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Flashcards in Orthognathic, Cleft, Craniofacial Deck (24)
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1
Q
Distraction osteogenesis consists of an osteotomy followed by distraction:
(A) in 1-3 days.
(B) in 5-7 days.
(C) in 10-12 days.
(D) after consolidation.
A

B

2
Q

n 8 year-old patient with unilateral cleft lip and palate has an unrepaired residual oronasal fistula. Your treatment plan may include:
(A) rotation of incisors prior to grafting.
(B) expanding the maxilla.
(C) maintaining the primary teeth in the cleft site.
(D) using an alloplastic bone substitute in the site.

A

B

3
Q
The most common speech alteration that might occur as a complication of LeFort I advancement in a repaired cleft palate patient is:
(A) denasality.
(B) frontal distortion.
(C) lateral distortion.
(D) hypernasality.
A

D

4
Q

Antibiotics in orthognathic surgical procedures:
(A) are contraindicated.
(B) reduce the incidence of infection.
(C) increase the risk of osseous necrosis.
(D) are most effective when started 2 days before surgery.

A

B

5
Q

The simultaneously performed genioplasty and sagittal split osteotomy:
(A) decreases the risk of inferior alveolar nerve sensory loss.
(B) should not be performed simultaneously.
(C) increases the risk of inferior alveolar nerve sensory loss.
(D) has no effect on the risk of inferior alveolar nerve sensory loss.

A

C

6
Q
Which of the following is the most stable surgical procedure?
(A) Maxillary inferior repositioning
(B) Segmental maxillary expansion
(C) Maxillary superior repositioning
(D) Mandibular advancement
A

C

7
Q
Which class of medication used for restless leg syndrome in the OSA patient has the highest incidence of rebound?
(A) Benzodiazepines
(B) Dopamine agonists
(C) Antiepileptics
(D) Opioids
A

B

8
Q

Which procedure offers the “mouth breather” decreased resistance to nasal airflow?
(A) Segmental LeFort I osteotomy
(B) Surgically assisted maxillary expansion (SAME)
(C) Mandibular narrowing
(D) Mandibular widening

A

B

9
Q
Relapse associated with mandibular distraction osteogenesis is reduced by simultaneous expansion of:
(A) muscles.
(B) ligaments.
(C) tendons.
(D) cartilage.
A

A

10
Q
Mandibular distraction has become a reliable procedure in the management of the following craniofacial deformities?
(A) Hemifacial microsomia
(B) Crouzon’s Disease
(C) Apert’s Disease
(D) Craniosynostosis
A

A

11
Q
Distraction osteogenesis consists of an osteotomy followed by distraction:
(A) in 3 days.
(B) in 7 days.
(C) in 10 days.
(D) after consolidation.
A

B

12
Q

An 8 year-old patient with unilateral cleft lip and palate has an unrepaired residual oronasal fistula. Your treatment plan may include:
(A) rotation of incisors prior to grafting.
(B) expanding the maxilla.
(C) maintaining the primary teeth in the cleft site.
(D) using an alloplastic bone substitute in the site.

A

B

13
Q
The most common speech alteration that might occur as a complication of LeFort I advancement in a repaired cleft palate patient is:
(A) denasality.
(B) frontal distortion.
(C) lateral distortion.
(D) hypernasality.
A

D

14
Q

Antibiotics in orthognathic surgical procedures:
(A) are contraindicated.
(B) reduce the incidence of infection.
(C) increase the risk of osseous necrosis.
(D) are most effective when started 2 days before surgery.

A

B

15
Q

The simultaneously performed genioplasty and sagittal split osteotomy:
(A) decreases the risk of inferior alveolar nerve sensory loss.
(B) should not be performed simultaneously.
(C) increases the risk of inferior alveolar nerve sensory loss.
(D) has no effect on the risk of inferior alveolar nerve sensory loss.

A

C

16
Q
Which of the following is the most stable surgical procedure?
(A) Maxillary inferior repositioning
(B) Segmental maxillary expansion
(C) Maxillary superior repositioning
(D) Mandibular advancement
A

C

17
Q
A maxillomandibular transverse discrepancy of up to \_\_\_\_\_ mm can be treated orthodontically without surgery.
(A) 5
(B) 7
(C) 9
(D) 11
A

A

18
Q

Which procedure offers the “mouth breather” decreased resistance to nasal airflow?
(A) Segmental LeFort I osteotomy
(B) Surgically assisted maxillary expansion (SAME)
(C) Mandibular narrowing
(D) Mandibular widening

A

B

19
Q
Relapse associated with mandibular distraction osteogenesis is reduced by simultaneous expansion of:
(A) muscles.
(B) ligaments.
(C) tendons.
(D) cartilage.
A

A

20
Q
Mandibular distraction has become a reliable procedure in the management of the following craniofacial deformities?
(A) Hemifacial microsomia
(B) Crouzon’s Disease
(C) Apert’s Disease
(D) Craniosynostosis
A

A

21
Q
The percentage of soft tissue to bony advancement associated with an anterior horizontal sliding osteotomy (genioplasty) of the mandible typically is:
A. 20-30
B. 40-50
C. 60-70
D. 80-90
A

ANSWER: D
RATIONALE:
While results of soft tissue advancement can vary depending on technique, a true horizontal genioplasy with a broad based soft tissue pedicle (standard technique) will result in an 80-90% soft tissue advancement.
REFERENCE:
Betts, Norman J and Fonseca, Raymond J. Soft Tissue Changes Associated with Orthognathic Surgery. In: Modern Practice in Orthognathic and Reconstructive Surgery. Ed. William H. Bell. W.B. Saunders Company. Philadelphia, PA. 1992. pp.2171-2209.

22
Q
Which of the following describes the effects of intrinsic aging of the skin that are noted histologically?
A. dermal collagen production increases
B. the epidermis thickens
C. dermal elastin production decreases
D. rete pegs are promoted and enhanced
A

ANSWER: C
RATIONALE:
Dermal elastin production decreases with age. Generalized age-related dermal atrophy incledues decreased rete peg, epidermal thinning, and decreased dermal collagen production.
REFERENCE:
Obagi, S, Bridenstine, J: Lifetime Skin Care. Oral & Maxillofacial Surgery Clinics of North America Vol 12, No 4. Nov 2000, p 533.

23
Q
The normal distance in Caucasians from the upper eyelid margin to the superior tarsal crease is usually:
A. 3 millimeters
B. 5 millimeters
C. 10 millimeters
D. 15 millimeters
A

ANSWER: C
RATIONALE:
The supratarsal crease is generally 9-10 millimeters above the lash line of the upper eyelid in Caucasians. The crease represents an area where fibers from the levator aponeurosis attach to the posterior surface of the skin.
REFERENCE:
Karesh, JW: Blepharoplasty. Atlas of Oral & Maxillofacial Surgery Clinics of North America Vol 6, No 2. Sept 1998, pp 88 & 95.

24
Q
During closed rhinoplasty, delivery of the lower lateral cartilages requires the surgeon to perform a marginal incision and which other incision?
A. intercartilaginous
B. transfixion
C. Killian
D. transcolumellar
A

ANSWER: A
RATIONALE:
During closed rhinoplasty, delivery of the lower lateral cartilages requires the use of a marginal incision and an intercartilaginous incision. The transfixion incision connects the right and left nares through the columnella and is near the caudal edge of the cartilaginous septum, not the lower lateral cartilage. The Killian incision is used to approach the septum. The transcolumnellar incision is used in open rhinoplasty.
REFERENCE:
Kennedy, BD, Cosmetic Rhinoplasty, in Oral And Maxillofacial Surgery Vol 6 , Fonseca, RJ editor WB Saunders Co, 2000. p 326.