Publications by authors named "Normala Basiron"

10 Publications

  • Page 1 of 1

A Case of Large Perianal Mucinous Adenocarcinoma Arising from Recurrent Abscess and Complex Fistulae.

Case Rep Surg 2020 18;2020:1798543. Epub 2020 Dec 18.

Plastic and Reconstructive Surgery Unit, Department of Surgery, UKM Medical Centre, Kuala Lumpur, Malaysia.

Mucinous adenocarcinoma of the perianal region is an oncologic rarity posing a diagnostic and therapeutic dilemma for treating oncologists. This is due to the low number of reported cases, compounded by the lack of definitive therapeutic guidelines. It accounts for 2% to 3% of all gastrointestinal malignancies and is historically known to arise from chronic anal fistulas and ischiorectal or perianal abscesses. We hereby report an interesting case of perianal mucinous adenocarcinoma in a 66-year-old male initially treated for a horseshoe abscess with complex fistulae. He presented with a 6-month history of a discharging growth in perianal region and painful defecation associated with occasional blood mixed stools. An incisional biopsy from the ulcer revealed mucinous adenocarcinoma. Contrast-enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) scan showed a localized perianal growth which involves the internal and external sphincter as well as suspicious involvement in the posterior aspect of the levator ani/puborectalis sling, which was further confirmed with colonoscopy (see figures). With no preset treatment protocol for this rare entity, he was managed with an abdominoperineal resection (APR) and vertical rectus abdominis myocutaneous flap (VRAM) tissue reconstruction. He had a turbulent postoperative period including intestinal obstruction secondary to internal herniation of bowel resulting in flap failure. The subsequent perineal wound was managed conservatively with advanced wound care and has since completely healed.
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http://dx.doi.org/10.1155/2020/1798543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765713PMC
December 2020

Blue rubber bleb nevus syndrome in a Malay girl: A case report and literature review.

Int J Surg Case Rep 2020 1;72:202-206. Epub 2020 Jun 1.

Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia. Electronic address:

Introduction: Blue Rubber Bleb Nevus Syndrome (BRBNS) also known as Bean's Syndrome is an atypical type of vascular malformation. To date, around 200 cases have been reported world-wide. In view of its low incidence rate, clinicians might misdiagnose and under treat. The key features of this syndrome are characterized by multiple cutaneous, soft tissue and gastrointestinal tract venous malformations.

Presentation Of Case: We report the first case of Blue Rubber Bleb Nevus Syndrome in Malaysia, a 23 years old Malay girl who suffers from multiple cutaneous venous malformation and gastrointestinal bleeding episodes.

Discussion: The typical morbidity for this syndrome is symptomatic anemia due to secondary iron deficiency due to the gastrointestinal venous malformation bleeding. In managing the gastrointestinal bleeding, it mainly depends on the severity of gastrointestinal bleeding, some may resolve spontaneously, while the others may be needing blood transfusion, and some may require GIT resections. As for cutaneous lesions, normally it is innocuous depending on the region and size. Large or problematic cutaneous venous malformation might benefit from sclerotherapy or excision.

Conclusion: Multidisciplinary approach is crucial in managing BRBNS case due to its complexity and the spectrum of multiple organ involvement to ensure the best outcome to the patient.
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http://dx.doi.org/10.1016/j.ijscr.2020.05.036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298517PMC
June 2020

A case of facial burn due to the misuse of garlic face mask for acne.

Australas J Dermatol 2018 Nov 29;59(4):336-337. Epub 2018 Jan 29.

Department of Plastic and Reconstructive Surgery, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.

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http://dx.doi.org/10.1111/ajd.12789DOI Listing
November 2018

Juvenile Breast Hypertrophy: A Successful Breast Reduction of 14.9% Body Weight without Recurrence in a 5-Year Follow-Up.

Case Rep Surg 2017 31;2017:3491012. Epub 2017 Jan 31.

Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.

Juvenile hypertrophy of the breast (JHB) is a rare and relentless disease affecting women in the peripubertal period. We present a 13-year-old girl with massive bilateral JHB, successfully treated with a breast reduction and free nipple graft technique. A total of 7300 grams of breast tissue had been removed, accounting for 14.9% of the patient's total body weight. Prophylactic hormonal therapy was not commenced. During the 5-year follow-up period, there was no recurrence and the patient remains satisfied with the aesthetic outcome. A recent meta-analysis study indicates that subcutaneous mastectomy is associated with reduced risk of recurrence, but it is more deforming and the aesthetic result is inferior to a reduction mammaplasty. In patients treated with the latter technique, some evidence exists suggesting that the use of a free nipple graft is associated with a less frequent risk of recurrence than a pedicle technique. This present case is unique as it demonstrates the clinical course of this patient at a considerably longer follow-up period than most reported studies. We adhered to the limited available evidence and highlight the long-term reliability of breast reduction with free nipple grafting as the first line surgical option in JHB, eliminating the need for repeated surgeries.
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http://dx.doi.org/10.1155/2017/3491012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5306971PMC
January 2017

Augmentation rhinoplasty in cleft lip nasal deformity: preliminary patients' perspective.

Plast Surg Int 2014 1;2014:202560. Epub 2014 Sep 1.

Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.

The correction of cleft lip nasal deformity is challenging and there have been numerous methods described in the literature with little demonstrated technical superiority of one over another. The common clinical issues associated with cleft lip nasal deformity are its lack of symmetry, alar collapse on the affected side, obtuse nasal labial angle, short nasal length, loss of tip definition, and altered columella show among others. We carried out augmentation of cleft lip rhinoplasties with rib graft in 16 patients over the one-year study period. Each of these patients was reviewed and given questionnaire before and after surgery to evaluate their response on the outcome to the approach. Preoperatively, nasal asymmetry is the main complaint (14/16, 87.5%) among our series of patients. Postoperatively, 12 (75%) patients out of the 16 reported significant improvement in their nasal symmetry with the other four marginal. All patients reported excellent nasal projection postoperatively with good nasal tip definition. Our series of patients reported overall good satisfaction outcome and will recommend this procedure to other patients with cleft lip nasal deformity. In conclusion, augmentation of cleft lip rhinoplasty can be employed to achieve perceivable and satisfactory outcome in patients with cleft lip nasal deformity.
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http://dx.doi.org/10.1155/2014/202560DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165198PMC
September 2014

Reverse abdominoplasty flap in reconstruction of post-bilateral mastectomies anterior chest wall defect.

Case Rep Med 2014 4;2014:942078. Epub 2014 Aug 4.

Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.

Reverse abdominoplasty was originally described for epigastric lift. Since the work by Baroudi and Huger in the 1970s, it has become clear that reverse abdominoplasty application can be extended beyond just aesthetic procedure. Through the knowledge of anterior abdominal wall vascularity, its application had included reconstructive prospect in the coverage of various chest wall defects. To date, reverse abdominoplasty flap has been used to reconstruct unilateral anterior chest wall defect or for larger defect but only in combination with other reconstructive techniques. Here, we presented a case where it is used as a standalone flap to reconstruct bilateral anterior chest wall soft tissue defect post-bilateral mastectomies in oncological resection. In conclusion, reverse abdominoplasty flap provided us with a simple, faster, and satisfactory reconstructive outcome.
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http://dx.doi.org/10.1155/2014/942078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137737PMC
August 2014

Lip and oral commissure reconstruction with the radial forearm flap.

Natl J Maxillofac Surg 2012 Jan;3(1):21-4

Department of Plastic Reconstructive Surgery, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia.

Introduction: The radial forearm free flap has been a workhorse flap for lip reconstruction due to its pliability, color match, and ability to incorporate the palmaris longus tendon for support. We report our experience with the use of the radial forearm free flap in three patients post-tumor resection.

Materials And Methods: Between 2009 and 2010, three patients had undergone resection of squammous cell carcinoma of the oral region and simultaneous reconstruction with the radial forearm free flap. The average patient age was 51 years and the average defect size was 4 × 3 cm(2). In two patients, anterograde radial forearm free flap was used with a fascia lata free tendon graft for support and in one patient, a retrograde radial forearm flap was used without the use of tendon as support.

Results: All three patients were satisfied with the initial management of tumor clearance. All three surgical margins were clear. Out of three, two patients complained that the flap was unsightly and were dissatisfied with the appearance and bulk of the flap.

Conclusion: Although the radial forearm flap is recognized as a gold standard for lip reconstruction, there always appears to be a need for secondary revision procedures to further improve both the functional as well as esthetic appearance of the lip reconstruction procedure. As a primary reconstructive procedure, the flap does not satisfy patient expectations. A comprehensive questionnaire as well as objective assessment follow-up study is warranted.
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http://dx.doi.org/10.4103/0975-5950.102144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513804PMC
January 2012

Low-grade liquid silicone injections as a penile enhancement procedure: Is bigger better?

Urol Ann 2012 Sep;4(3):181-6

Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.

To report our experience with 5 cases of complications of penile enhancement procedures secondary to liquid silicone injections and our method of management of its debilitating effects. All five patients were treated with excision of penile shaft skin down to buck's fascia followed by resurfacing with split thickness skin grafting. We conclude that penile enhancement procedures with liquid silicone by non-medical personnel could result in devastating consequences. We also demonstrate that a simple method of excision of the entire penile shaft skin and resurfacing with split skin grafting showed improvement in cosmetic as well as functional outcome.
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http://dx.doi.org/10.4103/0974-7796.102672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519113PMC
September 2012

Soft tissue cover for an exposed transplanted kidney with a pedicled myocutaneous anterolateral thigh perforator and vastus lateralis flap.

Urol Int 2011 28;87(1):117-9. Epub 2011 Jun 28.

Plastic Surgery Unit, Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. faizalali71 @ yahoo.co.uk

Surgical wound infection after a renal transplant procedure can lead to graft loss in the presence of host immunosuppression and graft exposure to the environment. Early cover of the wound with well-vascularized tissue will facilitate early wound healing and preservation of the graft. The pedicle anterolateral thigh perforator flap is a popular flap used for soft tissue reconstruction in the groin and perineum. We present a case of an anterolateral thigh flap used to cover an exposed transplanted kidney after surgical wound breakdown.
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http://dx.doi.org/10.1159/000324543DOI Listing
December 2011

Surgical management of large desmoid tumour of the anterior abdominal wall.

Asian J Surg 2008 Apr;31(2):90-5

Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.

Desmoid tumours are uncommon. They are locally invasive and incomplete excision leads to recurrence, which can pose a significant management challenge. Patients therefore require effective treatment, which essentially entails tumour excision with a clear surgical margin. The resulting wide defect may lead to difficulty in closure of the anterior abdominal wall. We report our experience in treating large desmoid tumours of the anterior abdominal wall. Between January 2000 and December 2001, three patients with large desmoid tumour of the anterior abdominal wall were treated with wide excision, which included a 3-cm margin of uninvolved tissues. This led to a considerable abdominal wall defect. The peritoneal defect was closed as a separate layer, though under considerable tension, while the abdominal wall musculature defect was closed with a polypropylene mesh. All three patients recovered well with no immediate or late postoperative morbidity. Follow-up until December 2006 has not revealed any tumour recurrence or hernia development. Wide excision of an anterior abdominal wall desmoid tumour with a clear margin of 3 cm including the peritoneum should be considered when managing such tumours. Closure under tension of the peritoneum did not seem to produce any morbidity.
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http://dx.doi.org/10.1016/S1015-9584(08)60065-2DOI Listing
April 2008
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