Monday, April 26, 2010

281-290 MCQ in Facial Plastic and Reconstructive Surgery

281-290

281) Which of the following surgical options is BEST for management of the upper lip vermillion deficiency noted in the drawing below? Click the picture to enlarge image.



A. Single excision
B. V-Y advancement
C. W-Plasty excision
D. Forked flap procedure
E. Abbé flap

282) Which of the following Pedicle Flaps has the LARGEST AREA of tissue transfer and the GREATEST REACH of any regional flap?

A. Pectoralis Major Flap
B. Bakamjian Flap
C. Temporalis Muscle Flap
D. Trapezius Flap
E. Latissimus Dorsi Flap

283) Which statement regarding the Latissimus Dorsi Musculocutaneous Flap is FALSE?

A. Lateral decubitus position is necessary for harvesting.
B. It has an axial blood supply from the thoracodorsal artery.
C. The thoracodorsal nerve innervates the latissimus dorsi muscle.
D. The skin paddle width can reach more than 10 cm.
E. Primary closure is always possible even in large skin paddle defects.

284) Which of the following statements regarding Gracilis Muscle free tissue transfer is TRUE in microvascular dynamic facial reanimation?

A. The gracilis muscle is localized in the lateral thigh.
B. The nerve supply is from the posterior branch of the obturator nerve.
C. The blood supply is from branches of the superficial femoris artery.
D. It is the most commonly used muscle in the two-stage technique.
E. The time between the two stages of reanimation is 6 months.

285) Which of the following techniques of monitoring is the MOST commonly used in the Jejunum Free Flap?

A. Visual monitoring of exteriorized segment of jejunum.
B. Arteriography
C. Photoplethysmography
D.  Hydrogen clearance analysis
E. Analysis of venous blood close to the transferred segment.

286) Which of the following statements regarding compression plating in mandible fractures is FALSE?

A. Compression plates require bicortical screws.
B. Compression plates are placed along the basal border of the mandible.
C. Strong compression plates alone applied with large screws will overcome the distracting forces with high success rates.
D. Tension bands are used with compression plate techniques.
E. A miniplate above the inferior alveolar nerve and arch bars attached to the teeth are forms of tension bands.

287) Which of the following surgical approaches is BEST for the management of a Le Fort III fracture?

A. Extended bilateral sublabial incision
B. Facial degloving
C. Bicoronal incision flap
D. Bilateral sublabial and subciliary incisions
E. Bilateral lateral rhinotomy and frontozygomatic incision

288) Which of the following vascularized donor sites provides the BEST free flap for total mandible reconstruction?

A. Rib
B. Scapula
C. Fibula
D. Iliac crest
E. Humerus

289) Which of the following mandible plating techniques is the one MOST USEFUL in the management of an atrophic mandible fracture?

A. Lag screws
B. Dynamic compression plates (DCP)
C. Exccentric dynamic compression plates (EDCP)
D. Mandible reconstruction plates (MRP)
E. Multiples monocortical miniplates

290) Which of the following statements regarding the Fibula Osteocutaneous Free Flap is FALSE?

A. The fibula free flap will require preserving 3 cm of bone both proximally and distally.
B. Curvature of the mandible can be achieved using multiple osteotomies.
C. The peroneal artery provides the primary blood supply for the overlying skin of the lateral aspect of the calf and the fibula.
D. 25 cm of fibular bone can be harvested without marked morbidity.
E. The fibula free flap is the ideal for reconstruction of subtotal and total defects of the mandible.



ANSWERS & REFERENCES



281) B     V-Y advancement

Ling E. H., Wang T.D., Cook T.A.: Diagnosis and Treatment of Secondary Bilateral Cleft Lip Deformities, Surgery of Cleft Lip and Palate Deformities, Facial Plastic Surgery Clinics of North America, Volume 4, Number 3, pp. 326-331, August 1996

282) E     Latissimus Dorsi Flap

Annino Jr. D. J., Shu R.S.: Musculocutaneous Flaps, Chapter 46 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p.p. 564-565, 2002

Annino Jr. D. J., Shu R.S., Gold D. R.: Musculocutaneous Flaps, Chapter 56 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, p.p. 757-764, 2009

283) E     Primary closure is always possible even in large skin paddle defects.

Annino Jr. D. J., Shu R.S.: Musculocutaneous Flaps, Chapter 46 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p.p. 564-565, 2002

Annino Jr. D. J., Shu R.S., Gold D. R.: Musculocutaneous Flaps, Chapter 56 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, p.p. 757-764, 2009

284) D     It is the most commonly used muscle in the two-stage technique.

Clark M. J., Shockley W. W.: Management and Reanimation of the Paralyzed Face, Chapter 53 Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p.p. 676-681, 2002

Clark M. J., Shockley W. W.: Management of the Paralyzed Face, Chapter 63 Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, p.p. 869-895, 2009


285) A     Visual monitoring of exteriorized segment of jejunum.
Burkey B. B., Coleman Jr, 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 Jr, J.R.: Microvascular Flaps, chapter 57 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 765-793, 2009

286) C     Strong compression plates alone applied with large screws will overcome the distracting forces with high success rates.

Kellman R. M.: Clinical Applications of Bone Plating Systems to Facial Fractures, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 725-726, 2002

Kellman R. M.: Clinical Applications of Bone Plating Systems to Facial Fractures, Chapter 68 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 945-963, 2009

287) C     Bicoronal incision flap

Doerr T. D., Mathog R. H.: Le Fort Fractures (Maxillary Fractures), Chapter 60 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp.764-765, 2002

Doerr T. D., Mathog R. H.: Le Fort Fractures (Maxillary Fractures), Chapter 71 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 991-1000, 2009

288) C     Fibula

Genden E. M., Buchbinder D., Urken M. L.: Mandible Reconstruction and Osseointegrated Implants, Chapter 48 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 591-598, 2002

Genden E. M., Buchbinder D., Urken M. L.: Mandible Reconstruction and Osseointegrated Implants, Chapter 58 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 795-805, 2009

289) D     Mandible reconstruction plates (MRP)

Kellman R. M.: Clinical Applications of Bone Plating Systems to Facial Fractures, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 727-729, 2002

Kellman R. M.: Applications of Bone Plating Systems to Facial Fractures, Chapter 68 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 945-963, 2009

290) A     The fibula free flap will require preserving 3 cm of bone both proximally and distally.

Genden E. M., Buchbinder D., Urken M. L.: Mandible Reconstruction and Osseointegrated Implants, Chapter 48 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 594-595, 2002

Genden E. M., Buchbinder D., Urken M. L.: Mandible Reconstruction and Osseointegrated Implants, Chapter 58 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 795-805, 2009

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 Updated:  May 1, 2017

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