-------------------------------
Updated: March 25, 2018
1301) Which of the following statements regarding the submental flap used for oncological oral cavity reconstruction is TRUE?
A. The submental flap is contraindicated in patients with clinical or radiological evidence of Level I metastatic disease.
B. It is based with the facial artery and vein
C. the donor site rarely can be closed primarily
D. The submental flap is associated with a similar length of operation than a radial free flap.
E. The survival of the flap is approximately 80%
1302) Which of the following is the MOST common reported complication in forearm free flap donor site?
A. Skin graft failure
B. Functional deficits
C. Sensory disturbances
D. Poor esthetic result
E. Long standing forearm pain
1203) What is the incidence of rhytidectomy flap necrosis in smokers?
A. It is increased 2 times
B. It is increased 5 times
C. It is increased 9 times
D. It is increased 12 times
E. It is increased 18 times
1304) Which of following statements regarding the submental flap is TRUE?
A. The submental flap is based in the facial artery and vein
B. The submental flap can be harvested as fascio-cutaneous or musculo-cutaneous design only - no osteo-cutaneous design possible.
C. The cutaneous paddle can be designed up to 5 cm wide
D. The submental flap can include strips of mylohyoid and anterior digastric muscle.
E. The cervical defect is closed by secondary intention healing.
1305) Which of the following statements is FALSE regarding Mandibular Angle Fractures?
A. The presence of a third molar weaken the angle of the mandibule.
B. These fracture occurred in the mandibule angle which has a cross-section area thinner than the body or ramus.
B. Fractures of the mandibular angle are more prone to postoperative complications.
D. The use of intraoral approach with a single miniplate of 2-mm along the superior border of angle (Champy technique) is insufficient for a successful repair.
E. Extraoral approach with rigid fixation and intraoral approach with semi-rigid fixation are adequate for treatment/management
1306) Which of the statements is FALSE regarding the FLAP drawing shown below? Please note that the arrow A is outside of the flap and the arrow B is the axial blood supply.
A. It is a fasciocutaneous or fascial flap.
B. The arrow A in the picture represents the supraclavicular artery.
C. The Doppler ultrasonography is useful in locating the axial pedicle to the flap.
D.The dissection is done deep to the fascia overlying the deltoid and trapezious muscles.
E. The spinal accessory nerve can be traumatized in the medial dissection.
1307) Which of the following techniques is the most commonly used in Radial Forearm Free Flap (RFFF) to reconstruct the donor site?
A. Primary closure
B. Full-thickness skin graft
C. Split-thickness skin graft
D. Alloderm
E. Alloderm and Split
thickness skin graft
1308) Which of the following statements regarding Z-plasty for nasal vestibular stenosis is FALSE?
A. It is used for nasal vestibular stenosis (Alar Subunit)
B. It is used also for scarring related to sill or columella
C. Two triangular flaps are transposed around the involved nasal ala.
D. Alternative techniques are local flaps, composite flaps or cartilage grafts
E. The use of a stent is not mandatory.
1309) Which of the following statements in the submental flap for oncological oral cavity reconstruction is FALSE?
A. It is based with the facial artery
B. The neck dissection is done prior to the submental flap.
C. It is indicated for reconstruction of small to moderate size defects of the oral cavity.
D. The inclusion of the anterior portion of the digastric muscle can improved survival
E. The donor site can be closed primarily
1310) Which of the following is the BEST method used in Radial Forearm Free Flap (RFFF) to decrease donor site morbidity?
A. Primary closure
B. Full-thickness skin graft
C. Split-thickness skin graft
D. Alloderm
E. Alloderm and Split thickness skin graft
ANSWERS & REFERENCES
1301) A The submental flap is contraindicated in patients with clinical or radiological evidence of Level I metastatic disease.
Howard B. E., Nagel T. H., Donald C. B., Hinni M. L., Hayden R. E.: Oncologic Safety of the Submental Flap for Reconstruction in Oral Cavity Malignancies, Otolaryngology-Head and Neck Surgery 2014, Vol. 150 (4)558-562
1302) A Skin graft failure
Wester J.L. Pittman A. L., Lindau R. H., Wax M. K., AlloDerm with Split-Thickness Skin Graft for Coverage of the Forearm Free Flap Donor Site, Otolaryngology-Head and Neck Surgery 2014, Vol. 150 (1) 47-52
1303) D It is increased 12 times
Perkins S. W., Waters H. H., in Rhytidectomy chapter 14 in Facial Plastic and Reconstructive Surgery (Papel Ira D.,editor), Fourth Edition, Thieme, 2016, pp. 139-158
Adamson P. , Moran ML., Complications of cervicofacial rhytdectomy, Facial Plastic Surgery Clini North America 1993; 112 pp. 257-270
1304) D The submental flap can include strips of mylohyoid and anterior digastric muscle.
Revenaugh P.C., Shipchandler T. Z., Burkey B.B., Microvascular and Regional Flaps in Head and Neck Reconstruction chapter 51 in Facial Plastic and Reconstructive Surgery (Papel Ira D.,editor), Fourth Edition, Thieme, 2016, pp. 650-677
1305) D The use of intraoral approach with a single miniplate of 2-mm along the superior border of angle (Champy technique) is insufficient for a successful repair
Hsueh W. D., Schechter C.B., Shaw I. T., Stupak H. D.: Comparison of Intraoral and Extraoral Approaches to Mandibular Angle Fracture Repair With Cost Implications, Laryngoscope, 126:591-595, 2016
1306) B The arrow A in the picture represents the supraclavicular artery.
Revenaugh P.C., Shipchandler T. Z., Burkey B.B., Microvascular and Regional Flaps in Head and Neck Reconstruction chapter 51 in Facial Plastic and Reconstructive Surgery (Papel Ira D.,editor), Fourth Edition, Thieme, 2016, pp. 650-677
1307) C Split-thickness skin graft
https://emedicine.medscape.com/article/881055-treatment
Wester J.L. Pittman A. L., Lindau R. H., Wax M. K., AlloDerm with Split-Thickness Skin Graft for Coverage of the Forearm Free Flap Donor Site, Otolaryngology-Head and Neck Surgery 2014, Vol. 150 (1) 47-52
Moubayed S. .P., Mourad M. W., Riera March A.:Facial Plastic and Reconstructive Surgery, Concepts, Questions and Answers, chapter 25 in Free TissueTransfer in Head and Neck Reconstruction, 2020, pp. 217-222
1308) B It is used also for scarring related to the sill and columella.
Choudhury N., Hariri A., Saleh H.: Z-plasty of the Alar Subunit to Correct Nasal Vestibular Stenosis, Otolaryngology-Head and Neck Surgery, 2014, 150(4), 703-706
1309) A It is based with the facial artery
https://emedicine.medscape.com/article/1289799-overview#a4
Amin A. A., Sakkary M.A., Khalil A. A., Rifaat M. A., Zayed S. B.: The submental flap for oral cavity reconstruction: Extended indications and technical refinements, Head and Neck Oncology 2011, 3:51
1310) A Primary closure
Wester J. L., Pittman A. L., Lindau R. H., Wax M. K.: Alloderm with Split Thickness Skin Graft for Coverage of the Forearm Free Flap Donor Site, Otolaryngology-Head and Neck Surgery 2014, Vol. 150 (1)47-52
---------------------------------------
Updated: March 25, 2018
No comments:
Post a Comment