701-710 MCQ in Facial Plastic and Reconstructive Surgery

701-710

701) Which of the following lines in the drawing represents a Killian incision? A. A
B. B
C. C
D. D
E. E

702) Which of the following statements about frontal sinus fractures is TRUE?

A. Mild force is required to fracture the anterior table of the frontal sinus.
B. Isolated anterior table fractures are the most common variety.
C. Associated facial fractures occur approximately 65% of the time
D. Treatment of facial fractures is standardized
E. Complications usually occur 6 months after fracture.

703) Which of following statements related to the use of the Laser Resurfacing is TRUE?

A. The most common problem after Laser Resurfacing is milia
B. Hyperpigmentation does not have an effective treatment
C. Erbium Laser Resurfacing has more risk of hypopigmentation than CO2 Laser Resurfacing.
D. True hypopigmentation occurs approximately 10 months after initial treatment.
E. Itching and blister formation are the initial presentations of herpetic viral infections.

704) Which of the following statements about facial Z-Plasty is FALSE?

A. It is used to align anatomic lines that are in unfavorable positions.
B. The arms are slightly greater than 1 cm.
C. It is used to lengthen a scar contraction.
D. It is used to rotate the dominant axis of a scar to a more favorable position.
E. It is used to avoid a contracture when an incision crosses a concavity.

705) Which of the following will benefit LEAST by Laser Skin Resurfacing?

A. Static rhytids
B. Dynamic rhytids
C. Actinic keratosis
D. Dyschromias
E. Acne

706) Which of the following statements is TRUE about Millard’s technique used in the repair of unilateral cleft lip?

A. It involves rotation and transposition flaps.
B. It is the best technique for achieving excellent cosmetic results in wider clefts.
C. It is used to decrease vertical scar contracture.
D. It has a tendency to form a small nostril.
E. Its use rarely will produce notching of the vermillian border.

707) Which of the following statements is FALSE about MIDFACE DEGLOVING?

A. It will require a sublabial incision through mucosa and periosteum.
B. It will require a full transfixion incision.
C. It will require a bilateral intercartilaginous incision.
D. It will require a complete anterior circumnasal release with preservation of infraorbital neurovascular bundle.
E. It will require a mid-columellar nasal incision.

708) Which of the following statements about lip anatomy and lip changes with advanced age is TRUE?

A. The height of the upper lip is approximately 10 mm at the midline.
B. The height of the lower lip is approximately 15 mm at the midline.
C. The central interlabial line between the upper and lower lips forms an M shape.
D. The upper lip has the appearance of a large smooth W.
E. The lower lip has the appearance of a M.

709) Which of the following statements about the use of tricholoracetic acid with concentration for medium depth peeling is TRUE?

A. Patients will require infiltration with local anesthesia and IV sedation.
B. The peeling agent will penetrate into the mid-reticular dermis.
C. The application of the peeling agent will produce severe redness.
D. 0.25% of acetic acid soaks in the postoperative period are contraindicated with tricholoracetic acid.
E. The peeling process for a full-face treatment usually lasts 10 days.

710) Which of the following about in microdermabrasion is TRUE?

A. It will produce debridement of the superficial papillary dermis.
B. It will require mild IV sedation.
C. It involves using a closed-loop with aluminum oxide crystals.
D. The end point of the technique is signaled by frosting of the skin.
E. Treatment sessions must be separated by 6 months.


ANSWERS & REFERENCES


701) A     A

Kasperbauer J.L., Facer G W., Kern E. B: Reconstructive Surgery of the Nasal Septum, Chapter 40 in Facial Plastic and Reconstructive Surgery, Second Edition, (Papel I.D, editor), 2002, pp.
461-472

Kasperbauer J.L., Facer G W., Kern E. B: Reconstructive Surgery of the Nasal Septum, Chapter 50 in Facial Plastic and Reconstructive Surgery, Third Edition, (Papel I.D, editor), 2009, pp.
649-661

702) C     Associated facial fractures occur approximately 65% of the time.

Strong B. E., Sykes J. M.: Frontal Sinus and Naso-orbito-ethmoid Complex Fractures, Chapter 59 in Facial Plastic and Reconstructive Surgery, Thieme, Second Edition, (Papel, I, editor), 2002, pp. 747-768

Strong B. E.: Frontal Sinus and Naso-orbito-ethmoid Complex Fractures, Chapter 70 in Facial Plastic and Reconstructive Surgery, Thieme, Third Edition, (Papel, I, editor), 2009, pp. 977-990

703) D     True hypopigmentation occurs approximately 10 months after initial treatment.

Hamilton M. M: Carbon dioxide laser resurfacing, in Facial Plastic Surgery Clinics of North America, ((Hamilton M. M, guest editor), Elsevier Saunders, Vol. 12, No. 3, 2004, pp. 289-295

704) B     The arms are slightly greater than 1 cm.

Cook T.A., Guida R.A., Burke A.L.C..: Soft Tissue Techniques, Chapter 3 in Facial Plastic and Reconstructive Surgery, Thieme, Second Edition, (Papel, I, editor), 2002, pp. 26-37

Cook T.A., Guida R.A., Burke A.L.C..: Soft Tissue Techniques, Chapter 3 in Facial Plastic and Reconstructive Surgery, Thieme, Third Edition, (Papel, I, editor), 2009, pp. 27-39

Papel I.D.: Z-Plasty in Atlas of Head and Neck Surgery-Otolaryngology (Bailey & Calhoun, editors), Second Edition, Lippincott & Williams, 2001, pp. 666-667

705) B     Dynamic rhytids

Hecht D.A., Light B., Toriumi D.M.: Atlas of Head and Neck Surgery-Otolaryngology (Bailey & Calhoun, editors), Second Edition, Lippincott & Williams, 2001, pp. 530-533

706) D     It has a tendency to form a small nostril.

Wang T. D: Unilateral Cleft Lip repair using a rotation and advancement technique, Atlas of Head and Neck Surgery-Otolaryngology (Bailey & Calhoun, editors), Second Edition, Lippincott & Williams, 2001, pp. 762-763

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

707) E     It will require a mid-columellar nasal incision.

Renner G. J..: Sublabial and septal incision in Atlas of Head and Neck Surgery-Otolaryngology (Bailey & Calhoun, editors), Second Edition, Lippincott & Williams, 2001, pp. 914-915

708) C     The central interlabial line between the upper and lower lips forms an M shape.

Fanous N. : Lip rejunvenation by vermillion advancement with volume and surface renovation, Management of the Peri-Oral Complex Area, Facial Plastic Surgery Clinics of North America (Ellis D. A. F., editor), Volume 5, N0 1, February 1997, pp. 71-76

709) E     The peeling process for a full-face treatment usually lasts 10 days.

Halaas Y. P.: Medium depth peeling, Facial Plastic Surgery Clinics of North America, ((Hamilton M. M, guest editor), Elsevier Saunders, Vol. 12, No. 3, 2004, pp. 297-303

710) C     It involves using a closed-loop with aluminum oxide crystals.

Beeson W. H. : Extended Posterior Rhytidectomy in FaceLift, Facial Plastic Surgery Clinics of North America, (Beeson, W.H., editor), Vol. 1, No. 2, pp. 215-216,1993


http://emedicine.medscape.com/article/843957-overview

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Updated: June 15, 2017

711-720 MCQ in Facial Plastic and Reconstructive Surgery

711-720

711) Which of the following ear structures in the drawing below will be modified by the represented tissue excision?

A. Lobule
B. Inferior aspect of the concha
C. Inferior aspect of the helix
D. Inferior aspect of the antihelix
E. Tragus

712) Which of the following statements about botulinum toxin is TRUE?

A. There are 5 different serotypes of botulinum toxin.
B. One unit of botulinum toxin A is defined as the necessary amount to kill approximately 90-100% of a group of 20 g. female Swiss-Webster mice.
C. Zinc has a critical role in the chemical reaction of botulinum toxin.
D. 1 unit of Botox is equivalent to approximately 1 unit of Dysport.
E. Botulinum toxin after reconstitution with saline maintains its clinical efficacy for at least 6 months.

713) Which of the following statements about Botox induced Eyelid Ptosis is FALSE?

A. It usually occurs 12 hours after initial injection.
B. Direct digital pressure can be used to prevent the diffusion of the toxin toward the eye.
C. Eyelid ptosis occurs due to diffusion of the Botox into the levator palpebrae superioris muscle.
D. Apraclonide 0.5% opthtalmic eye drops can be used for treatment.
E. Ophthalmic eye drops can achieve a 2 mm lid elevation.

714) Which of the following statements about the identification of potentially unstable and disruptive facial plastic surgery candidates is FALSE?

A. In general, 75% of unstable patients are men
B. Younger patients are more prone to behave aggressively
C. Male cosmetic rhinoplasty patients are likely at increased risk of unstable behavior.
D. Abuse of alcohol potentiates the risk of instability.
E. Internal motivation for surgery carries a higher risk for disruptive behavior than external motivation.

715) Which of the following factors is THE MOST important regarding Hair Replacement Surgery?

A. Hair density
B. Hair thickness
C. Hair color
D. Skin color
E. Hair direction

716) Which of the following patterns of scalp reduction is the IDEAL for use in Hair Replacement surgery?

A. S-shape pattern of excision.
B. Saggital midline ellipse pattern of excision.
C. Y-shaped pattern of excision.
D. U-shaped pattern.
E. Pattern tailored to the individual patient.

717) In which of the following areas will the "halo effect" complication occur after Hair Replacement Surgery?

A. Frontal
B. Vertex
C. Occipital
D. Temporal
E. Postauricular

718) Which of the following statements about tissue expansion in Hair Replacement Surgery is FALSE?

A. Scalp expansion creates a larger hair-bearing surface area.
B. Scalp expansion does not produce additional hair follicles.
C. Hair density decreases after scalp reduction.
D. Tissue expansion does not affect hair follicle morphology.
E. Scalp expansion will be of most benefit in patients with Norwood class VII.

719) In Expansion Surgery the ideal ratio of expander BASE TO SIZE of defect should be which of the following?

A. 1:1
B. 2:1
C. 3:1
D. 4:1
E. 5:1

720) Which of the following statements about the Juri flap is FALSE?

A. It is 25 cm long
B. It is 4 cm wide
C. It will span the entire frontal hairline
D. The donor area wound closure is often difficult to achieve
E. Dog ear formation is rarely found



ANSWERS & REFERENCES


711) A     Lobule

Siegert R.: Correction of the Lobule, Otoplasty, Facial Plastic Surgery, Vol. 20, No. 4, November 2004, pp. 294-297

712) C     Zinc has a critical role in the chemical reaction of botulinum toxin.

Lam S.M.: The basic science of botulinum toxin, Botox, ( Dayan S.H., Guest Editor), Facial Plastic Surgery Clinics of NorthAmerica, November 2003, pp.431-438

713) A     It usually occurs 12 hours after initial injection.

Vartanian A.J., Dayan S. H.: Complications of botulinum toxin A use in facial rejuvenation, Botox, Facial Plastic Surgery Clinics of NorthAmerica, (Dayan S. H., Guest Editor), Vol. 11. No. 4, November 2003, pp. 483-492

714) E     Internal motivation for surgery carries a higher risk for disruptive behavior than external motivation.

Powell D., Hobgood T.: Detection and Management of the unstable patient, Aesthetic Analysis, (Tardy M. E., editor), Facial Plastic Surgery Clinics of North America, Vol. 11, No. 3, August. 2003, pp. 307-318

715) A     Hair density

Stough D. B., Pomerantz M.A.: The Donor Area, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.139-148

716) E     Pattern tailored to the individual patient.

Unger M. G.: Scalp Reduction, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.163-180

717) B     Vertex

Stough III D. B., Randall J. K., Schauder C. S.: Complications in Hair Replacement Surgery, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.219-229

718) E     Scalp expansion will be of most benefit in patients with Norwood class VII.

Konior R. J., Kridel R. W. H.: Tissue Expansion in Scalp Surgery, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.203-217

719) C     3:1

Konior R. J., Kridel R. W. H.: Tissue Expansion in Scalp Surgery, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.203-217

720) E     Dog ear formation is rarely found

Rousso D. E.: The use of scalp flaps for frontal alopecia, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp. 183-202

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Updated: June 15, 2017

721-730 MCQ in Facial Plastic and Reconstructive Surgery

721-730

721) Which of the following BEST describes the technique shown in the drawing below used to
repair a complication of Hair Transplantation-scalp reduction?


A. Single Z-plasty flap
B. Frechet’s flap
C. Occipital advancement flap
D. Bilateral temporo-occipital flap
E. W-plasty flap

722) Which of the following represents NORMAL HAIR DENSITY in a candidate for Hair Replacement Surgery.?

A. 2 hairs per mm2
B. 4 hairs per mm2
C. 6 hairs per mm2
D. 4 hairs per ½ cm2
E. 6 hairs per ½ cm2

723) Which of the following muscles is a TRUE muscle elevator of the brow?

A. Frontalis
B. Procerus
C. Orbicularis oculi
D. Corrugator superciliii
E. Tranverse nasalis

724) Which of the following serotypes of botulinum toxin is the MOST potent?

A. A
B. B
C. C1
D. D
E. E

725) Which of the following IS NOT considered a NONABLATIVE laser resurfacing technique?

A. 1320-nm Nd:YAG laser
B. Erbium:glass laser
C. Erbium:YAG laser
D. Pulsed-dye laser
E. Q-switched 1064 Nd:YAG laser

726) Which type of grafting material is used in the Madame Butterfly Procedure?

A. Soft Palate Graft
B. Hard Palate Graft
C. Split Thickness Skin Graft
D. Full Thickness Skin Graft
E. Dermal Graft

727) Which of the following perioral age related change is FALSE?

A. The upper lip lengthens
B. The Philtrum flattens
C. The Cupid’s bow disappears
D. The Vermillion has a flat and thin profile
E. The upper incisors are visible in repose

728) Which of the following statements about Lip Advancement is FALSE?

A. Lip Advancement is ideal in patients with significant Vermillion Roll.
B. Lip Advancement is preferred in cases of undefined Cupid’s Bow.
C. The upper lip is outlined 0.5 cm above the Vermillion Border at the level of the Philtral Colums.
D. The upper lip is outlined with 0.3 cm above the central upper lip.
E. Lip advancemet will produce some incisor show.

729) Which of the following degrees of nerve injury is related to disruption of Endoneurium leaving the Perineurium intact?

A. First-degree injury
B. Second-degree injury
C. Third-degree injury
D. Fourth-degree injury
E. Fifth-degree injury

730) Which of the following lasers IS NOT ADEQUATE for the treatment of facial telangiectasias?

A. Long-pulsed Alexandrite laser
B. Coper Vapor laser
C. Continuous Wave Yellow Dye laser
D. Flashlamp-Excited Dye Laser FEDL)
E. Potassium Titanyl Phosphate Laser (KTP)

ANSWERS & REFERENCES


721) B     Frechet’s flap

Stough III D. B., Randall J. K., Schauder C. S.: Complications in Hair Replacement Surgery, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.219-229

Frechet P.: The Anchor Flap, International Journal of Cosmetic Surgery and Aesthetic Dermatology, Vol. 3, No. 2, 2001, pp. 53-58

722) A     2 hairs per mm2

Stough D. B., Pomerantz M.A.: The Donor Area, Hair Replacement Surgery (Konior R.J. & Rousso D.E., editors) , Facial Plastic Surgery Clinics of North America, May 1994, Vol.2, No.2, pp.139-148

723) A     Frontalis

Chen A.H., Frankel A. S.: Altering brow contour with botulinum toxin, Botox, (Dayan S. H., editor), Facial Plastic Surgery Clinics of North America, Vol. 11, No. 4, Nov. 2003, pp. 457-464

724) A     A

Chen A.H., Frankel A. S.: Altering brow contour with botulinum toxin, Botox, (Dayan S. H., editor), Facial Plastic Surgery Clinics of North America, Vol. 11, No. 4, Nov. 2003, pp. 457-464

725) C     Erbium:YAG laser

Williams E. F., Dahiya R.: Review of nonablative laser resurfacing modalities, Facial Plastic Surgery Clinics of North America, ((Hamilton M. M, guest editor), Elsevier Saunders, Vol. 12, No. 3, 2004, pp. 305-310

726) B     Hard Palate Graft

Shorr N. , Edelstein C., Shorr J. K.: Madame Buttefly Procedure: Total Lower Eyelid Reconstruction in Three Layers using a Hard Palate Graft, Management of the Unhappy Postblepharoplaty Patient with Lower Eyelid Retraction, Round Eye and Scleral Show, Special Article,(Wang T. D, editor), Facial Plastic Surgery of North America, Vol.6 No. 2, May 1998, pp. 221-245

727) E     The upper incisors are visible in repose

Chen J. T., Perkins S. W., Hamilton M. M.: Perioral Rejuvenation, Rejuvenation of the Lower Face and Neck, (Waldman S. R., editor), Facial Plastic Surgery Clinics of North America, Vol. 8, No. 2, May 2000, pp.223-233

728) A     Lip Advancement is ideal in patients with significant Vermillion Roll.

Chen J. T., Perkins S. W., Hamilton M. M.: Perioral Rejuvenation, Rejuvenation of the Lower Face and Neck, (Waldman S. R., editor), Facial Plastic Surgery Clinics of North America, Vol. 8, No. 2, May 2000, pp.223-233

729) C     Third-degree injury

Toriumi D. M., Woolford T. J., Teitlebaum B., Sabnani K., O’Grady K.: Growrth Factors in Nerve Regeneration, (Stucker F. J., editor), Facial Plastic Surgery Clinics of North America, Vol. 3, No. 3, August 1995, pp.287-300

730) A     Long-pulsed Alexandrite laser

Ries W. R, Clymer M.A., Charous S. J: Laser Treatment of Cutaneous Vascular Lesions, New Techniques in Facial Reconstruction, (Stucker F. J., editor), Facial Plastic Surgery Clinics of North America, Vol. 3, No. 3, August 1995, pp.307-318

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Updated: June 15, 2017

731-740 MCQ in Facial Plastic and Reconstructive Surgery

731-740

731) Which of the following deformities will be corrected by the use of a Composite Skin-Cartilage Graft placed into the pocket shown in the picture?

A. Alar Margin Retraction
B. Bossa formation
C. Alar pinching with tip narrowing
D. Alar Stenosis
E. Lateral Crural irregularities

732) Which of the following anesthesia regimens is adequate in facial Er: YAG Laser Skin Resurfacing?

A. Regional nerve block with 0.25% bupivacaine plus 1:200.000 epinephrine
B. Regional nerve block with 1% lidocaine plus 1:100.000 epinephrine
C. Regional nerve block with 2% lidocaine plus 2:100.000 epinephrine
D. EMLA cream applied 2 hours prior to the surgical procedure
E. Lorazepam ((Ativan) 1 mg by mouth on arrival and no subsequent anesthesia

733) Which of the following statements about Merkel Cell Carcinoma is TRUE?

A. Shaving or curetage is the most commonly used treatment.
B. Local recurrence is low, approximately 2%.
C. Wide local excision is used for recurrence only
D. It is resistent to Chemotherapeutic Agents
E. It is a radiosensitive tumor

734) Which of the following types of Saddle Nose Deformity is related to "moderate depression of the Dorsal Septum and Upper Lateral Cartilage with Nasal Valve Collapse"?

A. Type 1
B. Type 2
C. Type 3
D. Type 4
E. Type 5

735) Which of the following statements is FALSE about surgical correction of a Deviated Septum?

A. The Killian-type Incision is ideal for Posterior Septal Deviation.
B. Killian-type and Hemitransfixion Incisions are best performed on the concave side of the septal deviation.
C. The Hemitransfixion Incision is ideal for Caudal Septal Deviation.
D. The Hemitransfixion Incision will not affect significantly the nasal tip support.
E. The Killian-type Incision will affect significantly the nasal tip support.

736) Which of the following etiologies is MOST COMMONLY associated with External Nasal Valve Dysfuntion.?

A. Congenital
B. Traumatic
C. Iatrogenic
D. Pharmacological
E. Senescent (Aging)

737) Which of the following minor nasal tip support mechanisms has been recently considered a CRITICAL AND A MAJOR support mechanism?

A. Intercrural Ligament
B. Cartilaginous Septal Dorsum
C. Nasal Spine
D. Membranous Septum
E. Alar Cartilages attachment to overlying skin and musculature

738) Which of the following muscles used in Facial Reanimation is innervated by the Thoracodorsal Nerve and supplied by the Throacodorsal Artery?

A. Pectoralis Major
B. Pectoralis Minor
C. Latissimus Dorsi
D. Serratus Anterior
E. Rectus Abdominis

739) Which of the following etiologies is MOST COMMON in twisted noses?

A. Trauma
B. Iatrogenic
C. Pharmacological
D. Inflammatory
E. Congenital

740) Which of the following surgical techniques is the MOST efffective in opening the Internal Nasal Valve?

A. Spreader grafts
B. Flaring sutures
C. Splay grafts
D. Butterfly grafts
E. Batten grafts


ANSWERS & REFERENCES


731) A     Alar Margin Retraction

Perkins S. W., Tardy Jr. M.E.: External Columellar Incisional Approach to Revision of the Lower Third of the Nose, Open Rhinioplasty, (Toriumi D. M., Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 1 No. 1, August 1993, pp.79-98

Becker D. G.: Complications of Rhinoplasty, Chapter 39 in Facial Plastic and Reconstructive Surgery, (Papel I. D., Editor), Second Edition, Thieme, 2002, pp. 452-460

Becker D. G.: Complications of Rhinoplasty, Chapter 49 in Facial Plastic and Reconstructive Surgery, (Papel I. D., Editor), Third Edition, Thieme, 2009, pp. 639-648

732) D     EMLA cream applied 2 hours prior to the surgical procedure.

Koch R. J.: Laser Skin Resurfacing, Minimally Invasive Surgery, (Koch R. J., editor), Facial Plastic Surgery Clinics of North America, Vol. 9, No. 3, August 2001, pp.329-336

733) E     It is a radiosensitive tumor.

Brodland D. G.: The treatment of Merkel Cell Carcinoma with Mohs Micrographic Surgery, Advances in Mohs Surgery, (Dzubow L. M., editor), Facial Plastic Surgery Clinics of North America, Vol. 6, No. 3, August 1998, pp. 329-335

734) B     Type 2

Alsarraf R, Murakami CS: The saddle nose deformity, Functional Reconstructive Rhinoplasty, (Murakami C. S., editor), Facial Plastic Surgery Clinics of North America, Vol. 7, No. 3, August 1999, pp. 303-310

http://emedicine.medscape.com/article/840910-overview

735) E     The Killian-type Incision will affect significantly the nasal tip support.

Ducic Y., Hilger P. A.: Surgical Correction of the Deviated Septum, Functional Reconstructive Rhinoplasty, (Murakami C. S., editor), Facial Plastic Surgery Clinics of North America, Vol. 7, No. 3, August 1999, pp. 319-331

736) C     Iatrogenic

Chand M. S., Toriumi D. M.: Treatment of the External Nasal Valve, Functional Reconstructive Rhinoplasty, (Murakami C. S., editor), Facial Plastic Surgery Clinics of North America, Vol. 7, No. 3, August 1999, pp. 347-355

737) E     Alar Cartilages attachment to overlying skin and musculature.

Dyer II W. K.: Nasal Tip Support and its Surgical Modification, (Perkins S. W, , editor), Facial Plastic Surgery Clinics of North America, Vol. 12, No. 1, February 2004, pp. 1-13

738) C     Latissimus Dorsi

Clark J. M., Shockley W. W. : Management and Reanimation of the Paralyzed Face, Chapter 53, Facial Plastic and Reconstructive Surgery,(Papel I. D., editor), Second Editon, Thieme, Second Edition,, 2002, pp. 660-685

Clark J. M., Shockley W. W. : Management and Reanimation of the Paralyzed Face, Chapter 63, Facial Plastic and Reconstructive Surgery,(Papel I. D., editor), Third Edition, Thieme, Third Edition,, 2009, pp. 869-895

739) A     Trauma

TerKonda R. P. Sykes J. M: Repairing the Twisted Nose, Rhinoplasty and Septoplasty I, Otolaryngologic Clinics of North America, (Park S. S., Holt G. R. , Guest editors), Vol. 32 No. 1, February 1999, pp.53-64

740) A     Spreader grafts

Chand M. S., Toriumi D. M.: Treatment of the External Nasal Valve, Functional Reconstructive Rhinoplasty, (Murakami C. S., editor), Facial Plastic Surgery Clinics of North America, Vol. 7, No. 3, August 1999, pp. 347-355

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Updated: June 15, 2017

741-750 MCQ in Facial Plastic and Reconstructive Surgery

741-750

741) The Male Pattern Baldness represented in the picture below belongs to which of the following classifications?A. Nordwood Class II
B. Nordwood Class III
C. Nordwood Class IV
D. Nordwood Class V
E. Nordwood Class VI

742) Which of the following muscles is MOST COMMONLY used in Facial Reanimation?

A. Gracilis
B. Serratus anterior
C. Pectoralis minor
D. Extensor digitorum brevis
E. Rectus abdominis

743) Which of the following statements is TRUE about the External Nasal Valve Dysfunction?

A. The most common etiology of External Nasal Valve Dysfuntion is aging.
B. The incidence of External Nasal Valve Collapse will be minimized by preserving the Upper Lateral Cartilage.
C. The diagnosis of dysfunction can be made by stabilizing the Alar Rim to see if nasal airflow improves.
D. The diagnosis of dysfunction can be made by the Cottle Maneuver.
E. Dorsal Colllapse noted by an Inverted V Deformity is typical of this type of dysfunction.

744) Which of the following statements about "Spreader Grafts" used in Rhinoplasty is FALSE?

A. Spreader Grafts should span from the caudal border of the nasal bone to the Anterior Septal Angle.
B. Nasal Septal Cartilage is the ideal Spreader Graft material.
C. Conchal cartilage is not used as Spreader Graft material due to the intrinsic bowing.
D. Horizontal mattress sutures are the ideal sutures for use with Spreader Grafts.
E. The purpose of Spreader Grafting is to displace the Upper Lateral Cartilage laterally.

745) After Facial Nerve birth trauma what is the percentage of complete return of Facial Nerve Function?

A. 10%
B. 30%
C. 50%
D. 70%
E. 90%

746) Which of the following statements is TRUE about adequate margins of wide excision in Merkel Cell Carcinoma?

A. They are undefined.
B. They are assisted with frozen sections.
C. They are assisted with Mohs surgery.
D. An adequate margin is 3 cm.
E. An adequate margin is 5 cm.

747) Which of the following statements about Bipolar Radiofrequency Resurfacing is FALSE?

A. Its resurfacing power is based on a process called coblation.
B. The mechanism of resurfacing is basically the same as that used in Resurfacing Lasers.
C. A flow of isotonic saline solution covering the tissue treated is mandatory at all times.
D. The first pass can separate of the Epidermal-Dermal Junction.
E. The second pass extends into the papillary dermis.

748) Which of the following statements about microdermabrasion is TRUE?

A. The purpose of Microdermabrasion is to remove the papillary dermis.
B. Microdermabrasion is comparable to medium peels.
C. Microdermabrasion is safe for use on the neck.
D. Microdermabrasion should produce a mild fine bleeding.
E. Microdermabrasion is safe only in Fitzpatrick Skin Types I-III.

749) Which of the following types of Calvarial Bone Gafts is MOST USEFUL in the treatment of Cranioplasty/Craniosynostosis?

A. Bone dust
B. Bone chips
C. Bone strips
D. Partial thickness
E. Full thickness

750) Which of the following statements about the characteristic of normal perioral findings in young individuals is TRUE?

A. The upper lips are 10-15 mm in height at the midline.
B. The interface of the upper and lower lips forms a W.
C. The lower lip should be more anterior than the upper lip on profile view..
D. Both lips should protrude beyond a vertical line drawn from the subnasale to the pogonium.
E. The upper and lower lips meet in the midline.


ANSWERS & REFERENCES


741) C     Nordwood Class IV

Mayer T. G., Fleming R. W.: Management of Alopecia and Reconstructive Scalp Surgery, Chapter 28, in Otolaryngology-Head and Neck Surgery, (Cummings, Fredrickson, Harker, Krause, Schuller, editors), Second Edition, Vol. 1, 1993, pp. 480-531

Norwood OT, Shiell R.C.: Hair Transplant Surgery, 2nd. Ed. , Springfield, IL., Charles C. Thomas, 1984

742) A     Gracilis

Fong B. Shindo M.: Dynamic Facial Reanimation using Free-Tissue Transfer, Rehabilitation of Facial Paralysis, Facial Plastic Surgery Clinics of Noth America, (Perkins, S. W., editor), Vol. 5, No. 3, August 1997, pp. 247-255

743) C     The diagnosis of dysfunction can be made by stabilizing the Alar Rim to see if nasal airflow improves.

Chand M. S., Toriumi D. M.: Treatment of the External Nasal Valve, Functional Reconstructive Rhinoplasty, (Murakami C. S., editor), Facial Plastic Surgery Clinics of North America, Vol. 7, No. 3, August 1999, pp. 347-355

744) C     Conchal cartilage is not used as Spreader Graft material due to the intrinsic bowing.

Park S. S: Treatment of the Internal Nasal Valve,Functional Reconstructive Rhinoplasty, (Murakami C. S., editor), Facial Plastic Surgery Clinics of North America, Vol. 7, No. 3, August 1999, pp. 333-345

745) E     90%

Clark J. M., Shockley W. W. : Management and Reanimation of the Paralyzed Face, Chapter 53, Head and Neck Surgery-Otolaryngology, (Bailey B.J., editor), Lippincott Williams & Wilkins, Third Edition, Volume Two, 2001, pp. 660-685

Clark J. M., Shockley W. W. : Management of the Paralyzed Face, Chapter 63 in Facial Plastic and Reconstructive Surgery, (Papel I. D., Editor), Third Edition, Thieme, 2009, pp. 869-895

746) A     They are undefined.

Brodland D. G.: The Treatrment of Merkel Cell Carcinoma with Mohs Micrographic Surgery, Advances in Mohs Surgery, (Dzubow L. M, editor), Facial Plastic Surgry Clinics of North America, Vol. 6, No. 3, August 1998, pp. 329-335

Hendrix J. D., Slingluff C. L. : Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52 in Facial Plastic and Reconstructive Surgery, (Papel I. D., Editor), Third Edition, Thieme, 2009, pp. 675-702

747) B     The mechanism of resurfacing is basically the same as that used in Resurfacing Lasers.

Carniol P. J., Maas C.S.: Bipolar Radiofrequency Resurfacing, Minimally Invasive Surgery, (Koch R. J., editor), Facial Plastic Surgery Clinics of North America, Vol. 9, No. 3, August 2001, pp.337-342

748) C     Microdermabrasion is safe for use on the neck.

Koch R. J., Hamasono M. M.: Microdermabrasion, Minimally Invasive Surgery, (Koch R. J., editor), Facial Plastic Surgery Clinics of North America, Vol. 9, No. 3, August 2001, pp.377-382

749) E     Full thickness

Day T. A., Vuillemin, Laedrach K., Raveh J., Stucker F. J.: Calvarial Bone Grafting in Craniofacial Reconstruction, New Techniques in Facial Reconstruction, (Stucker F. J, , editor), Facial Plastic Surgery Clinics of North America, Vol. 3, No. 3, August 1995, pp.241-255

750) D     Both lips should protrude beyond a vertical line drawn from the subnasale to the pogonium.

Cheng J. T., Perkins S. W., Hamilton M. M.: Perioral Rejuvenation, Rejuvenation of the Lower Face and Neck, (Waldman S. R., editor), Facial Plastic Surgery Clinics of North America, Vol. 8, No. 2, May 2000, pp.223-233


---------------------------------------
Updated: June 15, 2017

751-760 MCQ in Facial Plastic and Reconstructive Surgery

751-760

751) The drawing represents the reconstruction repair of a left upper eyelid defect. Which of the following techniques IS REPRESENTED in the picture below? A. Tenzel semicircular flap
B. Mustardé lid repair
C. Cutler-Beard lid repair
D. Hughes flap repair
E. Butterfly flap repair

752) Which of the following medications is used for the INITIAL management of female pattern hair loss?

A. Minoxidil
B. Finasteride
C. Nioxin
D. Nizoral
E. Zinc

753) Which is of the following statements about the Mestizo nose is FALSE?

A. The radix is low.
B. The dorsum is slightly concave.
C. The columella is short.
D. The projection is low.
E. The tip is rotated caudally.

754) Which of the following muscles arises from the medial end of the orbit (nasal prominence) and runs superiorly and laterally to insert into the deep surface of the skin?

A. Procerus
B. Corrugator
C. Frontalis
D. Depressor supercillii
E. Orbicularis

755) Which of the following conditions is NOT A CONTRAINDICATION for the use of botulinum toxin type A?

A. Eaton-Lambert syndrome
B. Myastenia gravis
C. Psoriasis
D. Motor neuron disease
E. Multiple sclerosis

756) Which of the following is a CONTRAINDICATION for use of the Lateral Crura Overlay Tip Technique?

A. Acute nasalabial angle associated with tip ptosis
B. Long nose and tip ptosis
C. Overprojection associated with tip ptosis
D. Underprojection associated with tip ptosis
E. Long, inferiorly oriented lateral crura.with tip ptosis

757) Which of the following surgical maneuvers is NOT related to the repair of a Unilateral Cleft Lip-Nasal Deformity?

A. Forked flap incisions in the upper lip
B. Asymmetric vertical division of the lower lateral cartilages (LLC)
C. Suture reconstitution of the lower lateral cartilages
D. Placement sutures into the cephalic margin of the cleft side alar cartilage and the upper lateral cartilage
E. Nasal tip grafting

758) Which of the following is NOT RELATED to the aging nose?

A. Increased length
B. Columellar shortening
C. Dorsal concavity
D. Tip drop
E. Subcutaneous fat atrophy

759) Which of the following cells plays a KEY ROLE in the coagulation phase of wound healing?

A. Platelets
B. Neutrophils
C. Lymphocytes
D. Macrophages
E. Blood red cells

760) Which of the following statements regarding irradiated rib homograft cartilage is FALSE?

A. It is costal cartilage that has been harvested from cadaveric donors.
B. The cartilage is sterilized by exposue to 30.000 Gy.
C. Before using the implant it should be soaked in gentamicin sulfate solution.
D. It is easily carved.
E. It is less resistant to infection than most alloplasts.


ANSWERS & REFERENCES


751) C     Cutler-Beard lid repair

Jewtt B. S., Shockley W. W.: Reconstructive Options for Periocular Defects, Management of Facial Cutaneous Defects Part I, Otolaryngologic Clinics of North America, Vol. 34 No. 3, June 2001, pp.601-625

Kaltreider S. A.: Periocular Reconstruction, chapter 62 in  Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, Thieme, 2009, 855-867

752) A     Minoxidil

Epstein J. S.: The treatment of female pattern hair loss and other applications of surgical hair restoration in women, Facial Plastic Surgery Clinic of North America, (Epstein J. S., editor), Elsevier Saunders, Vol. 12, No. 2, , pp. 241-247, 2004

753) B     The dorsum is slightly concave.

Monasterio F. O., Orsini R.: Surgery of the Non-Indo-European Face, Rhinoplasty: Current Concepts (Guyuron B. Guest Editor), Clinics in Plastic Surgery, Vol. 23, No. 2, April 1996, pp. 341-356

754) B     Corrugator

Bassichis B. A., Thomas J.R: The use of Botox to treat glabellar rhytids, (Dayan S. H., Guest Editor), Facial Plastic Surgery Clinics of NorthAmerica, Vol. 11, N0. 4, 2003, pp. 453-456

755) C     Psoriasis

Vartanian A.J., Dayan S. H.: Complications of Botulinum Toxin A use in Facial Rejuvenation, Seminal Review Issue (Thomas J. R., Guest Editor), Facial Plastic Surgery Clinics of Noth America, Vol. 13, No. 1, February 2005, pp. 1-10

756) D     Underprojection associated with tip ptosis

Konior R. J., Kridel R. W. H.: Controlled Nasal Tip Positioning Via the Open Rhinoplasty Approach, Open Rhinioplasty, (Toriumi D. M., Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 1 No. 1, August 1993, pp.53-62

757) A     Forked flap incisions in the upper lip

Sykes J. M., Senders C. W., Wang T. D., Cook T. A.: The Use of Open Approach for Repair of Secondary Cleft Lip-Nasal Deformities, Open Rhinioplasty, (Toriumi D. M., Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 1 No. 1, August 1993, pp.111-126

758) C     Dorsal concavity

Rohirch R. J., Hollier L. H.: Rhinoplasty with Advancing Age, Special Articles, Rhinoplasty and Septoplasty, Part II (Park S. P., Holt G. R., Guest Editors), The Otolaryngologic Clinics of North America, August 1999, pp. 755-772

759) A     Platelets

Terris D.J.: Dynamic of Wound Healing, Chapter 16, Head and Neck Surgery-Otolaryngology, (Bailey B.J., editor), Lippincott Williams & Wilkins, Third Edition, Volume One, 2001, pp. 175-187

760) E     It is less resistant to infection than most alloplasts.

Kridel R. W. H., Kraus W. M.: Grafts and Implants in Revision Rhinoplasty, Revision Rhinoplasty, (Kridel R. W. H., editor), Saunders, Facial Plastic Surgery Clinics of North America, Vol. 3, No. 4, November 1995, pp. 473-486


---------------------------------------
Updated: June 15, 2017

761-770 MCQ in Facial Plastic and Reconstructive Surgery

761-770

761) The drawing below represents the right bony orbit seen from a 1/3 lateral view. What is the bony anatomical structure indicated by the arrow?

A. Maxilla
B. Greater wing of the sphenoid
C. Lesser wing of the sphenoid
D. Zygomatic bone
E. Frontal bone

762) Which of the following subjects of facial photography is ideal for the use of a RING FLASH UNIT?

A. Otoplasty
B. Rhinoplasty
C. Facelift
D. Intraoral techniques
E. Scars revisions views

763) Which of the following radiographic views is the SINGLE BEST for evaluation of mandibular fractures?

A. Lateral oblique view
B. Antero-posterior view
C. Towne’s view
D. Panorex view
E. Computed tomography

764) Which of the following statements about penetrating neck wounds is FALSE?

A. All neck injuries in Zones I, II and III that penetrate the platysma should be explored.
B. Symptomatic patients with penetrating neck injuries to Zone III require angiography prior to neck exploration.
C. Asymptomatic patients with penetrating neck injuries to Zone I require angiography prior to neck exploration.
D. Penetrating neck injuries to Zones I and III in both asymptomatic or symptomatic patients require routine angiography.
E. Angiography is not necessary for any penetrating neck injury to Zone II.

765) Which of the following surgical techniques is the IDEAL for repair of a cleft lip greater than 12 mm wide?

A. Millard’s repair
B. Triangular repair
C. Rose-Thompson repair
D. Quadrilateral repair
E. Mirault-Brown-McDowell repair

766) Which of the following statements about Trap-Door deformity is FALSE?

A. It is a bulging elevation of the skin with a surrounding depressed scar
B. It is usually seen after C, U or V-shaped transposition flaps
C. Prevention can be achieved with wide undermining of the surrounding skin
D. Early cases can be treated with intralesional 1 ml triamcinolone acetonide (40 mg/ml) injections
E. Multiple Running W-plasty can correct this deformity.

767) Which of the following statements about Le Fort Fractures is FALSE?

A. Le Fort I fracture is a horizontal fracture between the maxilla and palate/alveolar arch complex
B. Le Fort II fracture is the most common Le Fort fracture pattern
C. Serious concomitant intracranial injury is common
D. Serious concomitant ophthalmologic injury is also common
E. MRI with contrast is the examination of choice for evaluation of these fractures

768) Which of the following statements about a “SHORT NOSE” is FALSE?

A. There is decreased distance from the nasion to the tip defining point.
B. There is a low ratio of tip projection to nasal length.
C. There is a nasolabial angle greater than expected.
D. There is a overprojection of nasal tip.
E. There is overrotation of nasal tip.

769) Which of following regions of the auricle should remain after ear resection , if oncologically feasible, from the prosthetic point of view?

A. Upper portion of the auricle
B. Lower portion of the auricle
C. Concha
D. Lobule
E. Tragus

770) Which is of the following statements about surgical objectives in the management of a Mestizo nose is FALSE?

A. Underesection of the dorsal hump is advisable.
B. Septal cartilage graft is used to increase projection of the tip.
C. The radix can be elevated with a cartilage graft.
D. Wide resection of the upper edge of the lateral crura will achieve adequate tip rotation.
E. Percutaneous 2-mm osteotomies can be used to narrow the nasal pyramid.


ANSWERS & REFERENCES


761) B     Greater wing of the sphenoid

Hollinshead W. H: Anatomy for Surgeons, Volume 1

762) D     Intraoral techniques

Tardy Jr. M. E., Dayan S., Hecht D.: Preoperative Rhinoplasty, Evalualtion and Analysis, Office-Based Procedures in Facial Plastic Surgery (Porter J. P. P., Guest Editor), Otolaryngologic Clinics of North America, Vol. 35 No. 1, Februrary 2002, pp.1-27

763) D     Panorex view

Leach J.L., Newcomer M. T.: Mandibular Fractures, Chapter 65, Head and Neck Surgery-Otolaryngology, (Bailey B.J., editor), Lippincott Williams & Wilkins, Third Edition, Volume One, 2001, pp. 765-774

764) A     All neck injuries in Zones I, II and III that penetrate the platysma should be explored.

Stewart M. G.: Penetrating Face and Neck Trauma, Chapter 68, Head and Neck Surgery-Otolaryngology, (Bailey B.J., editor), Lippincott Williams & Wilkins, Third Edition, Volume One, 2001, pp. 814-821

765) B     Triangular repair

Stal S., Klebuc M., Taylor T. D., Spira M., Edwards M.: Algorithms for the Treatment of Cleft Lip and Palate, Common Pediatric Plastic and Reconstruction Diagnosis (Stal S., Friedman J., Guest Editors), Clinics in Plastic Surgery, Vol. 25, No. 4, October 1998, pp.493-507

766) E     Multiple Running W-plasty can correct this deformity.

Vural E., Key J. M.: Complications, Salvage, and Enhancement of Local Flaps in Facial Reconstruction, Management of Facial Cutaneous Defects, Part II, Otolaryngologic Clinics of North America, (Park S. S. , Guest editors), Vol. 34 No. 4, August 2001, pp.739-751

767) E     MRI with contrast is the examination of choice for evaluation of these fractures.

Doerr T. D., Mathog R. H.:Le Fort Fractures (Maxillary Fractures): Chapter 60, Facial Plastic and Reconstructive Surgery,(Papel I. D., editor), Second Editon, Thieme, Second Edition, 2002, pp. 759-768

Doerr T. D., Mathog R. H.:Le Fort Fractures (Maxillary Fractures): Chapter 71, Facial Plastic and Reconstructive Surgery,(Papel I. D., editor), Second Editon, Thieme, Third Edition, 2009, pp. 9911-1000

768) D     There is a overprojection of nasal tip.

Dyer II W. K., Beaty M, M. Prabhat A.: Architectural Deficiencies of the Nose, Treatment of the Saddle Nose and Short Nose Deformities, Rhinoplasty and Septoplasty I, Otolaryngologic Clinics of North America, (Park S. S., Holt G. R. , Guest editors), Vol. 32 No. 1, February 1999, pp.89-112

http://emedicine.medscape.com/article/840066-overview

769) E     Tragus

Lemon J. C., Chambers M. S., Martin J. W.: Prosthetic Rehabilitation of Patients with Advanced Nonmelanoma Skin Cancer, Clinics in Plastic Surgery (Schusterman M.A, Guest Editor), Vol. 24 No. 4, October 1997, pp. 797-815

770) D     Wide resection of the upper edge of the lateral crura will achieve adequate tip rotation.

Monasterio F. O., Orsini R.: Surgery of the Non-Indo-European Face, Rhinoplasty: Current Concepts (Guyuron B. Guest Editor), Clinics in Plastic Surgery, Vol. 23, No. 2, April 1996, pp.341-356

---------------------------------------
Updated: June 25, 2017

771-780 MCQ in Facial Plastic and Reconstructive Surgery

771-780

771) Which of the following is FALSE about the flap represented in the drawing below?A. It is a serial Z-plasty.
B. It is based on a 4-flap 45 degree Z-plasty.
C. The result after completion will be a lengthening created by a 90 degree Z-plasty.
D. It is not ideal for facial surgery.
E. It is ideal for the neck surgery.

772) Which of the following medications is not approved for management of female pattern hair loss?

A. Minoxidil
B. Finasteride
C. Nioxin
D. Nizoral
E. Zinc

773) Which of the following statements about penetrating neck trauma is FALSE?

A. Zone I comprises the root of the neck inferior to the inferior border of the cricoid cartilage.
B. Zone II is the zone of the neck between the angle of the mandible and the inferior border of the cricoid cartilage.
C. Zone III is the zone comprising the neck superior to the angle of the mandible up to the skull.
D. Zone II is the largest zone.
E. Zone II is the least common site of entry.

774) Which of the following anatomical areas of the mandible is MOST COMMONLY ASSOCIATED with the HIGHEST incidence of infection?

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

775) Which of the following operative maneuvers will DECREASE projection?

A. Lateral crural steal
B. Columellar strut
C. Lateral crural overlay
D. Septocolumellar suture
E. Tip graft

776) Which of the following anatomical areas is LESS LIKELY to develop hypertrophic scarring or keloids?

A. Central third of the face
B. Presternal area
C. Upper back
D. Shoulders
E. Neck

777) The MOST COMMON complication after reduction of a zygomatic fracture is?

A. Malar depression
B. Ectropion
C. Diplopia
D. Enophthalmos
E. Oroantral fistula

778) Which of the following rhinoplasty techniques WILL NOT improve projection?

A. Excision of the cephalic lower lateral cartilage
B. Transdomal sutures
C. Lateral cura steal
D. Columellar strut
E. Tip graft

779) Which of the following photographic parameters is MOST DIFFICULT to adjust in the documentation of a facial scar?

A. Close up
B. Exposure
C. Flash intensity
D. Velocity
E. Depth of field

780) In the execution of serial excisions what is the WAIT TIME between the first and second excision?

A. After the initial scar is healed
B. 1 months
C. 3 months
D. 8 months
E. 12 months



ANSWERS & REFERENCES


771) A     It is a serial Z-plasty.

Davidson T. M., Webster R. C.: Scar Revision, A Self-Instructional Package from the Committee on Continuing Educaltion in Otolaryngology, AAO-HNS Foundation, Incc., 1983, pp. 32-46

772) B     Finasteride

Epstein J. S.: The treatment of female pattern hair loss and other applications of surgical hair restoration in women, Facial Plastic Surgery Clinic of North America, (Epstein J. S., editor), Elsevier Saunders, Vol. 12, No. 2, , pp. 241-247, 2004

773) E     Zone II is the least common site of entry.

Stewart M. G.: Penetrating Face and Neck Trauma, Chapter 68, Head and Neck Surgery-Otolaryngology, (Bailey B.J., editor), Lippincott Williams & Wilkins, Third Edition, Volume One, 2001, pp. 814-821

Stewart M. G.: Penetrating Face and Neck Trauma, Chapter 72, Head and Neck Surgery-Otolaryngology, (Bailey B.J., editor), Lippincott Williams & Wilkins, 4th Edition, 2006, pp. 1017-1026

774) B     Angle

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

2001, pp. 765-774

775) C     Lateral crural overlay

Konior R. J., Kridel R. W. H.: Controlled Nasal Tip Positioning Via the Open Rhinoplasty Approach, Open Rhinioplasty, (Toriumi D. M., Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 1 No. 1, August 1993, pp.53-62

Becker D. G.: Complications of Rhinoplasty, Chapter 39 in Facial Plastic and Reconstructive Surgery, (Papel I. D., Editor), Second Edition, Thieme, 2002, pp. 452-460

776) A     Central third of the face

Stepnick D. W.: Facial Scars and Keloids in Current Therapy in Otolaryngology-Head and Neck Surgery, Sixth Edition, (Gates, G.A., editor), Mosby, 1998, pp.116-121

http://emedicine.medscape.com/article/876214-overview

777) A     Malar depression

Appling W. D., Stewart M. G.: Zygomatic fracture in Current Therapy in Otolaryngology-Head and Neck Surgery, Sixth Edition, (Gates, G.A., editor), Mosby, 1998, pp.116-121

778) A     Excision of the cephalic lower lateral cartilage

Adamson P. A., The Failed Rhinoplasty in Current Therapy in Otolaryngology-Head and Neck Surgery-4, (Gates, G.A., editor), Mosby, 1998, pp.137-143

779) B     Exposure

Davidson T. M., Webster R. C.: Scar Revision, A Self-Instructional Package from the Committee on Continuing Educaltion in Otolaryngology, AAO-HNS Foundation, Incc., 1983, pp. 17-20

780) C     3 months

Davidson T. M., Webster R. C.: Scar Revision, A Self-Instructional Package from the Committee on Continuing Educaltion in Otolaryngology, AAO-HNS Foundation, Incc., 1983, pp. 20-27

Kokoska M. S., Regan Thomas J.: Scar Revision, Chapter 5 in Facial Plastic and Reconstructive Surgery, (Papel I. D., Editor), Third Edition, Thieme, 2009, pp. 59-65

---------------------------------------
Updated: June 15, 2017

781-790 MCQ in Facial Plastic and Reconstructive Surgery

781-790

781) The suture represented in the drawing below will achieve which of the following rhinoplasty effects?
A. Projection
B. Underprojection
C. Rotation
D. Underotation
E. Flaring

782) Which of the following facial areas has FIRST PRIORITY for reconstruction after burns to the face?

A. Eyelids
B. Ears
C. Cheeks
D. Nose
E. Forehead

783) Which of the following facial areas has LEAST PRIORITY for reconstruction after burns to the face?

A. Eyelids
B. Ears
C. Cheeks
D. Nose
E. Forehead

784) Which of the following measures is NOT INDICATED in the management of postoperative orbital hemorraghe after Blepharoplasty?

A. Elevation of the head of the patient’s bed
B. Ice pack compresses
C. Lateral Canthotomy and Inferior Cantholysis
D. Dexamethasone
E. Mannitol

785) Which of the following statements regarding skin staples in FALSE?

A. They are made of stainless steel
B. They are used in hair-bearing areas of the scalp
C. They do not evert the skin edges
D. They are minimally reactive
E. They can be left in place up to 14 days without complications

786) Which of the following techniques use a semicircular rotational myocutaneous flap from the lateral canthal region to repair a lower or upper eyelid defect of up to 50% of the eyelid margin?

A. Primary closure associated with Lateral Canthotomy and Inferior Cantholysis
B. Tenzel Technique
C. Hughes Technique
D. Cutler-Beard Technique
E. Leone Technique

787) Which of the following statements regarding the management of the oriental blepharoplasty is FALSE?

A. Most patients will prefer a small fold instead of the caucasion eyelid fold.
B. The closed technique carries more chance of postoperative asymmetry.
C. The closed technique will not recreate the crease in one third of patients.
D. The closed technique works better if performed on thin eyelids.
E. The open technique carries less chance of a postoperative puffy fold appearance.

788) Which of following operative goals in Non-Caucasian Rhinoplasty is INCORRECT?

A. Increase nasal projection
B. Decrease alar flare
C. Narrow nasal base
D. Augment dorsum
E. Decrease anterior nasal spine

789) Which of the following statements regarding electrical injury in children is FALSE?

A. Electrical injury occurs most commonly under 4 years of age.
B. Partial-thickness lateral commisure burns are usual.
C. Intense edema is followed by sloughing of necrotic tissue and bleeding
D. Commisure splinting can be useful for 6-12 months
E. Reconstruction is done by the release of scar tissue and placement of local flap from the ipsilateral side.

790) Which of the following is the IV FLUID OF CHOICE in Adult Burn Replacement Therapy?

A. Lactated Ringer’s solution
B. Normal saline solution
C. Half normal saline solution
D. 5% dextrose in water
E. Dextran


ANSWERS & REFERENCES


781) A     Projection

Pastorek N. J.: The Large Nose in Current Therapy in Otolaryngology-Head and Neck Surgery, Sixth Edition, (Gates, G.A., editor), Mosby, 1998, pp.157-164

Nolst Trenité G.J.: Surgery of the Nasal Tip Intranasal Approach, Chapter 44 in in Facial Plastic and Reconstructive Surgery (Papel I, editor), Third edition, 2009, pp. 563-576

782) A     Eyelids

Young V. L., Bartell T. H.: Burns of the face in: Facial Scars, Incision, Revision and Camouflage,(Tomas J. R. & Holt G. R, editors), Mosby, 1989, pp.229-270

783) B     Ears

Young V. L., Bartell T. H.: Burns of the face in: Facial Scars, Incision, Revision and Camouflage,(Tomas J. R. & Holt G. R, editors), Mosby, 1989, pp.229-270

Abrams M. J., Shumrich K. A.: Facial Burns, Case 79 in Otolaryngology, A case Study Approach (Tami, Seiden, Pensak, Gluckman, Cotton, editors), 1998, pp.289-292

784) B     Ice pack compresses

Shumrich K. A., Kersten R. C.: Eyelid Surgery Postoperative Complication, Case 74 in Otolaryngology, A case Study Approach (Tami, Seiden, Pensak, Gluckman, Cotton, editors), 1998, pp.271-273

785) C     They do not evert the skin edges

Thomas J. R.: Wound Closure Materials in Facial Scars, Incision, Revision and Camouflage,(Tomas J. R. & Holt G. R, editors), Mosby, 1989, pp.69-74

786) B     Tenzel Technique

Kaltreider S. A.: Periocular Reconstruction, Chapter 52 in Facial Plastic and Reconstructive Surgery (Papel I, editor), second edition, 2002, pp. 646-659

Kaltreider S. A.: Periocular Reconstruction, Chapter 62 in Facial Plastic and Reconstructive Surgery (Papel I, editor), Third edition, 2009, pp. 855-867

787) B     The closed technique carries more chance of postoperative asymmetry.

Choi A. K.: Oriental Blepharoplasty: Nonincisional Suture Technique versus Conventional Incisional Technique, Facial Plastic Surgery, Vol. 10 No. 1, January 1994, pp. 67-83

788) E     Decrease anterior nasal spine

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

789) B     Partial-thickness lateral commisure burns are usual.

Hill D. P.: Electrical, Cold, Chemical, and Thermal Injury, Biological Basis of Facial Plastic Surgery, pp. 174-180

790) A     Lactated Ringer’s solution

Hill D. P.: Electrical, Cold, Chemical, and Thermal Injury, Biological Basis of Facial Plastic Surgery, pp. 174-180


---------------------------------------
Updated: June 15, 2017

791-800 MCQ in Facial Plastic and Reconstructive Surgery

791-800

791) Which of the following eyelid types is represented in the drawing below?

A. The Caucasian
B. The African American
C. The Asian
D. The Latino
E. The Middle-Eastern

792) Which of the following eyelid anatomical structures does NOT function as a "retractor"?

A. Levator aponeurosis
B. Muller’s muscle
C. Capsulopalpebral fascia
D. Inferior tarsal muscle
E. Whitnall’s ligament

793) Which of the following transposition-grafting is MOST COMMOMLY used in facial nerve paralysis rehabilitation?

A. Hypoglossal-Facial
B. Spinal Accessory-Facial
C. Glossopharyngeal -Facial
D. Phrenic-Facial
E. Ansa hypoglossi-Facial

794) The five year cure rate for Primary Basal Cell Carcinoma after Mohs Micrographic Surgery is reached by which percentage of patients?

A. 80%
B. 85%
C. 90%
D. 95%
E. 99%

795) For each specimen, what is the percentage of lateral and deep margins that can be checked using the Horizontal Sectioning Technique in Mohs Surgery?

A. 95%
B. 96%
C. 97%
D. 99%
E. 100%

796) Which of the following flaps is a TRANSPOSITION flap?

A. Paramedian forehead flap
B. Melolabial flap
C. Limberg flap
D. O-T flap
E. V-Y flap

797) Which of the following statements about the Coronal/Hairline Forehead Lift is FALSE?

A. It can not be applied to male patients with male-pattern baldness.
B. Subperiosteal plane dissection is used.
C. Scoring-resection of frontal and corrugator muscles is done.
D. Numbness in the forehead flap and beyond the incision line occurs.
E. There is a potential for stretch-back with recurrent brow ptosis.

798) Which of the following measurements represents NORMAL levator function?

A. 5 mm
B. 10 mm
C. 15 mm
D. 20 mm
E. 25 mm

799) Which of the following surgical techniques is the BEST for repairing injury to the upper or lower eyelid involving a 25% of tissue loss?

A. Primary closure associated with Lateral Canthotomy /Lateral Cantholysis
B. Semicircular Rotation-Advancement Flap (Tenzel)
C. Pedicled Lid Switch Flap (Mustarde)
D. Bridge Flap (Cutler-Beard)
E. Tarsoconjuntival Flap (Hughes)

800) An unrecognized laceration to the Levator Aponeurosis of the upper eyelid will result in

A. Lagopthalmus
B. Ectropion
C. Entropion
D. Ptosis
E. Mild scleral show


ANSWERS & REFERENCES


791) C     The Asian

Choi A. K.: Oriental Blepharoplasty: Nonincisional Suture Technique versus Conventional Incisional Technique, Facial Plastic Surgery, Vol. 10 No. 1, January 1994, pp. 67-83

McCurdy Jr. J. A.: Cosmetic Surgery of the Asian Face, Chapter 35 in Facial Plastic and Reconstructive Surgery (Papel I, editor), Third edition, 2009, pp. 435-458

792) E     Whitnall’s ligament

Sykes J. M., Dugan F. M. Jr.: Evaluation and Management of Eyelid Trauma, Facial Plastic Surgery, Vol. 10, No. 1, April 1994, pp. 157-171

793) A     Hypoglossal-Facial

Fucci M. J., Buchman C. A., Slattery III W. H.:Neurorrhaphy Techniques for Facial Paralysis, Rehabilitation of Facial Paralysis (Shindo M. L, Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 5 No. 3, August 1997, pp. 223-240

Clark J. M., Shockley W. W.: Management of the Paralyzed Face, Chapter 63, Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 869-894

794) E     99%

Lang Jr. P. G.: Mohs Micrographic Surgery for Basal Cell Carcinoma, Facial Plastic Surgery Clinics of North America, (Dzubow L. M., Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 6 No. 3, August 1998, pp. 275-295

Hendrix Jr. J. D., Slingluff C. L.: Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52, Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 675-702

795) E     100%

Lang Jr. P. G.: Mohs Micrographic Surgery for Basal Cell Carcinoma, Facial Plastic Surgery Clinics of North America, (Dzubow L. M., Guest Editor), Facial Plastic Surgery Clinics of North America, Vol. 6 No. 3, August 1998, pp. 275-295

Hendrix Jr. J. D., Slingluff C. L.: Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52, Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 675-702

796) C     Limberg flap

Park S. S.: Local and Regional Cutaneous Flaps, Chapter 44 in Facial Plastic and Reconstructive Surgery (Papel I, editor), second edition, 2002, pp. 528-548

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

797) B     Subperiosteal plane dissection is used.

Ramirez O. M.: Why I Prefer the Endoscopic Forehead Lift, Communications in Cosmetic Surgery, Plastic and Reconstructive Surgery, September 1995, pp.1033-1039

798) C     15 mm

Karesh J. W.: Diagnosis and Management of Acquired Blepharoptosis and Dermatochalasis, Facial Plastic Surgery, Vol. 10, No.2, April 1994, pp. 185-200

799) A     Primary closure associated with Lateral Canthotomy /Lateral Cantholysis

Sykes J. M., Dugan F. M. Jr.: Evaluation and Management of Eyelid Trauma, Facial Plastic Surgery, Vol. 10, No. 1, April 1994, pp. 157-171

http://emedicine.medscape.com/article/1281955-treatment

800) D     Ptosis

Sykes J. M., Dugan F. M. Jr.: Evaluation and Management of Eyelid Trauma, Facial Plastic Surgery, Vol. 10, No. 1, April 1994, pp. 157-171

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Updated: June 15, 2017