1-10 MCQ in Facial Plastic and Reconstructive Surgery

1-10
-----------------------------
Updated: May 28, 2018

1) Which of the following unilateral cleft lip repairs is the ONE represented in the drawing below?


A. Millard
B. Tennison-Randall
C. Millard with triangular flap inferiorly based
D. Two-triangle flap
E. LeMesurier

2) The “pinch technique” in blepharoplasty is MOST commonly used with which technique

A. Subciliary transcutaneous lower eyelid blepharoplasty, skin technique
B. Subciliary transcutaneous lower eyelid blepharoplasty, skin-muscle technique
C. Subciliary transcutaneous lower eyelid blepharoplasty, both techniques mentioned above
D. Transconjuntival lower lid blepharoplasty
E. Lower eyelid blepharoplasty, SOOF (suborbicularis oculi fat) technique

3) The END POINT of microdermabrasion is which of the following?

A. Erythema.
B. Edema
C. Blister formation
D. Yellow-pale decoloration of the skin
E. Frosting

4) Which of the following techniques is the MOST useful to treating glabellar frown lines?

A. Chemical peeling
B. Botox injection
C. Microdermabrasion
D. Dermabrasion
E. CO2 laser resurfacing

5) The VERTICAL GLABELLAR frown lines are due to the contraction of which muscle?

A. Frontalis muscle
B. Corrugator muscle
C. Procerus muscle
D. Orbicularis oculi muscle
E. Depressor supercilii

6) The helical rim in microtia repair is created by which number CONTRALATERAL COSTAL RIB?

A. 5
B. 6
C. 7
D. 8
E. 9

7) Which of the following statements IS TRUE about a “note flap”?

A. It is a rotation flap
B. It is useful to close a rectangular defect
C. It is useful to close a fusiform defect
D. It is useful to close a circular defect
E. It is an advancement flap

8) An aggressive helical rim setback will PRODUCE which of the following occurrences?

A. Protrusion of the lobule
B. Extrusion of the sutures
C. Vertical post deformity
D. Telephone ear deformity
E. Reverse telephone ear deformity

9) On the lateral view the columelar show or alar/columellar relationship SHOULD BE how many mm?

A. 0 mm
B. 1 mm
C. 3 mm
D. 5 mm
E. 6 mm

10) The nasolabial angle in the male IS CHARACTERIZED by which of the following?

A. It is 80 degrees.
B. It is 105 degrees.
C. It is more acute than the female.
D. It is more obtuse than the female.
E. There is no difference between males and females.


ANSWERS & REFERENCES


1) B     Tennison-Randall

Bumsted R. M.: Management of Unilateral Cleft Lip, Chapter 10, in Pediatric Facial Plastic and Reconstructive Surgery (Smith, Bumsted, editors), Raven Press, pp. 131-145, 1992

Capone R. B., Sykes J. M.: in chapter 76 Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) pp. 1059-1078, 2009

 http://emedicine.medscape.com/cleftlip


2) D     Transconjuntival lower lid blepharoplasty

Rankin B.S., Arden R.L., Crumley R.L.: Lower Eyelid Blepharoplasty in chapter 27 Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 202, 2002

Crumley R. L., Torkian B. A., Karam A. M.: in chapter 23 Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) pp. 271-285, 2009

Perkins S. W. , Prischmann J.: Lower Eyelid Blepharoplasty, chapter 187, Bailey's Head & Neck Surgery Otolaryngology,  (Johnson J.T., Rosen C. A.,editors), Volume two, fifth edition, Wolters Klumer/Lippincott Williams & Wilkins, 2014, pp. 3085-3102

3) A     Erythema

http://www.emedicine.com/ent/topic739.htm

Freeman M. S.: Microdermabrasion, Facial Rejuvenation: Nonsurgical Modalities, Facial Plastic Surgey Clinics of North America, Vol. 9 No. 2, pp. 257-259, 2001

4) B     Botox injection

Carruthers J., Carruthers A.: Botulinum Toxin (Botox) Chemodenervation for Facial Rejuvenation in Facial Plastic of North America, Vol. 9 No. 2, p. 198, May 2001

Gillman G. S.: Cosmetic Uses of Neurotoxins and Injectable Fillers, chapter 197, Bailey's Head & Neck Surgery Otolaryngology,  (Johnson J.T., Rosen C. A.,editors), Volume two, fifth edition, Wolters Klumer/Lippincott Williams & Wilkins, 2014, pp. 3239-3251

 http://emedicine.medscape.com/article/841964-overview

5) B     Corrugator muscle

Zimbler M.S., Kokoska M.S., Thomas J.R.: Anatomy and Pathophysiology of Facial Aging in Facial Plastic of North America, Vol. 9 No. 2, p. 183, May 2001

Graham III H. D., Quatela V. C., Sabini P.: in chapter 20 Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) pp. 227-241, 2009

 Karini K., Adamson P.A.:, chapter 185, Bailey's Head & Neck Surgery Otolaryngology,  (Johnson J.T., Rosen C. A.,editors), Volume two, fifth edition, Wolters Klumer/Lippincott Williams & Wilkins, 2014, pp. 3053-3073

6) E     9


Ruder R.O: Congenital Malformation of the Auricle in chapter 64, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) p. 808, 2002

Ruder R.O: Congenital Auricular deformities in chapter 75, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1043-1057, 2009

7) D     It is useful to close a circular defect

Park S.: Local and Regional Cutaneous Flaps in chapter 44, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) p. 808, 2002

Park S.: Congenital Auricular deformities in chapter 54, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 721-743, 2009

8) E     Reverse telephone ear deformity

Nachlas N.E :Otoplasty in chapter 27, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) p. 320, 2002

Nachlas N.E.: Otoplasty in chapter 34, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 421-433, 2009

http://emedicine.medscape.com/reversetelephonearticle

9) C     3 mm

Orten S.S., Hilger P.A.: Facial Analysis of the Rhinoplasty Patient in chapter 31, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 365-366, 2002

Boahen K.D.O., Orten S.S., Hilger P.A.: Facial Analysis of the Rhinoplasty Patient in chapter 38, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 477-487, 2009

Gillman G. S.: Rhioplasty: Incisions, Aproaches and Analysis, chapter 180, Bailey's Head & Neck Surgery Otolaryngology,  (Johnson J.T., Rosen C. A.,editors), Volume two, fifth edition, Wolters Klumer/Lippincott Williams & Wilkins, 2014, pp.2941-2951


10) C     It is more acute than the female

Orten S.S., Hilger P.A.: Facial Analysis of the Rhinoplasty Patient in chapter 31, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 365, 2002

Boahen K.D.O., Orten S.S., Hilger P.A.: Facial Analysis of the Rhinoplasty Patient in chapter 38, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 477-487, 2009

Gillman G. S.: Rhioplasty: Incisions, Aproaches and Analysis, chapter 180, Bailey's Head & Neck Surgery Otolaryngology,  (Johnson J.T., Rosen C. A.,editors), Volume two, fifth edition, Wolters Klumer/Lippincott Williams & Wilkins, 2014, pp.2941-2951

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 Updated: May 28, 2018

11-20 MCQ in Facial Plastic and Reconstructive Surgery

11-20

11) Which surgical management IS NOT INDICATED in the mandible fracture represented in the drawing below? Click the picture to enlarge image.

A. Two lag screws
B. Four-hole dynamic compression plate
C. Four-hole dynamic compression plate (DCP) and an arch bar
D. Four-hole eccentric dynamic compression plate (EDCP)
E. Reconstructive plate

12) At which age is a cleft lip repair BEST PERFORMED?

A. 1 month
B. 3 months
C. 6 months
D. 9 months
E. 12 months

13) In the 60 degree Z-plasty technique the length of the scar dimension is INCREASED by which percentage?

A. 25 percent
B. 30 percent
C. 50 percent
D. 60 percent
E. 75 percent

14) A webbed scar resulting as a complication of upper eyelid blepharoplasty is BEST corrected by which technique?

A. Single excision
B. Serial excision
C. Z-plasty repair
D. Geometric broken line closure repair
E. Dermabrasion

15) Which statement is TRUE about the NORMAL ANATOMY of the lower eyelid?

A. The lower eyelid margin is 2 mm above the inferior corneal limbus.
B. The lower eyelid margin is 2 mm below the inferior corneal limbus.
C. The lateral canthal angle is 2 mm inferior to the medial canthal angle.
D. The lateral canthal angle is 2 mm superior to the medial canthal angle.
E. The lateral canthal angle and the medial canthal angle are at the same level.

16) Which of the following statements is FALSE about the running W-plasty technique for scar revision?

A. Each limb of the triangles should be 5 mm in length.
B. The apex of the triangles should be 60 degree angles.
C. The final triangle at the terminal corners of a running W-plasty should be at a 60 degree angle.
D. It is used in scars oriented perpendicular to the RSTL (relaxed skin tension lines).
E. It is used in unfavorable scars of the cheek area.

17) Which of the following IS NOT a treatment for retrobulbar hematoma occuring as a complication of blepharoplasty?

A. Ice saline compresses
B. Opening suture lines
C. Diamox, 500 mg, slow IV push
D. Decadron, 10 mg IV push
E. Medial canthotomy with inferior cantholysis

18) Which of the following statements is TRUE about the vertical axis of normal ear architecture?

A. It is inclined posteriorly 5 degrees.
B. It is inclined anteriorly 5 degrees.
C. It is inclined posteriorly 15 degrees
D. It is inclined anteriorly 15 degrees.
E. It remains in the vertical axis without inclination either anteriorly or posteriorly.

19) Where is the IDEAL PLACE from which to harvest the skin graft used in third stage reconstruction of congenital microtia repair?

A. Thigh
B. Supraclavicular
C. Preauricular
D. Postauricular
E. Buttocks

20) Which of the following statements is TRUE about the scapha?

A. It is the fossa located between the superior and inferior crus of anthelix.
B. It is the fossa located between the tragus and antitragus.
C. It is the fossa located between the concha cymba and the concha cavum.
D. It is the fossa located between the inferior crus of anthelix and the cymba concha.
E. It is the fossa located between the helix and the antihelix.


ANSWERS & REFERENCES


11) B     Four-hole dynamic compression plate

Greenberg A.M.: Craniomaxillofacial Fractures, Principles of Internal Fixation Using the AO/ASIF Technique, Springer-Verlag, pp.54-56, 1993

12) B     3 months


Sykes M. Jonathan: Diagnosis and Treatment of Cleft Lip and Palate Deformities in chapter 65, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 818, 2002

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

13) E     75 percent

Cook T. A., Guida R. A., Burke A. J. C., Soft Tissue Techniques in chapter 3, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 26-37, 2002

Triana Jr. R. J., Murakami C. S., Larrabee Jr. W. F.: Skin Grafts and Local Flaps in chapter 4, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, third edition (Ira Papel, editor) pp. 41-58, 2009

Frodel J.L., Wang T.D: Scar Revision in Plastic Surgery Clinics of North America, Vol. 6 Number 2, p. 150, May. 1998

14) C     Z-plasty repair

Pastorek N.: Upper lid Blepharoplasty in Plastic Surgery Clinics of North America, Vol. 3 Number 2, p. 143, May. 1995

Crumley R. L., Torkian B. A., Karam A. M.: Lower Eyelid Blepharoplasty in chapter 23, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 271-285, 2009

15) D     The lateral canthal angle is 2 mm superior to the medial canthal angle

Shorr N., Edelstein C., Shorr J.K.: Madame Butterfly Procedure Total Lower Eyelid Reconstruction in Three Layers using a Hard Palate Graft in Facial Plastic Surgery Clinics of North America, Vol. 6 Number 2, pp. 22-223, May. 1998

Crumley R. L., Torkian B. A., Karam A. M.: Lower Eyelid Blepharoplasty in chapter 23, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, third edition (Ira Papel, editor) pp. 271-285, 2009

16) C     The final triangle at the terminal corners of a running W-plasty should be at a 60 degree angle

Park S.: Scar Revision through W-Plasty in Facial Plastic Surgery Clinics of North America, Vol. 6 Number 2, p. 158, May. 1998

17) E     Medial canthotomy with inferior cantholysis

Adamson P.A. Constantinides M.S.: Complications of Blepharoplasty in Facial Plastic Surgery Clinics of North America, Vol. 3 Number 2, p. 214, May. 1995

Rankin B. S., Arden R. L., Crumley R. L.:Lower Eyelid Blepharoplasty in chapter 18, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 196-207, 2002

Crumley R. L., Torkian B. A., Karam A. M.: Lower Eyelid Blepharoplasty in chapter 23, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 271-285, 2009

18) C     It is inclined posteriorly 15 degrees

Cheney M.L.: Repair of Typical and Atypical Microtia in Facial Plastic Surgery Clinics of North America, Vol. 5 Number 4, p. 372, Nov. 1997

Ridley M. B., VanHook S. M.: Aesthetic Facial Proportion in chapter 11, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 119-133, 2009

19) E     Buttocks

Cheney M.L.: Repair of Typical and Atypical Microtia in Facial Plastic Surgery Clinics of North America, Vol. 5 Number 4, p. 337, Nov. 1997

Ruder R.O.: Congenital Auricular Deformities in chapter 75, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1043-1057, 2009

20) E     It is the fossa located between the helix and the antihelix

Lazor J.: Anatomy and Embryology in Facial Plastic Surgery Clinics of North America, Vol. 5 Number 4, p. 307, Nov. 1997

Nachlas N. E.: Otoplasty in chapter 27, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 309-321, 2002

Nachlas N.E.: Otoplasty in chapter 34, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 421-433, 2009

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 Updated: April 26, 2017

21-30 MCQ in Facial Plastic and Reconstructive Surgery

21-30

21) Which of the following surgical techniques used for cleft palate repair is REPRESENTED in the drawing below? Click the picture to enlarge image.

A. Von Langenbeck’s Palatoplasty
B. Three-Flap Palatoplasty
C. Two-Flap Palatoplasty
D. Furlow’s Palatoplasty
E. Four-Flap Palatoplasty

22) Which of the following scars is MOST likely to be well camouflaged?

A. 4 cm linear scar running perpendicular to the RSTL (relaxed skin tension lines)
B. 4 cm linear scar elevated and parallel to the RSTL
C. 4 cm linear scar depressed and parallel to the RSTL
D. 4 cm linear scar parallel to the RSTL without depression or elevation
E. 4 cm linear scar perpendicular to the lower eyelid edge

23) A 10-year-old boy has a linear vertical forehead scar extending from the hairline to the left eyebrow after facial trauma which occurred 1 year ago. Which is the MOST useful scar revision technique in this case?

A. Running W-plasty
B. Single W-plasty
C. Multiple Z-plasty
D. Single excision
E. Serial excision

24) Which is the following surgical techniques is BEST for reconstruction of a full-thickness defect involving 40% of the upper lip reaching the oral commisure?

A. Abbé flap
B. Estlander flap
C. Primary closure
D. Rhomboid flap
E. Nasolabial flap

25) Which of the following statements is TRUE about Millard technique for unilateral cleft lip repair?

A. Minimal tissue is discarded.
B. The suture line is not well camouflaged.
C. The alar base and nasal floor are difficult to reconstruct due to poor access to the nose.
D. The procedure will not allow alterations or adjustments during the operation.
E. Contraction of the vertical scar and/or notching of the vermilion is seldom encountered.

26) A patient is complaining of ear pain on the third postoperative day after an otoplastic procedure. Which of the following conditions is MOST likely the cause of the ear pain?

A. Hematoma
B. Infection
C. Wound dehiscence
D. Granuloma formation
E. Keloid formation

27) The satyr's ear (devil's ear) deformity is BEST treated with:

A. V-Y plasty
B. Z-Plasty
C. Interval intralesional injection with steroids
D. Excision and primary closure
E. Transposition flap

28) A-50-year-old female underwent rhytidectomy and blepharoplasty procedures with local anesthesia and I.V. sedation. The next day postop, less than 24 hours after the surgical procedure, the patient have noted to have a right-sided paralysis of the temporal branch of the facial nerve. The BEST immediate treatment is:

A. Immediate exploration and direct anastomosis without microscope assistance
B. Immediate reexploration and direct anastomosis with microscopic assistance
C. Corticosteroids
D. Corticosteroids and antiviral medications
E. Reassurance

29) The Z-Plasty INVOLVES:

A. An advancement flap
B. A rotation flap
C. A transposition flap
D. An interpolation flap
E. An interpolation and rotation flap

30) The MOST common complication of TRANSCONJUNTIVAL lower blepharoplasty is:

A. Inadequate fat excision
B. Excessive fat excision
C. Inferior oblique muscle injury
D. Eyelid malposition
E. Bleeding

ANSWERS & REFERENCES


21) D     Furlow’s Palatoplasty

Skykes J. M.: Diagnosis and Treatment of Cleft Lip and Palate Deformities, Chapter 65 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 824-828, 2002

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

Davit III A. J., Otteson, Losee J. E.: Comprehensive Cleft Care, Chapter 103 in
Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp. 1556-1573
-
22) D     4 cm linear scar parallel to the RSTL without depression or elevation

Wang T.: Scar Revision in Plastic Surgery Clinics of North America, Vol. 6 Number 2, pp. 137-138, May. 1998

Kokoska M. S., Thomas J.R.: Scar Revision in chapter 5, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 59-65, 2009

Regan Thomas J., Mobley S. R.: Scar Revision and Camouflage, chapter 21 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 295-301

23) A     Running W-plasty

Park S.: Scar Revision through W-Plasty in Plastic Surgery Clinics of North America, Vol. 6 Number 2, p. 160, May. 1998

Kokoska M. S., Thomas J.R.: Scar Revision in chapter 5, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 59-65, 2009

Regan Thomas J., Mobley S. R.: Scar Revision and Camouflage, chapter 21 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 295-301

24) B     Estlander flap

Cupp C. L., Larrabee, Jr.: Reconstruction of the lips, Operative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 4. No. 1, March, pp. 46-53, 1993

Hooffmann J.F., Cook T.A.: Reconstruction of Facial Defects, Chapter 26 in Otolaryngology-Head and Neck Surgery (Cummings, Fredrickson, Harker, Krause, Schuller, editors), Second Edition, Mosby, Vol. 1, p. 445, 1993

Baker S. R.: Reconstruction of Facial Defects, chapter 24 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 342-363

25) A     Minimal tissue is discarded

Sykes J. M.: Diagnosis and Treatment of Cleft Lip and Palate Deformities in chapter 65, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 813-829, 2002

Bardach J., Salyer K.E.: Surgical Techniques in Cleft Lip and Palate, Mosby Second Edition, p. 9, 1991

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

26) B     Infection

Nachlas N. E.:Otoplasty in chapter 27, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, second edition (Ira Papel, editor) pp. 309-321, 2002

Nachlas N.E: Otoplasty in chapter 34, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 421-433, 2009

Cheney M.L., Rounds M: Otoplasty in Facial Plastic Surgery Clinics of North America, Vol. 5 Number 4, p. 323 Nov. 1997

27) A     V-Y plasty

Perkins S., Dayan S.: Rhytidectomy in chapter 15 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers p. 169, 2002

Perkins S., Naderi S.: Rhytidectomy in chapter 19, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 207-225, 2009

Baker S. R.: Rhytidectomy, chapter 28 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 404-427

28) E     Reassurance

Perkins S., Dayan S.: Rhytidectomy in chapter 15 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, pp. 168-169, 2002

Perkins S., Naderi S.: Rhytidectomy in chapter 19, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 207-225, 2009

Baker S. R.: Rhytidectomy, chapter 28 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 404-427

29) C     A transposition flap

Kokoska M.S., Thomas J. Regan: Scar Revision in chapter 5 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, p. 57, 2002

 Kokoska M. S., Thomas J.R.: Scar Revision in chapter 5, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 59-65, 2009

Regan Thomas J., Mobley S. R.: Scar Revision and Camouflage, chapter 21 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 295-301

30) A     Inadequate fat excision

Weinberg D.A., Baylis H. I.: Transconjuntival lower blepharoplasty in chapter 31 in Facial Plastic Surgery (Millet M.J., editor), Appleton & Lange, p. 306, 1997

Palmer FR 3rd, Rice DH, Churukian MM.: Transconjunctival blepharoplasty. Complications and their avoidance: a retrospective analysis and review of the literature, Arch Otolaryngol Head Neck Surg. 1993 Sep;119(9):993-9.

Korchia D, Braccini  F., Paris J, Thomassin JM: Transconjunctival approach in lower eyelid blepharoplasty,  Can J Plast Surg. 2003 Autumn; 11(3): 166–170.


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Updated: April 26, 2017

31-40 MCQ in Facial Plastic and Reconstructive Surgery

31-40

31) After intervention, which of the following scars in the one with the HIGHEST possibility of a POOR cosmetic result?

A. A
B. B
C. C
D. D
E. E

32) The MOST useful palatoplasty technique for repair of complete unilateral cleft palate deformity is:

A. Furlow’s technique
B. Von Langenbeck palatoplasty technique
C. Three-Flap palatoplasty technique
D. Two-Flap palatoplasty technique
E. Two-Flap palatoplasty technique with associated vomerian flaps

33) The MOST adequate timing for alveolar bone grafting in cleft deformities is:

A. 3 months of age, associated with lip repair
B. 1 year of age, associated with palate repair
C. 3 years of age
D. 10 years of age
E. 18 years of age

34) Which of the following statements BEST describes the Millard lip repair?

A. The medial segment is rotated superiorly and the lateral segment is advanced medially.
B. The medial segment is rotated inferiorly and the lateral segment is advanced medially.
C. The medial segment is advanced laterally and the lateral segment is rotated inferiorly.
D. The medial segment is advanced laterally and the lateral segment is rotated superiorly.
E. The medial and the lateral segments have a rotation and advancement component.

35) Which of the following statements about the triangular flap technique to repair a unilateral cleft lip is TRUE?

A. Minimal tissue is discarded.
B. The suture line is well camouflaged.
C. Exact measurements are difficult to obtain and results are not consistently reproducible.
D. The procedure will allow alterations or adjustments during the operation after the triangular flap has been executed.
E. It is a consistent clef lip repair technique for decreasing vertical lip contraction

36) Which of the following wound adhesives is the one APPROVED by the Food and Drug Administration (FDA) for closure of the skin?

A. Butyl-2-cyanoacrylate
B. Octyl-2-cyanoacrylate
C. Ethyl-2-cyanoacrylate
D. Butyl-8-cyanoacrylate
E. Octyl-8-cyanoacrylate

37) Which of the following statements is TRUE about brow position?

A. The medial end of the brow is located along a vertical line drawn through the ala of the nose.
B. In men, the brow should be well above the orbital rim.
C. The lateral end of the eyebrow is located 2 mm above an horizontal line passing through the medial end of the eyebrow.
D. In women the brow is more horizontal and is positioned more inferiorly than the male eyebrow.
E. The maximum height of the brow should be at the medial limbus

38) Which of the following is an absolute CONTRAINDICATION to facial chemical peeling?

A. History of herpes infection
B. Fitzpatrick Type IV
C. Fitzpatrick Type VI
D. Telangiectases
E. Recent isotretinoin treatment

39) Which of the following statements is FALSE about blepharoptosis?

A. It involves a thin upper eyelid.
B. It involves a high upper eyelid fold.
C. The levator function is normal.
D. It involves a low upper eyelid fold.
E. Involutional ptosis is the most common etiology.

40) The BEST candidates for chemoexfoliation rejuvenation technique are:

A. Oriental males and females.
B. African American females.
C. Males in general.
D. Males with oily skin.
E. Females with fair skin.



ANSWERS & REFERENCES


31) C     C


Kokoska M. S., Thomas J. R.: Scar Revision, Chapter 5 in Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, p. 57, 2002

Kokoska M. S., Thomas J.R.: Scar Revision in chapter 5, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 59-65, 2009

Regan Thomas J., Mobley S. R.: Scar Revision and Camouflage, chapter 21 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.295-301

32) D     Two-Flap palatoplasty technique

Sykes J. M: Diagnosis and Treatment of Cleft Lip and Palate Deformities in chapter 65 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, p. 828, 2002

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

33) D     10 years of age

Sykes J. M: Diagnosis and Treatment of Cleft Lip and Palate Deformities in chapter 65 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, p. 828, 2002

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

34) B     The medial segment is rotated inferiorly and the lateral segment is advanced medially.

Sykes J. M: Diagnosis and Treatment of Cleft Lip and Palate Deformities in chapter 65 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, p. 828, 2002

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

35) E     It is a consistent clef lip repair technique for decreasing vertical lip contraction

Sykes J. M: Diagnosis and Treatment of Cleft Lip and Palate Deformities in chapter 65 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, p. 828, 2002

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

36) B     Octyl-2-cyanoacrylate

Mobley S. R., Hillinski J., Toriumi D. M.: Surgical Tissue Adhesives, Facial Plastic Surgery Clinics of North America, New Horizons in Facial Plastic Surgery, (Sclafani, editor), Vol. 10., No. 2, , pp. 147-154, 2002

Toriumi D. M., Bagal A. A.: Cyanoacrylate Tissue Adhesives for Skin Closure in the Outpatient Setting, Office-Based Procedures in Facial Plastic Surgery, Otolaryngologic Clinics of North America, Vol. 35, No. 1, p. 105, 2002

http://www.emedicine.com/ent/topic375.htm

Egan K. K., Kim D. W., Toriumi D. M.: Tissue Adhesives in chapter 9, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 91-97, 2009

37) A      The medial end of the brow is located along a vertical line drawn through the ala of the nose.

Becker F.F., Johnson, Jr., C. M.: Surgical treatment of the upper Third of the Aging Face, chapter 30 in Otolaryngology-Head and Neck Surgery (Cummings, Fredrikson, Harker, Krause, Schuller, editors), Second Edition, Mosby, p. 551, 1993

Quatela V.C., Graham III, H.C., Sabini P.: Rejuvenation of the Brow and Midface in chapter 16 Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, pp. 172-173, 200

Graham III H. D., Quatela V. C., Sabini P.: Endoscopic Approach to the Brow and Midface in chapter 20, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 227-241, 2009

38) E     Recent isotretinoin treatment

Perkins S.W.: Chemical Peel, chapter 32 in Otolaryngology-Head and Neck Surgery (Cummings, Fredrikson, Harker, Krause, Schuller, editors), Second Edition, Mosby, p. 589-591, 1993

Mandy S. H., Monheit G. D.: Dermabrasion and Chemical Peels in Chapter 20,Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, pp. 223-240, 2002

Mandy S.H., Monheit G.D.: Dermabrasion and Chemical Peels in chapter 25, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 301-320, 2009

39) D     It involves a low upper eyelid fold.

Millay D.J., Larrabee Jr., W. F.: Eyelid Reconstruction in chapter 43 Facial Plastic and Reconstructive Surgery (Papel and Nachlas, editors), Mosby, 1992

40) E     Females with fair skin.

Cortez E. A.: Phenol Peeling Revisited, Rejuvenation of the Lower Face and Neck, Facial Plastic Surgery Clinics of North America, Saunders, Volume 8, Number 2, pp. 123-125, May 2000

Mandy S.H., Monheit G.D.: Dermabrasion and Chemical Peels in chapter 25, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 301-320, 2009

Perkins S. W., Sandel IV H. D.: Management of Aging Skin, chapter 27 in Cummings Otolaryngology Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 390-404

----------------------------------------
 Updated: April 30, 2017

41-50 MCQ in Facial Plastic and Reconstructive Surgery

41-50 

41) Which of the following statements ABOUT TO THE NOSE describe the drawing below?

A. Projection/Goode method
B. Projection/Simons method
C. Rotation/Goode method
D. Rotation/Simons method
E. Zero Meridian of Gonzalez-Ulloa

42) Microdermabrasion PRODUCES a controlled removal of the:

A. Total epidermis
B. Stratum corneum epidermis
C. Papillary dermis
D. Superficial reticular dermis
E. Deep reticular dermis

43) Which of the following anesthetic agents has an ESTER chemical structure?

A. Lidocaine
B. Bupivacaine
C. Mepivacaine
D. Ropivacaine
E. Tetracaine

44) Which of the following IS NOT a topographic subunit of the nose?

A. Nasal dorsum
B. Nasal tip
C. Nasal supratip
D. Lateral nasal sidewalls
E. Soft triangles

45) Which of the following statements is TRUE about the nose?

A. The thickest area of the skin is located at the rhinion.
B. The basal view represents a triangle in which the lobule is one half of the height of the triangle and the columella the remaining half.
C. The nasofrontal angle should be 120 degrees.
D. The nasolabial angle should be 80 degrees.
E. The face is divided by horizontal lines into facial fifths.

46) Which of the following subtypes of basal cell carcinoma (BCC) is the MOST common?

A. Nodular BCC
B. Superficial BCC
C. Morpheaform BCC
D. Infiltrative BCC
E. Basosquamous carcinoma

47) Which of the following areas IS NOT appropriate for healing by second intention?

A. Medial canthus
B. Nasal ala
C. Melolabial fold
D. Posterior auricular sulcus
E. Convex surfaces of the face

48) Which of the following subtype of melanoma is the MOST common?

A. Superficial spreading melanoma
B. Nodular melanoma
C. Lentigo maligna melanoma
D. Acral lentiginous melanoma
E. Micronodular melanoma

49) Which of the following statements regarding proper positioning and orientation of the auricle is TRUE?

A. The ear is tilted at an angle of 30 degrees posteriorly.
B. The vertical height of a normal adult ear is 8 cm.
C. The top of the ear is 0.5 cm above the level of the brow.
D. The normal auricle protrudes approximately 30 degrees from the skull.
E. The helical rim usually protrudes 4 cm from the head.

50) Which of the following sequences is the one which defines the PROPER order in which to perform the different types of rhinoplasty osteotomy?

A. Lateral, intermediate, medial
B. Intermediate, lateral, medial
C. Medial, lateral, intermediate
D. Intermediate, medial, lateral
E. Medial, intermediate, lateral

ANSWERS & REFERENCES

41) B     Projection/Simons method

Ridley M. B., VanHook S. M.: Aesthetic Facial Proportions, Chapter 9 in Facial Plastic and Reconstructive Surgery (Papel, editor) Second Edition, Thieme, p. 104, 2002

Ridley M. B., VanHook Steven M.: Aesthetic Facial Proportions chapter 11, in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 119-133, 2009

 Zimbler M. S.: Aesthetic Facial Analysis, chapter 19, in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.269-280

42) B     Stratum corneum epidermis

Szachowicz Edward: Microepidermabrasion, An Adjunct to Medical Skin Care in Office-Based Procedures in Facial Plastic Surgery, Otolaryngologic Clinics of North America, (J. P. Porter, editor), Volume 35, Number 1, Saunders, 2002

43) E      Tetracaine

Ahlstrom K.K., Frodel J.L.: Local Anesthetics for Facial Plastic Procedures in Otolaryngologic Clinics of North America, Office-Based Procedures in Facial Plastic Surgery, Saunders ,Vol. 35, Number 1, p. 35, 2002

Lustik S. J., Newlands S. D..: Anesthesiology, Chapter 15 in Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.235-249

http://emedicine.medscape.com/article/1831870-overview

44) C     Nasal supratip

Ridley M.B., VanHook S.M.: Aesthetic Facial Proportion, chapter 9 in Facial Plastic and Reconstructive Surgery ( Papel, editor) Second Edition, Thieme, p. 103, 2002

Ridley M. B.,VanHook Steven M.: Aesthetic Facial Proportions chapter 11, in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 119-133, 2009

Baker S.R.: Reconstruction of Facial Defects, chapter 24, in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.342-363

45) C     The nasofrontal angle should be 120 degrees.

Orten S.S., Hilger P. A.: Facial Analysis of the Rhinoplasty Patient, chapter 31 in Facial Plastic and Reconstructive Surgery (Papel, editor) Second Edition, Thieme, pp. 361-368, 2002

Boahene K. D. O., Orten S. S., Hilger P. A.: Facial Analysis of the Rhinoplasty Patient in chapter 76, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 477-487, 2009

46) A     Nodular BCC

Padgett O.K., Hendrix, Jar, J.D.: Cutaneous Malignancies and their Management in Otolaryngologic Clinics of North America, Saunders, Volume 34 Number 3, p 525, 2001

Hendrix J. D., Slingluff C. L.: Diagnosis and Treatment of Cutaneous Malignancies in chapter 52, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 675-702, 2009

47) E     Convex surfaces of the face

Padgett J.K., Hendrix, Jr, J.D.: Cutaneous Malignancies and their Management in Otolaryngologic Clinics of North America, Saunders, Volume 34 Number 3, pp. 548-550, 2001

Hom D. B., Tope W. D.: Minimally Invasive Options and Skin Grafts for Cutaneous Reconstruction in Chapter 43, Facial Plastic and Reconstructive Surgery, second edition (Ira Papel, editor), Thieme Medical Publishers, pp. 512-527, 2002

Hom D. B. , Tope W. D.: Minimally Invasive Options and Skin Grafts for Cutaneous Reconstruction in chapter 53, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 703-719, 2009

48) A     Superficial spreading melanoma

Padgett J.K., Hendrix, Jr, J.D.: Cutaneous Malignancies and their Management in Otolaryngologic Clinics of North America, Saunders, Volume 34 Number 3, pp. 525-537, 2001

 Berger A. J., Myers J. N.,  Nemechek A. J., Yao M.: Malignant Melanoma of the Head and Neck Region, Chapter 114 in Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.1739-1759

http://emedicine.medscape.com/article/280245-overview

49) D      The normal auricle protrudes approximately 30 degrees from the skull.

Park S. S., Hood R. J.: Auricular Reconstruction in Otolaryngologic Clinics of North America, Saunders, Volume 34 Number 4, pp. 713-716, 2001

 Zimbler M. S.: Aesthetic Facial Analysis, chapter 19, in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.269-280

 Winkler A., Wudel J. M..: Chapter 170 in Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume two, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.2759-2771

50) E      Medial, intermediate, lateral

Mostafapour S.P., Murakami C.S., Larrabee, Jr. W.F.: Management of the Bony Nasal Vault chapter 34 in Facial Plastic and Reconstructive Surgery (Papel, editor) Second Edition, Thieme, pp. 402-405, 2002

Most S.P., Murakami C. S., Larrabee Jr. W. F.:Surgery of the Bony Nasal Vault, in chapter 42, Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 547-553, 2009

Tardy M. E. Jr., Regan Thomas J.: Rhinoplasty, chapter 36, in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.508-544

----------------------------------------
 Updated: April 30, 2017

51-60 MCQ in Facial Plastic and Reconstructive Surgery

51-60

51) Which of the following statements regarding this stage of the microtia reconstruction (shown in the picture) is TRUE? Click the picture to enlarge image.

A. Usually is done at the time of carving the auricular framework.
B. The flap used can be either superiorly or inferiorly based.
C. The designed flap will require to have an internal cartilage support.
D. A composite graft from the contralateral ear can be used if not enough tissue is available.
E. The fibroadipose lobular remnant is transposed posteriorly and inferiorly.

52) Which of the following is the MOST common complication of dermabrasion?

A. Milia
B. Skin infection
C. Scarring
D. Hypopigmentation
E. Hyperpigmentation

53) Which of the following is the MOST common complication of transcutaneous blepharoplasty?

A. Hematoma
B. Epiphora
C. Ectropion
D. Eyelid malposition
E. Entropion

54) Which of the following DESCRIBES the cymba?

A. A fossa posterior to the superior crus of the antihelix
B. A fossa between the superior and inferior crus of the antihelix
C. A fossa between the helix and antihelix
D. A portion of the concha located superiorly to the crus of the helix
E. A portion of the concha located inferiorly to the crus of the helix

55) Which of the following chemical peeling agents is the MOST commonly used and the most VERSATILE?

A. Glycolic acid
B. Retinoic acid
C. Trichloroacetic acid
D. Baker-Gordon solution
E. Phenol

56) Which of the following statements about an aesthetic evaluation of the nose is TRUE?

A. The nasolabial angle is more acute in women than in men.
B. The nose in women possess a prominent rhinion and a delicate skin.
C. The nose with a broad, wide and flat appearance is called a leptorrhine nose.
D. The nasofrontal angle is approximately 120 degrees.
E. The Frankfort line extends from the superior aspect of the tragus to the margin of the lower eyelid.

57) Which of the following areas is the IDEAL skin/donor site in the repair of a defect of the skin at the tip of the nose?

A. Preauricular
B. Postauricular
C. Forehead
D. Supraclavicular
E. Infraclavicular

58) Which of the following is the EARLIEST symptom of local anesthetic systemic toxicity?

A. Lightheadedness
B. Slurred speech
C. Visual disturbances
D. Circumoral numbness and tingling
E. Tinnitus and hypotension

59) Which of the following statements about the African American nose is FALSE?

A. The nose is flat, broad and short.
B. The nose has the appearance of an infantile dorsum lacking projection.
C. The nose has an overdevelopment of the anterior nasal spine.
D. The nose has an acute nasolabial angle.
E. The nose has a short, thick and hidden columella.

60) Which of the following anesthetic agents has the LONGEST duration of action?

A. Lidocaine (plain)
B. Lidocaine (with epinephrine)
C. Tetracaine
D. Bupivacaine
E. Cocaine

ANSWERS & REFERENCES



51) E     The fibroadipose lobular remnant is transposed posteriorly and inferiorly.

Ruder R. O.: Microtia Reconstruction, Chapter 57 in Facial Plastic and Reconstructive Surgery 9 (Papel and Nachlas, editors), Mosby Year Book, pp. 540-541, 1992

Ruder O.R.: Congenital Auricular Deformities 75, in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1043-1057, 2009

Aguilar III E. A. ,  Echo Anthony: Congenital Auricular Malformation, Chapter 191 in
Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume two, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp. 3161-3175

52) A     Milia

Mandy S. H., Monheit G. D.: Dermabrasion and Chemical Peels in Chapter 25, in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 301-320, 2009

Perkins S. W.,  Sandel IV H. D.: Management of Aging Skin, chapter 27 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 390-404

http://emedicine.medscape.com/article/1126231-treatment

53) D      Eyelid malposition

Rankin B.S., Arden R. L, Crumley R.L.: Lower Eyelid Blepharoplasty in Chapter 18 in Facial Plastic and Reconstructive Surgery, Thieme, Second Edition, pp. 204-206, 2002

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

 Friedman O., Zaldivar R. A., Wand T. D.: Blepharoplasty, chapter 30 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 439-451

54) D     A portion of the concha located superiorly to the crus of the helix.

Nachlas N.E.: Otoplasty in Chapter 27 in Facial Plastic and Reconstructive Surgery, Thieme, Second Edition, pp. 309-310, 2002

Nachlas N.E.: Otoplasty in Chapter 34 in Facial Plastic and Reconstructive Surgery, Thieme, Third Edition, pp. 421-433, 2009

Adamson P. A., Doud Galli S. K., Chen T.: Otoplasty, chapter 33 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 475-480

55) C     Trichloroacetic acid

Mandy S. H., Monheit G. D.: Dermabrasion and Chemical Peels in Chapter 25, in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 301-320, 2009

 http://emedicine.medscape.com/article/1829120-overview

56) D     The nasofrontal angle is approximately 120 degrees.

Orten S.S., Hilger P.A.: Facial Analysis of the Rhinoplasty Patient, Chapter 31 in Facial Plastic and Reconstructive Surgery, Thieme, Second Edition, pp. 361-368, 2002

Boahene K. D. O., Orten S. S., Hilger P. A.: Facial Analysis of the Rhinoplasty Patient, Chapter 38 in Facial Plastic and Reconstructive Surgery, Thieme, Third Edition, pp. 477-487, 2009

Davidson, T.M., Murakami, W.T.: Rhinoplasty planning: Aesthetic concepts, dynamics and facial construction, SIPAC, American Academy of Otolaryngology-Head and Neck Surgery, pp. 15-19, 1982

57) A     Preauricular

Burget G. C.: Aesthetic Restoration of the Nose, Clinics in Plastic Surgery, Vol. 12, No. 3, pp. 463-465

Hom D. B., Tope W. D.: Minimally Invasive Options and Skin Grafts for Cutaneous Reconstruction, Chapter 53 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 703-719, 2009

58) D      Circumoral numbness and tingling

Ehlert T.K., Arnold D. E.: Local Anesthesia for Soft-Tissue Surgery, Otolaryngology Clinics of North America, Vol. 23, No. 5, pp. 837-840

Lustik S. J., Newlands S. D., Chapter 15 in Anesthesiology, Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.235-249

59) C      The nose has an overdevelopment of the anterior nasal spine.

Toriumi D.M., Skykes J. M., Johnson C. M.: Open Structure Rhinoplasty for Management of the Non-Caucasian Nose, Surgical Techniques in Otolaryngology-Head and Neck Surgery, Vol. 1, No. 4, pp. 225-233, 1990

Boyette J. R., Stucker F. J.: African American Rhinoplasty in Multicultural Aesthetics in Facial Plastic Surgery, Facial Plastic Surgery Clinics of North America (Regan Tomas J. editor), August 2014, pp. 379-393

60) D      Bupivacaine

Ahlstrom K.K., Frodel J.L.: Local Anesthetics for Facial Plastic Procedures in Otolaryngologic Clinics of North America, Office-Based Procedures in Facial Plastic Surgery, Saunders, Vol. 35, Number 1, p. 35, 2002

Fletcher M: Anesthesia in Facial Plastic Surgery, Chapter 14 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 145-146, 2002

Fletcher M: Anesthesia in Facial Plastic Surgery, Chapter 17 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 189-197, 2009

------------------------------------------
 Updated:  April 30, 2017

61-70 MCQ in Facial Plastic and Reconstructive Surgery

61-70
61) Which of the following is the unilateral cleft lip repair REPRESENTED in the drawing below? Click the picture to enlarge image.

A. Millard
B. Tennison-Randall
C. Millard with triangular flap superiorly based
D. Two-triangle flap superiorly based
E. LeMesurier

62) Which of the following techniques is the IDEAL for the reconstruction of an upper or lower full-thickness eyelid defect of up to 50%?

A. Primary closure with skin grafting
B. Transposition flap
C. Rotational myocutaneous flap from the lateral canthal area, Tenzel Flap
D. Two-stage reconstruction, Hughes tarso-conjuntival flap
E. Two-stage reconstruction, the Cutler Beard technique

63) A patient is under local anesthesia and IV sedation and suddenly develops PVC, premature ventricular contractions with pulse above 50.Which of the following options IS INDICATED in this particular patient?

A. Carotid sinus massage
B. Lidocaine
C. Atropine
D. Verapamil
E. Bretylium

64) Cutaneous malignancy of the external ear is MOST commonly found in the:

A. Antihelix
B. Conchal bowl
C. Lobule
D. Tragus
E. Scapha

65) Which of the following anesthetic agents is MOST likely to be involved in an allergic reaction?

A. Lidocaine
B. Bupivacaine
C. Mepivacaine
D. Ropivacaine
E. Tetracaine

66) The BEST donor site for a bone graft to close a residual alveolar cleft is the:

A. Calvarial bone
B. Iliac crest bone
C. Autogenous rib
D. Symphyseal area of the mandible
E. Allogenic bone

67) Which of the following components IS NOT a component in Jessner’s Formula?

A. Resorcinol
B. Salicylic acid
C. Lactic acid
D. Ethanol
E. Glycolic acid

68) Which PERCENTAGE is expected to induce skin allergic reaction when using bovine dermal collagen?

A. 1%
B. 3%
C. 5%
D. 10%
E. 15%

69) Which of the following is FALSE about the Baker-Gordon formula?

A. An intravenous line with preoperative and intraoperative adequate hydration is mandatory.
B. Croton oil acts as a vesicant enhancing phenol absorption.
C. The liquid soap, Septisol, is a surfactant that reduces skin tension.
D. The Baker-Gordon formula can be refrigerated for multiple usages.
E. The phenol component is diluted to 88% (full strength preparation)

70) Which of the following anesthetic agents is metabolized in the plasma by the cholinesterase?

A. Lidocaine
B. Bupivacaine
C. Mepivacaine
D. Ropivacaine
E. Tetracaine

ANSWERS & REFERENCES


61) A     Millard

Bumsted R. M.: Chapter 10 in Pediatric Facial Plastic and Reconstructive Surgery, (Smith and Bumsted, editors), Raven Press, pp.131-145, 1993

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders, Chapter 76 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 1059-1078, 2009

 Davit III A. J., Otteson T., Losee J. E.: Comprehensive Cleft Care, Chapter 103 in
Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.1556-1573

62) C     Rotational myocutaneous flap from the lateral canthal area, Tenzel Flap

Custer P.L.: Conceptual Approach to Eyelid Reconstruction, Otolaryngologic Clinics of the North America, Vol. 23, No. 5, pp. 997-1001, 1990

Kaltreider S.A.: Periocular Reconstruction in Chapter 52 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 650-652, 2002

Kaltreider S. A.: Periocular Reconstruction, Chapter 62 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 855-867, 2009

63) B      Lidocaine

Courtiss E.H., Kanter M. A.: The Prevention and Management of Medical Problems During Office Surgery, Plastic and Reconstructive Surgery, Vol. 85, No. 1, pp. 131-134, 1990

64) A     Antihelix

Estrem S.A., Renner G.J.: Special Problems Associated with Cutaneous Carcinoma of the Ear in Facial Skin Malignancy II, Otolaryngology Clinics of North America, Vol. 26, No. 2, pp. 231-233, 1993
 
65) E     Tetracaine

Ahlstrom K.K., Frodel J.L.: Local Anesthetics for Facial Plastic Procedures in Otolaryngologic Clinics of North America, Office-Based Procedures in Facial Plastic Surgery, Saunders, Vol. 35, Number 1, pp. 34-35, 2002

http://emedicine.medscape.com/article/873879-overview

66) B     Iliac crest bone

Davis P.T., Hochman M., Funcik T.: Alveolar Cleft Bone Crafts, Facial Plastic Surgery, Vol. 9, No 3, pp.232-238, 1993

Davit III A. J., Otteson T., Losee J. E.: Comprehensive Cleft Care, Chapter 103 in
Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.1556-1573

67) E     Glycolic acid   

Mandy S. H., Monheit G.D.: Dermabrasion and Chemical Peels Chapter 20 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 228-230, 2002

Monheit G. D., Mandy S. H.: Dermabrasion and Chemical Peers, Chapter 25 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 301-320, 2009

Perkins S. W., Sandel IV J. D.: Management of Aging Skin, chapter 27 in Cummings Otolaryngology-Head & Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.390-404

68) B     3%

Monhian N. Ahn M. S., Maas C. S.: Injectable and Implantable Materials for Facial Wrinkles Chapter 22 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p, 250, 2002

Maas C. S., Kenneth C. Y., Egan K. K.: Neuromodulators and Injectable Soft Tissue Substitutes, Chapter 28 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 337-353, 2009

Gillman G. S.: Cosmetic Uses of Neurotoxins and Injectable Fillers, Chapter 197 in
Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume two, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014, 3239-3251

69) D     The Baker-Gordon formula can be refrigerated for multiple usages.
 

Mandy S. H., Monheit G.D.: Dermabrasion and Chemical Peels Chapter 20 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 234-239, 2002

Monheit G. D., Mandy S. H.: Dermabrasion and Chemical Peels, Chapter 25 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 301-320, 2009

 Perkins S. W., Sandel IV J. D.: Management of Aging Skin, chapter 27 in Cummings Otolaryngology-Head & Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp.390-404

70) E     Tetracaine

Ahlstrom K.K., Frodel J.L.: Local Anesthetics for Facial Plastic Procedures in Otolaryngologic Clinics of North America, Office-Based Procedures in Facial Plastic Surgery, Saunders, Vol. 35, Number 1, p. 34, 2002

Fletcher M. V.: Anesthesia in Facial Plastic Surgery, Chapter 17 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 189-197, 2009

Lustik S. J., Newlands S. D.: Anesthesiology, Chapter 15 in Bailey's Head & Neck Surgery Otolaryngology, (Johnson J.T., Rosen C. A., editors), Volume one, Fifth edition, Wolters Kluwer / Lippincott Williams & Wilkins, 2014,  pp.235-249

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Updated:  May 1, 2017

71-80 MCQ in Facial Plastic and Reconstructive Surgery

71-80

71) Which of the following statements about the flap shown below is FALSE?


A. The design is a rotation-advancement flap.
B. It is useful to close circular cheek defects.
C. On the scalp the rotation flap should have 4 times the diameter of the defect.
D. It is ideally designed to move along an arc of  less than 30 degrees.
E. Both 90 and 180 degree arc flaps can be used in the design.

72) The transconjuntival blepharoplasty is BEST indicated for addressing one of the following anatomic abnormalities:

A. Herniated orbital fat
B. Pseudoherniated orbital fat
C. Lower eyelid skin laxity
D. Hypertrophied orbicularis oculi muscle
E. Lower eyelid rhytids

73) Which of following measures will INCREASE the toxic effects of phenol application?

A. Intravenous hydration
B. Extending the time of the application for a full-face peel
C. Decreasing the concentration of phenol
D. Cleansing and degreasing of entire face
E. Administration of oxygen

74) Dermabrasion is the treatment of CHOICE for which of the following:

A. Postacne scars
B. Traumatic scars
C. Facial wrinkles
D. Actinic keratosis
E. Melasma

75) Hyperpigmentation as a side effect of dermabrasion will be INCREASED by which of the following?

A. Hydroquinone
B. Kojic acid
C. Sun avoidance
D. Estrogens
E. Tretinoin

76) Which of the following anesthetics is MOST likely related to cardiovascular toxicity?

A. Lidocaine
B. Prilocaine
C. Mepivacaine
D. Etidocaine
E. Bupivacaine

77) If a skin graft is wrapped in saline soaked gauze and placed in a sterile jar in a refrigerator at 4° C, what is THE MAXIMUM TIME that it can be stored before grafting?

A. 72 hours
B. 1 week
C. 2 weeks
D. 3 weeks
E. 4 weeks

78) Which of the following surgical techniques will NOT improve an upper lateral cartilage nasal valve collapse?

A. Spreader graft placement
B. Flaring sutures placement
C. Splay graft placement
D. Columellar graft placement
E. Butterfly graft placement

79) What is the RATE of revision rhinoplasty?

A. 1%
B. 4%
C. 12%
D. 20%
E. 25%

80) Which of the following group/patients is NOT usually predisposed to the tip bossae formation?

A. Patients with thin skin and nasal tip bifidity.
B. Patients with thick skin and normal interdomal width.
C. Patients with vertical dome division.
D. Patients with overresection of the lateral crura.
E. Patient with thin skin, strong cartilages and excessive interdomal width.

ANSWERS & REFERENCES

71) C     On the scalp the rotation flap should have 4 times the diameter of the defect.

Triana R.J. Jr., Murakami C. S., Larrabee Jr. W. F.: Skin Grafts and Local Flaps, Chapter 4 in Facial Plastic and Reconstructive Surgery, (Papel, editor), Thieme, Second Edition, pp. 46-48, 2002

Triana R.J. Jr., Murakami C. S., Larrabee Jr. W. F.: Skin Grafts and Local Flaps, Chapter 4 in Facial Plastic and Reconstructive Surgery, (Papel, editor), Thieme, Third Edition, pp. 41-58, 2009

Baker S. R.: Reconstruction of Facial Defects, chapter 24 in Reconstruction of Facial Defects, Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp.342-363

72) B     Pseudoherniated orbital fat

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

http://emedicine.medscape.com/article/838605-overview63

Friedman O., Zaldivar R. A., Wang T. D.: Blepharoplasty, chapter 31 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, Mosby Elsevier, 2010, pp. 439-451

73) C     Decreasing the concentration of phenol

Mandy S. H., Monheit G.D.: Dermabrasion and Chemical Peels Chapter 20 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 228-239, 2002

Mandy S. H., Monheit G.D.: Dermabrasion and Chemical Peels Chapter 25 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 301-320, 2009

Perkins S. W., Sandel IV H. D.: Management of Aging Skin, chapter 27 in Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp. 390-404

74) A     Postacne scars

Mandy S. H., Monheit G.D.: Dermabrasion and Chemical Peels Chapter 20 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 228-239, 2002

Mandy S. H., Monheit G.D.: Dermabrasion and Chemical Peels Chapter 25 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 301-320, 2009

http://emedicine.medscape.com/article/1126231-overview

75) D     Estrogens

Hruza G.J.: Dermabrasion in Facial Rejuvenation Nonsurgical Modalities, Facial Plastic Surgery Clinics of North America, Saunders, Vol.9 No. 2, pp. 275-281

76) E     Bupivacaine

Ehlert T.K., Arnold D. E.: Local Anesthesia for Soft-Tissue Surgery, Otolaryngology Clinics of North America, Vol. 23, No. 5, pp. 836-837

Fletcher M.: Anesthesia in Facial Plastic Surgery Chapter 14 Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 145-146, 2002

Fletcher M.: Anesthesia in Facial Plastic Surgery Chapter 17 Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 189-197, 2009

77) D     3 weeks

Hom D. B., Tope W. D.: Minimally Invasive Options and Skin Grafts for Cutaneous Reconstruction, chapter 43 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p. 525, 2002

Hom D. B., Tope W. D.: Minimally Invasive Options and Skin Grafts for Cutaneous Reconstruction, chapter 53 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, p. 703-719, 2009

78) D     Columellar graft placement

Dolan R.W.: Nasal Valve and Nasal Alar Dysfunction in Facial Plastic Surgery of North America, Saunders, Vol. 8, No. 4, pp. 452-459

Papel I. D.: Surgery of the Middle Vault, Chapter 43 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 555-561, 2009

Becker D. G.: Complications in Rhinoplasty, Chapter 49 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 639-648, 2009

79) C     12%

Quatela V.C., Wayen I.: Challenges of Secondary Rhinoplasty in Facial Plastic Surgery of North America, Advances in Rhinoplasty, ( G. R. Holt, Guest editor), Saunders, Nov. 2000, Vol. 8, No. 4, p. 515

Christophel J. J., Park S. S.: Complications in Rhinoplasty, Facial Plastic Surgery Clinics of North America, (Constantinides, Guest editor), Feb. 2009, Vol. 17, No. 1, pp. 145-156

Kamer K. M,, McQuown: Revision Rhinoplasty, Analysis and Treatment, Arch Otolaryngology, Head Neck Surgery, Vol. 114, March 1988, pp. 257-266

 Kim D. W., Lopez M. A., Toriumi D. M.: Revision Rhinoplasty, chapter 39 in Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp. 580-594

80) B     Patients with thick skin and normal interdomal width.

Becker D. G.: Complications of Rhinoplasty, chapter 39 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p. 525, 2002

Becker D. G.: Complications in Rhinoplasty, Chapter 49 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) p. 639-648, 2009

Kim D. W., Lopez M. A., Toriumi D. M.: Revision Rhinoplasty, chapter 39 in Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp. 580-594

-----------------------------------------
 Updated:  April 30, 2017

81-90 MCQ in Facial Plastic and Reconstructive Surgery

81-90

81) Which of the following statements about the local flap shown below is TRUE? Click the picture to enlarge image.
A. It is a bilateral rotation-transposition flap.
B. It is also called O-T flap.
C. It is useful to close circular defects in the scalp area.
D. Using a triple flap instead of two flaps is a disadvantage for closing.
E. There is no need for undermining using this particular flap.

82) Which of the following anatomical structures is RELATED to the posterior lamella of the eyelid?

A. The grey line
B. The orbital septum
C. The tarsal plate
D. The pretarsal orbicularis oculi muscle
E. The Müller’s muscle

83) Which of the following reconstructive surgical techniques is the BEST for closure of defects encompassing 40% of the lower lip but not involving the oral commisure?

A. The Abbé technique
B. The Estlander technique
C. The Karapandzic technique
D. The Cutler Beard technique
E. Primary closure

84) The thoracodorsal artery is the primary source of BLOOD SUPPLY for the:

A. Pectoralis Major Flap
B. Trapezius Flap
C. Latissimus dorsi Flap
D. Deltopectoral Flap
E. Nape of neck

85) Which of the following measures is BEST for the treatment of a tachycardia over 130 due to epinephrine effect?

A. Midazolam
B. Verapamil
C. Propanolol
D. Carotid body massage
E. Hydralazine

86) What is the PERCENTAGE of basal cell carcinoma skin lesions involving the lower eyelid?

A. 90%
B. 70%
C. 50%
D. 20%
E. 10%

87) Which of the following statements about the paramedian forehead flap is FALSE?

A. It is a axial flap.
B. It is mostly supplied by the infratrochlear vessels.
C. It is useful for reconstruction of any or all nasal subunits.
D. It is a delayed flap requiring a minimum of two stages.
E. The single-vessel paramedian forehead flap has a pedicle of approximately 1.5 cm wide at its origin.

88) Using the CO2 laser resurfacing technique, the treated area changes from pink to a yellow chamois color. Which LEVEL of tissue penetration has the laser reached?

A. Epidermis
B. Papillary dermis
C. Upper reticular dermis
D. Deep reticular dermis
E. Subcutaneous tissue

89) The Fasanella-Servat surgical technique is MOST useful in the management of:

A. Senile ectropion
B. Cicatricial ectropion
C. Involutional entropion
D. Cicatricial entropion
E. Eyelid ptosis

90) Which of the following chemical peeling agents has the HIGHEST risk for scarring?

A. Salicylic acid 15%
D. Trichloracetic acid 35%
C. Trichloracetic acid 50%
D. Glycolic acid 70%
E. Pure phenol 88%



ANSWERS & REFERENCES


81) C     It is useful to close circular defects in the scalp area.

Larrabee W. F., Jr., Design of Local Skin Flaps, Facial Plastic Surgery, Otolaryngologic Clinics of North America, Vol. 23, No. 5, pp. 912-917, 1990

Park S. S.: Local and Regional Cutaneous Flaps, Chapter 44 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 535-539, 2002

http://emedicine.medscape.com/article/1821831-overview

82) C     The tarsal plate

Rankin B.S., Arden R.L., Crumley R.L.: Lower Eyelid Blepharoplasty chapter 18 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, p. 196, 2002

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

 Sand J. P., Zhu B. Z., Desai S.C.: Surgical Anatomy of the Eyelids, Functional and Cosmetic Eyelid Surgery,  Facial Plastic Surgery Clinics of North America (Branham G. H.,editor), May 2016, pp.89-95

83) A     The Abbé technique

Hoffmann J.F., Cook T.A.: Reconstruction of Facial Defects, Chapter 26 in Otolaryngology-Head and Neck Surgery (Cummings, Fredrickson, Harker, Krause, Schuller, editors), Second Edition, Mosby, Vol. 1, p. 445, 1993

Cupp C. L., Larrabee, Jr.: Reconstruction of the lips, Operative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 4. No. 1, March, pp. 46-53, 1993

Baker S. R.: Reconstruction of Facial Defects, chapter 24 in Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp. 343-363

84) C     Latissimus dorsi Flap

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, chapter 47 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 576-577, 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

85) C     Propanolol

Courtiss E.H., Kanter M. A.: The Prevention and Management of Medical Problems During Office Surgery, Plastic and Reconstructive Surgery, Vol. 85, No. 1, pp. 134-136, 1990

86) B     70%

Funk G. F., Hoffman H.T., Carter K. D.: Special Considerations in the Management of Malignant Skin Lesions about the Eye in Otolaryngologic Clinics of North America, Vol. 26 No. 2, p. 221

87) B     It is mostly supplied by the infratrochlear vessels.

Mellette, Jr, J. R.: The Paramedian Forehead Flap for Nasal Reconstruction, Facial Plastic Surgery Clinics of North America, Saunders, Vol. 6, No. 3, pp. 365-370, 1998

Park S. S.: Local and Regional Cutaneous Flaps, chapter 54 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 721-743, 2009

Baker S. R.: Reconstruction of Facial Defects, chapter 24 in Cummings Otolaryngology-Head and Neck Surgery, Fifth edition, Volume one, Mosby Elsevier, 2010, pp. 342-363

88) C     Upper reticular dermis

Price C.R., Carniol P. J., Glaser D.A.: Skin Resurfacing with the Erbium: YAG Laser, Facial Plastic Surgery Clinics of North America, Saunders, Vol. 9, No. 2, pp. 291-301

89) E     Eyelid ptosis

 http://www.emedicine.com/ent/topic97.htm

Couch S. M.: Correction of Eyelid Crease Asymmetry and Ptosis, Functional and Cosmetic Eyelid Surgery,  Facial Plastic Surgery Clinics of North America (Branham G. H.,editor), May 2016, pp.153-162

90) C     Trichloracetic acid 50%

Mandy S. H., Monheit G. D.: Dermabrasion and Chemical Peels, Chapter 25 in Facial Plastic and Reconstructive Surgery, Thieme Medical Publishers, Third edition (Ira Papel, editor) pp. 301-320, 2009

Staffel J. G.: Chemical Peeling, Chapter 182A in Head and Neck Surgery-Otolaryngology,
(Bailey, B. J., Johnson J. T., Newlands S.D., editors) , 4th Edition, pp. 2717-2723, 2006

http://emedicine.medscape.com/article/842768-overview

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 Updated:  May 1, 2017