291-300 MCQ in Facial Plastic and Reconstructive Surgery

291-300

291) The four-hole plating system shown below was used to repair a mandible symphysis fracture. Which type of plating system is the one represented in the drawing? Click the picture to enlarge image.



A. Dynamic compression plate system (DCP)
B. Eccentric dynamic compression plate system (EDCP)
C. Reconstruction plate
D. Titanium hollow screw reconstruction plate (THORP)
E. Fracture plate (four-hole) with lag screws

292) Which of the following mandible fractures has the HIGHEST incidence of infection?

A. Symphysis/Parasymphysis
B. Body
C. Ramus
D. Angle
E. Condyle

293) The MOST common complication after the reduction of a zygomatic fracture is:

A. Diplopia
B. Enophthalmos
C. Orbital entrapment
D. Ectropion or inferior scleral show
E. Malar depression

294) Which of the following mandible fractures is usually managed by CLOSED REDUCTION in a dentate, adult patient?

A. Symphysis
B. Parasymphysis
C. Body
D. Angle
E. Condyle

295) Which of the following statements regarding the Jejunal Free Flap is TRUE?

A. It is rarely used in circumferential defects of the cervical esophagus.
B. It is harvested only by laparoscopic approach.
C. The second loop of jejunum is usually used.
D. Isoperistaltic orientation of the jejunum is not mandatory.
E. Dysphagia is usually not present postoperatively.

296) Which of the following statements is FALSE regarding oromandibular reconstruction with free-tissue transfer?

A. The fibula free flap has a high rate of success, around 95%.
B. The fibula free flap is the workhorse flap for oromandibular reconstruction.
C. The fibula free flap will allow osseointegrated implants
D. Through and through defects of the oral cavity are best reconstructed with use of the fibula free flap.
E. The Fibula Free Flap has reconstructive capacity in cases up to and including near-total mandibulectomy.

297) Which of the following statements is TRUE regarding flap failure after microvascular flap anastomosis?

A. Flap failure in free-tissue transfer is about 20-25%.
B. Thrombosis of the artery is more common than the thrombosis of the vein.
C. The failure of arterial anastomosis occurres within the first 24 hours.
D. The failure of venous anastomosis occurres within the first 12 hours.
E. Bleeding will cause flap failure and therefore, aspirin is contraindicated in the postoperative period.

298) Which of the following is A SOURCE of major bleeding when harvesting a calvarial bone graft?

A. Sigmoid sinus
B. Sagital sinus
C. Superficial temporal artery
D. Inferior petrosal sinus
E. Superior petrosal sinus

299) Which of the following statements regarding Open Structure Rhinoplasty is FALSE?

A. The marginal incision is made along the caudal margin of the intermediate and medial crura. extending to the angle and dome, then laterally to the lateral crura.
B. The midcollumellar incision has an inverted gull-wing shape.
C. The skin-soft tissue envelope is dissected from the lower lateral cartilages.
D. The columellar strut is placed between the medial crura and extended to the nasal spine.
E. The leading edge of the tip graft is placed 2 mm above the existing domes.

300) Which of the following surgical options is BEST for the management of a “tight upper lip” after repair of a bilateral cleft lip?

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


ANSWERS & REFERENCES



291) B     Eccentric dynamic compression plate system (EDCP)

Greenberg A. M.: Basics of AO/ASIF Principles and Stable Internal Fixation of Mandibular Fractures, Chapter 5, in Craniomaxilofacial Fractures, (Greenberg A. M., editor), Springer-Verlag, pp. 41-67

Costantino P. D.: Principles of Facial Plating Systems, Chapter 67 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 929-944, 2009

292) D     Angle

Leach J. L., Newcomer M. T.: Mandibular Fractures, Chapter 65 in Head and Neck Surgery-Otolaryngology (Bailey), Third Edition, Lippincott Williams & Wilkins, 2001, pp. 768-774

Smith J. E., Leach J. L .: Mandibular Fractures, Chapter 69 in Head and Neck Surgery-Otolaryngology (Bailey), 4th Edition, Lippincott Williams & Wilkins, 2006, pp. 961-974

293) E     Malar depression

Gates G. A.: Zygomatic Fracture in Current Therapy in Otolaryngology-Head and Neck Surgery, Mosby, Sixth Edition, 1998, pp. 135-138

294) E     Condyle

Leach J. L., Newcomer M. T.: Mandibular Fractures, Chapter 65 in Head and Neck Surgery-Otolaryngology (Bailey), Third Edition, Lippincott Williams & Wilkins, 2001, pp. 766-773

Smith J. E., Leach J. L .: Mandibular Fractures, Chapter 69 in Head and Neck Surgery-Otolaryngology (Bailey), 4th Edition, Lippincott Williams & Wilkins, 2006, pp. 961-974

295) C     The second loop of jejunum is usually used. 

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

296) D     Through and through defects of the oral cavity are best reconstructed with use of the fibula free 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

297) C     The failure of arterial anastomosis occurres within the first 24 hours.

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

298) B     Sagital sinus

Cheney M.L.: Reconstructive Grafting by the Open Nasal Approach, Open Rhinoplasty, Facial Plastic Surgery Clinics of North America (Toriumi D. M, Guest Editor), Saunders, Vol. 1, Number 1, pp. 99-109, August 1993

299) D     The columellar strut is placed between the medial crura and extended to the nasal spine.

Toriumi D. M., Johnson C. M.: Open Structure Rhinoplasty, Featured Technical Points and Long-Term Follow-up, in Open Rhinoplasty, Facial Plastic Surgery Clinics of North America (Toriumi D. M, Guest Editor), Saunders, Vol. 1, Number 1, pp. 1-21, August 1993

Adamson P. A., Litner J. A.: Open Rhinoplasty, Chapter 41 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 529-546, 2009

300) E     Abbé flap

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

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 Updated:  May 1, 2017