Sunday, October 23, 2022

1551-1560 MCQ in Facial Plastic and Reconstructive Surgery

 1551-1560

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Updated: October 12, 2022 

1551) A "negative vector of the eye" noted in the lateral view of patient prior to blepharoplasty/eyelid surgery is related to

A. The upper eyelid
B. The lower eyelid
C. The lateral canthus
D. The medial canthus
E.  The brow

1552) Which of the following work up is the BEST recommended option for a patient with a self inflicted neck penetrating wound with a knife in Zone I? The patient is stable hemodynamically, without expanding hematoma or active bleeding?.

A. CT angiography
B. MRI angiography
C. Catheter conventional angiograpy
D. Ultrasound 
E. Surgical exploration

1553) The most common open approach used in the repair of Frontal Sinus Fractures is

A. Laceration present in the forehead
B. Horizontal midforehead furrow
C. Gullwing approach in the suprabrow position
D. Gullwing approach in the subbraw position
E.
Coronal approach

1554) Which of the following regional flaps is the best for reconstruction of a large posterior neck and scalp oval shape defect size 12 cm x 9 cm?

A. Pectoral Major Musculocutaneous flap
B. Trapezius Musculocutaneous flap
C. Sternocleidomastoid Musculocutaneous flap
D. Plastysma Musculocutaneous flap
E. Temporalis Muscle flap

1555) Which of the following statements regarding the FRICKE Flap is false?

A. It is a cutaneous laterally-based mono-pedicle transposition flap from the supraorbital area.
B. It is ideal for reconstruction of upper and lower eyelid defects (anterior lamella)
C. It is necessary to keep 1:4 ratio the base to length dimension.
D. It is mandatory the dissection just below the 
underlying muscles of the brow.
E. It is recommended do not exceed and angle of 90 degree rotation of the flap.

1556) Which of the following rhinoplasty deformities will MOST LIKELY BE corrected by applying the surgical technique represented in the drawing below?  Please note that an spreader graft is used in each side of the nasal septum as well as a columellar strut that interdigitates with the spreader grafts.

A. Saddle nose
B. Crooked nose
C. Short nose
D. Overprojected nose tip
E.  Pollybeak nasal deformity
.
1557) Which of statements regarding M-plasty technique is FALSE?
 
A. It is an excisional technique used to remove dog ears cutaneous deformities.
B. 
It is also used for shortening the final wound length to conserve normal tissue.
C. It is placed on the end of an incision to avoid crossing an aesthetic facial subunit.
D. It is useful for closing facial wounds under tension.
E.
"M" figure design  should have 30 degrees angles.

1558) Which of statements related to the "Tongue-in-Groove Technique in Septorhinoplasty is FALSE?

A. It is used in correcting a hanging columella/excess of columellar show.
B. The caudal septum is placed into the groove between the medial crura
C. It is useful for control nasal tip rotation, adjust tip position and correct caudal septal deviation.
D. It is not a conservative technique, involving resection of cartilage, therefore decreasing  the support of the nasal tip.
E. It can be used in primary and revision rhinoplasty cases.

1559) Which of the following indications is the LEAST adequate to apply the spreader flaps in rhinoplasty?

A. Unoperated nose, primary rhinoplasty.
B. Previous dorsal hump resection/secondary rhinoplasty.
C. Prominent dorsal hump.
D. Tension nose deformity
E. Mild crooked nose

1560) Which of the following statements regarding the Lower Trapezius flap is FALSE?

A. It is the most versatile of the trapezious flaps.
B. It is ideal for large defects in the posterior neck and posterior scalp
C. It is supply by the Transverse Cervical Artery (TCA) and the dorsal scapular artery (DSA)
D. It is mandatory the preservation of both arteries  - TCA and DSA - for flap survival.
E) It is usually close the donor site performing wide undermining of the margins.




ANSWERS & REFERENCES


1551) B     
The lower eyelid

Karimnejad K., Walen S.: Functional and Cosmetic Eyelid Surgery, Complications in Eyelid Surgery, Facial Plastic Surgery Clinic N. America, 24 , May 2016, pp. 193-203

1552) A    
CT angiography

Saito N., Hito R., Burke PA., Sakai O.: Imaging of penetrating injuries of head and neck current practice at a level I trauma center in the United States. Keio J Med 2014 63 (2): 22-33

Stewart M. G.: Penetrating Face and Neck Trauma, chapter 76 in Bailey's Head & Neck Surgery Otolaryngology, Volume One, Fifth Edition, (Johnson and Rosen, editors), 2014, pp. 1131-1140
 
1553) E     Coronal approach

Rodman R., Kellman R. M.: Chapter 36 Frontal Sinus Fractures, in Facial Plastic and Reconstructive Surgery, Clinical Reference  Guide, (Desai S.C, editor), Plural Publishing, 2017, pp. 357-362

1554) B    Trapezius Musculocutaneous flap
 
Day A. T., Chaudhary H., Richmon J. D.: Chapter 40, Regional Flaps, in Facial Plastic and Reconstructive Surgery, Clinical Reference  Guide, (Desai S.C, editor), Plural Publishing, 2017, pp. 403-414

1555) D.   It is mandatory the dissection just below the underlying muscles of the brow.


1556) C    Short nose 

Katira Kristopher, Guyuron B.: Contemporary Techniques for Effective Nasal Lengthening, Rhinoplasty: Contemporary Innovations, Facial Plastic Surgery Clinic N. America, 23 (2015), pp. 81-91

1557) D     It is useful for closing facial wounds under tension.


1558) D      It is not a conservative technique, involving resection of cartilage, therefore decreasing  the support of the nasal tip.
  
Russell W. H. Kridel, Bruce A. Scott, and Hossam M. T. Foda: The Tongue-in-Groove Technique in Septorhinoplasty, A 10-Year Experience, Archives of Facial Plastic Surgery,Vol. 1, No. 4, Published online: Oct 1, 1999
1459) B        Previous dorsal hump resection/secondary rhinoplasty.

Kovacevic M., Wurm J.: Spreader Flaps for Middle Vault Contour and Stabilization, Rhinoplasty: Contemporary Innovations, Facial Plastic Surgery Clinic N. America, 23 (2015), pp. 1-9


1560)    It is mandatory the preservation of both arteries  - TCA and DSA - for flap survival.

Day A. T., Chaudhary H., Richmon J. D.: Chapter 40, Regional Flaps, in Facial Plastic and Reconstructive Surgery, Clinical Reference  Guide, (Desai S.C, editor), Plural Publishing, 2017, pp. 403-414

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

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Updated: October 12, 2022 

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