261) Which of the following is an ADVANTAGE of the unilateral cleft lip repair technique represented in the drawing below? Click the picture to enlarge image.
A. Extensive undermining is not required.B. Vertical scar contracture is very uncommon.
C. Small nostril does not occur using this technique.
D. Good nasal access is provided.
E. There is no excessive tension in closing.
262) Which of the following statements is FALSE regarding open rhinoplasty technique?
A. Osteotome or rasp can be used to reduce a dorsal hump.
B. A single cut linear technique or a perforating technique are adequate for lateral osteotomies.
C. Lateral osteotomy begins at the anterior end of the inferior turbinate.
D. Lateral osteotomy follows a low, high, low pathway.
E. Lateral osteotomy is always performed after the intermediate osteotomy.
263) Which of the following statements represents the role of the “FORKED FLAP” incisions of the upper lip used in secondary cleft lip-nasal deformities?
A. They provide additional columellar length and increase projection of the bilateral cleft lip-nose deformity.
B. They provide additional columellar length and increase projection of the unilateral clef lip-nose deformity.
C. They provide reduction in columella length and decrease projection of the unilateral cleft lip-nose deformity.
D. They provide reduction in columellar length and decrease projection of the bilateral cleft lip-nose deformity.
E. They provide reduction in columellar length and increase projection in unilateral and bilateral cleft lip-nose deformities.
264) Which of the following is FALSE about local flaps?
A. Provide better donor site match
B. Involve one stage most of the time
C. Based on axial pattern blood supply
D. Produce distortion of the surrounding structures
E. Allow minimal donor site morbidity
265) In microvascular anastomosis, which of the following medications SHOULD NOT BE USED postoperatively in order to lessen the likelihood of vessel thrombosis?
A. Aspirin
B. Ibuprofen
C. Heparin
D. Dextran
E. Prednisone
266) Which of the following statements regarding intraoperative management of microvascular flaps is TRUE?
A. Unipolar cautery is very useful for controlling bleeding close to the pedicle.
B. End-to-side anastomosis is not useful in microvascular anastomosis.
C. Interrupted stitches with 5-0 nylon are used for anastomosis.
D. The use of anastomotic devices in free-tissue transfer is contraindicated.
E. If the lumen size of the vessels mismatch the surgeon can use the fish-mouth and unequal bites techniques for closing.
267) The vast majority of microvascular surgeons prefer WHICH OF THE FOLLOWING TECHNIQUES in order to monitor flap status postoperatively?
A. Clinical assessment
B. Doppler ultrasonography
C. Doppler flowmetry
D. Photoplethysmography
E. Hydrogen clearance measurements
268) Which of the following statements is TRUE regarding the Radial Forearm Free Flap?
A. The Esmarch bandage and tourniquet control of the upper extremity are unnecessary in its harvesting.
B. The Allen test is not required in younger patients.
C. Primary closure of the donor site is usually accomplished.
D. The risk of pathologic fracture after harvesting radial bone is insignificant.
E. The medial and lateral antebrachial nerves are fundamental in obtaining a sensate flap.
269) Which of the following statements is TRUE regarding the Lateral Arm Free Flap?
A. The Esmarch bandage and tourniquet control of the upper extremity are necessary in its harvesting.
B. Primary closure of the donor site extremely difficult to accomplished.
C. The lateral arm flap has only one venous drainage, the deep venous system.
D. The variability of the lateral arm skin thicknesses is one of this flap's advantages.
E. The lateral arm flap is based on the anterior radial collateral artery.
270) Which of the following describes the FRANKFORT LINE in aesthetic facial surgery?
A. Superior margin of the tragus to the infraorbital rim (lateral plane)
B. Line connecting the ear lobule to the subnasale (lateral plane)
C. A line parallel to the Gonzales-Ulloa line (lateral plane)
D. A line connecting both infraorbital rims (frontal plane)
E. A line connecting both upper eyelids (frontal plane)
ANSWERS & REFERENCES
261) D Good nasal access is provided.
Sykes J. M.: Diagnosis and Treatment of Cleft Lip and Palate Deformities, Chapter 65 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, p.p. 821, 2002
Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders, Chapter 76 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, p.p. 1066, 2009
262) D Lateral osteotomy follows a low, high, low pathway.
Larrabee, Jr. W. F.: Open Rhinoplasty and the Upper Third of the Nose, Open Rhinoplasty, in Facial Plastic Surgery Clinics of North America, Volume 1, Number 1 August 1993, pp. 23-30
Most S. P., Murakami C. S., Larrabee Jr. W. F.: Surgery of the Bony Nasal Vault, Chapter 42 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, p.p. 547-561, 2009
263) A They provide additional columellar length and increase projection of the bilateral cleft lip-nose deformity.
Sykes J. M., Senders C. W., Wang T. D., Cook T. A.: Use of the Open Approach for Repair of Secondary Cleft Lip-Nasal Deformities, in Open Rhinoplasty, Facial Plastic Surgery Clinics of North America, Volume 1, Number 1 August 1993, pp. 117-122
264) C Based on axial pattern blood supply
Shumrick K. A., Chadwell J. B., Campbell A. C.: Local Skin Flaps: Anatomy, Physiology, and General Types, Chapter 161 in Head & Neck Surgery-Otolaryngology (Bailey, B. J., editor), 4th Edition, Lippincott Williams & Wilkins, pp. 2357-2367, 2006
Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002
Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009
Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009
266) E If the lumen size of the vessels mismatch the surgeon can use the fish-mouth and unequal bites techniques for closing.
Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002
Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009
267) A Clinical assessment
Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002
Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009
268) E The medial and lateral antebrachial nerves are fundamental in obtaining a sensate flap.
Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002
Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009
269) D The variability of the lateral arm skin thicknesses is one of this flap's advantages.
Burkey B. B., Coleman J. R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 577-578, 2002
Burkey B. B., Schmalbach C. E., Coleman J. R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 765-793, 2009
Ridley M. B, VanHook S.M.: Aesthetic Facial Proportions, Chapter 9 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 99-108, 2002
Ridley M. B, VanHook S.M.: Aesthetic Facial Proportions, Chapter 11 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 119-133, 2009
Zimbler M.S.: Aesthetic Facial Analysis, chapter 19 in Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp.269-280
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Updated: May 1, 2017
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