methods: A prospective, single-centre case series was conducted at Assiut University Hospital from June 2023 to May 2025, involving children with mature postburn cubital contracture. They underwent scar excision, stepwise release, then reconstruction using Doppler-mapped perforator-based propeller LAPF. Follow-up occurred at 3, 6, and 12 months, assessing elbow motion and function with the Arabic version of QuickDASH (reported by parents in younger children and self-reported by older children, where feasible), scars with POSAS, and occurrence of complications.

Results: Fifteen children (4–18 years; mean 11 ± 7; 60% male) underwent surgery. The mean post-release defect was 7 ± 2 × 9 ± 3 cm; flap size was 8 ± 2 × 11 ± 3 cm with 120°–180° rotation. Donor sites were closed primarily in 10 patients (66.7%) and grafted in 5 (33.3%). Extension deficit improved from 73.1 ± 26.4° to 9.6 ± 7.4°; flexion–extension arc increased from 78.5 ± 21.9° to 126.8 ± 10.7°; Arabic QuickDASH improved from 51.2 ± 12.6 to 4.5 ± 2.8 at 12 months (all p < 0.001). All flaps survived; venous congestion in 3 patients (20%), with 2 (13.3%) having partial necrosis. No elbow instability or permanent ulnar nerve deficit occurred. POSAS improved to ~3 at 12 months.

Conclusions: LAPF is a reliable regional option for pediatric post-burn cubital contracture reconstruction, providing sustained improvements in elbow motion and patient-reported function with overall acceptable morbidity. A longer follow-up is required to confirm durability through growth.

Research Authors
Mohamed Mostafa Elyounsi 1 Tarek Raief 2 Ahmed Abdelkarim 3 Wagdy M. A. 4 Ahmed Ali 5
Research Date
Research Department
Research Journal
The Egyptian Journal of Plastic and Reconstructive Surgery
Research Member
Research Publisher
Egyptian Scoiety of Plastic Surgeons
Research Website
https://ejprs.journals.ekb.eg/article_479716.html
Research Year
2026

Reduction Glossoplasty for Congenital Macroglossia by Keyhole Technique: A Case Report

Research Abstract

Abstract

Background: Macroglossia is a term used to describe a large tongue which protrudes outside of the mouth while in a resting position. It is relatively an uncommon condition in children. True macroglossia; congenital or acquired; includes both muscular hypertrophy and tissue infiltration. Congenital macroglossia commonly presents as part of a syndrome, or idiopathic muscular hypertrophy which is a rare entity of true tongue enlargement without any underlying etiology. It is responsible for many functional and psychological disorders. The current surgical approaches emphasise protecting the neurovascular bundles, retaining sufficient length, and preserving lingual movement. The keyhole technique combines both an anterior wedge resection and a central tongue reduction. This debulks the tongue significantly while protecting the lateral neurovascular bundles.

Case Presentation: A five-year-old boy presented with congenital macroglossia due to idiopathic muscular hypertrophy. Other aetiologies, especially syndromes like Beckwith-Widemann syndrome Trenaunay Klipper syndrome and Down syndrome or vascular anomalies, like venous malformations were excluded. Macroglossia was surgically corrected by the keyhole technique. Functional and aesthetic results were excellent at rest and during mobility of the tongue.

Conclusions: Congenital macroglossia requiring reduction glossoplasty is relatively rare and these procedures are, therefore, uncommonly performed. Regardless of its rarity, it can be life saving for some infants and children, and life altering for the others. Reduction glossectomy can greatly enhance the functional and aesthetic results of macroglossia.

Research Authors
Ahmed A.A. Ali
Research Date
Research Department
Research Journal
The Egyptian Journal of Plastic and Reconstructive Surgery
Research Member
Research Publisher
Egyptian Society of Plastic Surgeons
Research Website
https://ejprs.journals.ekb.eg/article_487293.html
Research Year
2026
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