391-400 MCQ in Facial Plastic and Reconstructive Surgery

391-400

391) Which of the following cleft defects is BEST repaired with the surgical technique shown in the drawing? Click the picture to enlarge image.


A. Cleft of the secondary palate
B. Complete unilateral cleft
C. Complete bilateral cleft
D. Submucous cleft
E. Oral-nasal fistulas of the hard palate

392) Which of the following cell types is MOST predominantly seen in the epidermis?

A. Langerhan’s cells
B. Keratinocytes
C. Melanocytes
D. Merkel’s cells
E. Cuboidal cells of the basal layer

393) Which of the following statements is TRUE regarding the use of irradiated costal cartilage in augmentation rhinoplasty?

A. Warping is quite common > 20 %
B. Significant resorption is also common > 25%
C. It should not be used to fashion a tip graft
D. All perichondrium should be removed from the rib graft
E. The most medial portion of the rib donor is the ideal for grafting

394) THE WAIT TIME before applying MAKE UP to the area of incision after an Upper Blepharoplasty is:

A. 2 days
B. 4 days
C. 6 days
D. 12 days
E. 14 days

395) Which of the following statements regarding Rhinoplasty is TRUE?

A. The best visualization is achieved by a bipedicle (bucket-handle) approach.
B. The nasal skin is thinner superiorly and inferiorly.
C. Medial osteotomies are performed before lateral osteotomies.
D. Lateral osteotomies start at the level of the floor of the nose.
E. The External Rhinoplasty approach divides a major support mechanism of the nose.

396) Which of the following statements about congenital microtia is TRUE?

A. Auricular reconstruction should be performed after atresia repair.
B. The best time to perform the surgery is after 8 years of age.
C. Irradiated cartilage is an alternative framework as satisfactory as autogenous cartilage.
D. The autogenous costal cartilage is taken from ipsilateral side of the chest.
E. The ninth rib is dissected to form the helical rim.

397) What PERCENTAGE of shrinkage is expected when using a composite graft of skin and cartilage to correct an alar margin retraction?

A. 1%
B. 5%
C. 10%
D. 20%
E. 30%

398) Which of the following treatment options is the BEST for a 18 month year old child with a submucous cleft palate easily noted on physical examination, but without hipernasality or speech disorder?

A. Two-flap palatoplasty
B. Three-flap palatoplasty
C. Furlow’s palatoplasty
D. Von Langenbeck’s palatoplasty
E. No surgical management

399) Which of the following statements regarding mandibular fractures is TRUE?

A. Mandibular fractures that are directed inferiorly and anteriorly are classified as horizontally unfavorable.
B. A Towne’s view gives an excellent view of the angle of the mandible.
C. Almost all condylar fractures are managed by open reduction.
D. When a symphysis fracture is identified, a subcondylar fracture should be rule out.
E. Almost all symphysis-parasymphysis mandibular fractures are managed by closed reduction.

400) Which fat pocket is MOST commonly involved post-surgically in the persistence of fat pseudo-herniation?

A. Medial upper eyelid fat pocket
B. Central upper eyelid fat pocket
C. Medial lower eyelid fat pocket
D. Central lower eyelid fat pocket
E. Lateral lower eyelid fat pocket


ANSWERS & REFERENCES


391) A     Cleft of the secondary palate

Senders C. W., Sykes J.M.: Cleft Palate, Chapter 12 in Pediatric Facial and Reconstructive Surgery (Smith and Bumsted, editors), Raven Press, 1993, pp. 159-171

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders, Chapter 40 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 1059-1078, 2009

392) B     Keratinocytes

Bennett R.G.: Anatomy and Physiology of the Skin, Chapter 1, Facial Plastic and Reconstructive Surgery, (Ira Papel, editor), Thieme Medical Publishers, second edition, 2002, pp.5

Bennett R.G.: Anatomy and Physiology of the Skin, Chapter 1, Facial Plastic and Reconstructive Surgery, (Ira Papel, editor), Thieme Medical Publishers, Third edition, 2009, pp.5

393) D     All perichondrium should be removed from the rib graft

Weber S. M., Cook T. A., Wang T. D.: Irradiated costal cartilage in augmentation rhinoplasty, Operative Techniques in Otolaryngology, Dec. 2007, Vol. 18, No. 4 , pp. 274-283

394) C     6 days

Pastorek N. J.: Upper lid Blepharoplasty, Chapter 17 in Facial Plastic and Reconstructive Surgery, (Ira Papel, editor), Thieme Medical Publishers, second edition, 2002, p. 193

Pastorek N. J.: Upper lid Blepharoplasty, Chapter 22 in Facial Plastic and Reconstructive Surgery, (Ira Papel, editor), Thieme Medical Publishers, Third edition, 2009, p. 268

Pastorek N.J.: Blepharoplasty chapter 179 in Head & Neck Surgery-Otolaryngology, (Bialey B.J, editor), Third Edition, 2001, p. 2314

395) C     Medial osteotomies are performed before lateral osteotomies.

Calhoun K. H.: Introduction to Rhinoplasty, Chapter 174 in Facial Plastic and Reconstructive Surgery, (Ira Papel, editor), Thieme Medical Publishers, second edition, 2002, pp.2229-2240

Toriumi D. M., Hecht D. A., Emer J. J.: External Rhinoplasty Approach, 175 in Facial Plastic and Reconstructive Surgery, (Ira Papel, editor), Thieme Medical Publishers, second edition, 2002, pp.2241-2253

396) E     The ninth rib is dissected to form the helical rim.

Ruder R. O.: Congenital Malformation of the Auricle, Chapter 64 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Second Edition, pp. 803-812, 2002

Ruder R. O.: Congenital Malformation of the Auricle, Chapter 75 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 1043-1057, 2009

397) C     10%

Quatela V. C., Wayne I.: Challenges of Secondary Rhinoplasty, Advances in Rhinoplasty, Facial Plastic Surgery Clinics of North America, Vol. 8, No. 4, 2000, p. 526

398) E     No surgical management

Bardach J., Salyer K.E.: Surgical Techniques in Cleft Lip and Palate, Mosby, Second Edition, 1991, pp. 242-243

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, pp. 1059-1078, 2009

399) D     When a symphysis fracture is identified, a subcondylar fracture should be rule out.

Leach J.L., Newcomer M.T.: Mandibular Fractures, Chapter 65 in Head and Neck Surgery-Otolaryngology, (Bailey, B.J., editor), Lippincott Williams & Wilkins, Third Edition, 2001, pp. 765-775

Garza J. R.: Mandibular Fractures, Chapter 72 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 1001-1015, 2009

400) E     Lateral lower eyelid fat pocket

Pastorek N.: Blepharoplasty, A Self-Instructional Package Committee on Continuing Education in Otolaryngology, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc., 1983, pp.106-107

Crumley R. L., Torkian B. A., Karam A. M.: Lower Eyelid Blepharoplasty, Chapter 23 in Facial Plastic and Reconstructive Surgery, (Papel, editor) Thieme, Third Edition, pp. 271-285, 2009

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Updated: June 1, 2017