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512 Cards in this Set

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Antia-Buch flap
ear margin reconstruction
advantage of rectus abdomenis flap in h/n recon
bulk for tongue recon
mandible involvement with Ca
radical neck dissec
nasal reconstruction/lining

turn-over flap

septal mucosal flap
<1 cm = turn-over

>1 cm = septal mucosal flap
palate malignancy prognosis
mucoeipdermoid = good

adenoid cystic = poor
Van der Woodes sydrome
mucous pits

syndactyly
Down's syndrome
variable mental function
strbismus
saddle nose
microgenia
no cleft
hypertelorism

primary
secondary
tertiary
normal
prim = 30-35 mm

secon = 35 - 39 mm

tert = >40 mm

normal = 28 mm
cleft palate = faliure of
primary palate = medial paltine processes

secondary palate = lateral palatine prosesses
parotid Ca
high grade poor survival

20 - 40%

with ln's = 10%
retrobulbar hematoma
mannitol
carbonic anhydrase inhibitor

lateral canthotomy
Rx of lower 1/3 nasal fracture
spreader grafts
canine teeth erupt
10 - 11 yrs
maxillary blood supply post laforte I
ascending pharyngeal

ascending branch of facial art
cervico-facial lymphatic anomalies
80% have facial bone hypertrophy
blow in fractures
proptosis

diplopia

superior fissure syndrome

rupture globe
zygoma fracture - diplopia

% initial

% permanent
10% initially

1/2 are permanent

present 2 wks = surgery
cleft lip = failure
medial nasal prominence

maxillary nasal proninence
submaxillary gland

malignancies
1/2 are malignant
nerve involvement on frozen section = rad neck dissec.
leukoplakia - Ca

erythroplasia - Ca
leuk = 7%

eryth = 60%
crouzon's and aperts (acrocephalosyndactyly)

similarities
atosom dom
exorbitism
class III occl
mid face hypoplasia
hrdocephalus
strabismus
hypertelorism
crouzon's and aperts

dissimilar
aperts = cleft palate 70%
syncactyly
mental retardation

crouzon's = normal intelligence
cyanoacrylate
glue fixation provides compressive forces = plate fixation
indication for mandible distraction under age 2
migrogenia with tongue based airway obstruction
most common nonsyndromic synsotosis
saggital
carpenter syndrome
bicoronal synostosis +
saggital and lambdoid

polydactyly + toe syncactyly
unilateral plagiocephalay
ipsilateral flattening

anterior displacement of ear
binder syndrome
normal intelligence
nerves to

tensor velli pallatini

levator velli pallatini
tensor = trigeminal

levator = glossolpharyngeal
strickler syndrome
pierre robin with eye involvement
ramsey hunt
facial paralysis

secondary to herpes zoster
nager syndrome
treacher collin's

with pre-axial dificiencies
mobius
cranial n's III-XI
platysmla flap

complx rate
40%
most common complx of upper face fracture
infrorbital n. anesthesia
CSF leak

glucose
30 mg

halo sign

30% of severe face frx
60% resolve w/o surgery
diplopia with face frx.
when present pre op
% persist post op
1/2 persist post op
(approx 26%)
blindness

etiol w frx
swelling optic n.

dx = ct scan
velocardiofacial syndrome

test
FISH
(fluorescent in situ hybridization)
pierre robin

incidence of cleft
50%
1st & 2nd branchial arch syndromes
lateral facial microsomias

traeacher collins
hemifacial microsomia
goldenhar- epibulbar dermoids
rhomberg's
binder syndrome
nsaomaxillary hypoplasia
flatter nose

class III occl
borders of buccal space
orbic. oris
masseter
zygomatic major
buccinator at mandible
stenson's duct
retrobulbar hematoma

Rx
release lat canthal tendon

re-explore

ophth consult
frankfort horizontal
porion(tragion) and orbitale
normal mandibular opening
40-50 mm
mandibular distraction

latentcy
1 week
phenlypherin eye gtts

Rx for
horner's syndrome
nasal fracture

DNS

post op deformity
dns = 50%

defprmity 70%
coronal cat scan
requires neck extension
(not for patients with cervical trauma)
temporalis myofascial flap

artery

use
deep temporal artery

TMJ reconstruction
frontal sinus

age aeration
6 yrs
tongue lymph node met. levels
has skip levels therefore

all levels
frey syndorome

Rx
neurectomy

anticholinergics

topic robinol,prontal
nasoethmoid frx
operative dissection kept below the ethmoid artery to avoid the optic nerve
horner's syndrome
myosis
ptosis
anhydrosis
normal incisor show
2-3 mm
meatae

superior
middle
inferior
s = posterior ethomoid

m = frontal

i = nasolacrimal
most common cause of tmj ankylosis
trauma
what causes open bite with sagital split osteotomy?
improper seating of condyle
non union of mandible
body
origin of levator palpabrae
sphenoid
transconjunvtival approach

must repair
lateral canthal tendon
bell's palsy

Rx

emg
corticosteroids

acyclovir

14 - 21 days
supratrochlear nerve

location
medial corregator
amputated ear

Rx
replant or

post auricular pocket
eye injury in face fractures
12% orbital floor

37% malar fractures
Crouzon's
no mental retardation

autosomal dominent
ct cuts for malar fractures
1.5 mm
enophthalmus

etiol
def.
correction
usulally medial wall and floor fracture

measure anterior cornea to lat orb rim = > 3 mm diff

immediate goal over correction
traumatic optic neuropathy
1-2%

color perception decreased
highest complication rate in

mandible fracture
angle

infection
orif condyle fracture

complication
weakness VII
temporalis muscle flap

complication
weakness VII

hollow donor site
mandible fracture in children

most common
condyle 2/3
Tessier cleft


(treacher collins)
tessier 6
arnold's nerve
vagus (X)
TMJ

indications for surgery
internal derrangement with chronic pain

trismus
foramina

frontal encephlocele

V2

V3
f.enceph = foramen cecum

V2 = rotundum

V3 = ovale
adenoid cystic carcinoma

salivary glends
parotid = uncommon

submaxillary = common (34%)
beckwidth widman syndrome
omphalocele

macroglossia

midface retrusion
maxilla fractures

head injury
54%
tongue muscle

innervation
hypoglossal (XII)

exc palatoglossus = vagus (X)
pfeiffer syndrome
bil coronal sysostosis

thumb & hallux enlarged

exorbitism
lip SCC

tumor classification T3 =
4.5 cm

have 60/5 ln mets
klippel feil
short neck
low hair line
c spine deformity
cl palate
hearing loss
treacher collins syndrome
micrognathia
max/mand hypoplasia
inc cl palate
hearing loss

no hypertelorism
treacher collins syndrome
complete form = zygoma/temporo/auricular displasia

tessier cleft 6,7, & 8
velocardiofacial syndrome
autosomal domiment

FISH
f
in stu
hydradenitis
most common craniofacial anomaly

Rx first
genetic transmission
palsy ?
hemifacial microsomia

1st correct microsomia

no genetic transmisssion

facial palsy (VII) = 10-45%
surgical approac to zyg arch

coronal incision - through which layer
must incise

superficial temporal fascia
laceration canniculus
repair over silicone stent
inserts on lateral orbital tubercle
lateal rectus
" check ligament
" horn levator
" palpebral ligament

NOT lateral lim of lockwoods ligament
facial processes

medaial nasal process
lateral nasal process
fronto nasal process
medial = tip, columella, phyltrum, premaxilla

lateral = ala

fron-nas = nasal root & bridge
temporalis

innervation
V3
ocular parasympathetics

function
course
injured with
dilate pupil

occulomotor nerve (III)

injured with surgery
nasocillary nerve

lacrimal nerve

frontal nerve
all V1

pass through sup orb fissure
scaphocephaly

Rx
cranial vault remodelling

"barrel stave" grafting
short face syndrome

Rx
Laforte I

with inferior positions
cranial suture fusion

mediated by
TGG - Beta

fibroblast growth factor = coronal suture
tongue

tumor classification
T1 = < 2cm
T2 = 2-4cm
T3 = > 4cm
T4 = invades mandible

N1 = single ln =< 3cm
facial artery branch of

internal carotid
supraorbital
lip Carcinoma

tumor classification
invading adjacent structure

= T4
muscle associated with the hammulus
tensor veli palatini
stylopharyngeus muscle

embryologic origin
3rd branchial arch
compressible dermoid cyst with

ptosis =
extends through lateral wall

needs cat scan
mental nerve

exits below which tooth
2nd bicuspid (pre molar)
branchial cleft sinus

passes near
hypoglossal nerve (XII)
la forte osteotomy

how large a defect not requiring bone graft
5 mm
nasal glioma
off midline
red
firm
does not transilluminate
central region of

mandiblular distraction
fibrous zone
rheumatoid arthritis

Rx of mandibular retrusion
la forte I
how much maxillary advancement can be done

after which = diatraction
10mm
lingual nerve
branch of V3
down's syndrome
no cleft palate
unicystic ameloblastoma

Rx
currettage/enucleation
consequence of malar fracture
malar ptosis
orbital floor defect

requiring surgery =
2 cm
gummy smile, long nose, obtuse nas/lab angle, lip incompetence,excessive show upper incisors, class II occl,normal SNB
vertical maxillary excess
mandibular deficiency
true retrogenia
class II occl
SNB decreased
mandibular excess
prognathism
wide lower face
class III

SNB increased
maxillary deficience
dec facial height
edentulous look
protrude chin
wide ala
class III occl
SNB normal or increased
why should mandibular distaction below the age of 2 years be limited to tongue based airway obstructuction
tooth buds injury
35 y.o. unable to close his mouth since hearing a loud pop when yawning

Rx
attempt closed reduction with sedation
mouth since hearing a loud pop when yawning

Rx if problem recurrs
mri to plan

reduction of articular emminence
16 y.o. rheumotoid w mandible retrusion and ant open bite
skel maturity is complete

Rx
la forte I w max impaction

unloads the tmj
35 y.o with nasal trauma and purple mass on the septum

Rx
immediat i&d of septal hematoma
nasal fracture

Rx
usually wait 5-10 days till swelling goes down

delay septoplasty till healed
nerve to block the maxillary teeth
nasopalatine and

anterior superior alveolar

(both are branches of the infraorbital nerve)
recurrent "multinodular" pleomorphic adenoma

Rx
resection

plus radiation
bilateral parasymphytseal fracture

which muscle acts on the anterior segment
geniohyoid
tessier clefts

which have displacement of the medial canthus of the eye
no. 3
fracture of ant. and post. walls of frontal sinus

Rx
cranialization
obliteration of the frontal sinus
(removal of mucoca)
indicted in compromised nasalfrontal duct

"permit" the duct +/- graft material to fill the sinus
simultaneous contractions of which muscles causes side to side motion of the mandible
medial and lateral pterygoid
manible fracture and concommitant cervical spine fracture
10%
sphinctor pharyngoplasty =

transposition of which muscles
palatopharyngeus
10 y.o w uncorrected left coronal synostosis, and passively correctable head tilt w no muscle mass =
paresis of the ipsilateral superior oblique
unilateral coronal sysostosis results in orbital roof flattening = sup oblique paresis
tilt = compensation to raise affected eye
naso-orbitoethmoid fracture

Rx of lacraimal system with ORIF fractures
none = observation
alar displacement in unilateral cleft lip
lateral
inferior
posterior
treacher collins
mandibulofacial dysostosis
buccal musosa

innervation
trigeminal (V)
injury to auriculotemporal nerve during parotid surgery =
numb tragus, eternal auditory canal, temporal skin
foramen ovale
mandibular division trigeminal (V3)
jugular foramen
accessory nerve, IX, X
optic foramen
optic n. (II), and ophthalmic artery
lateral nasal process
nasal ala
medial pterygoid

action
medial, upward, forward motion of mandible
corpus collosum deformity

from which suture
metopic
Angle classification
first molars
first rx of neonate with tongue based airway obstruction
side or prone positioning

lip tongue adhesion, tracheostomy, mand distraction only if prone position is unsuccessful
mutation in genetic loci for fibroblast growth factor receptors (FGFR) effect

which suture
coronal
external auditory meatus

embrylogy
first branchial groove
temporalis muscle
nerve
mand div trigeminal (V3)
hyphema
anterior chamber blood
DFSP (dermatofibrosarcoma protuberans)

1cm margin resection =
local recurrence

3cm margin

4% metas
trigonocepahly
hypotelorism
salivary gland hemangiomas
parotid
vertical maxillary excess
la forte I impaction

guide to adequacy of elevation
upper lip tooth relationship

NOT cephalometrica
exposed maxilla fixation plates

rx
oral hygiene
facial artey musculotaneous flap

muscle
buccinator
Rx concylar neck and symphysis frx in child
orif symphysis and imf x 2 wks
Rx ectropion and lower lid shortening 2 months post orbital floor repair
(with no eye signs)
observe (message)
Binder syndrome
maxillonasal dysplasia
involves nasal floor
retracted columella,lip junc.
isolated cleft palate

% assoc anomalies
50%
incisor relation

horizontal
vertical
overjet

overbite
saggital split osteotomy

% numb V3 (mental)
10%
tensor veli palatini

nerve
trigeminal
submental flap

artery
msuculaotaneous

facial artery
Stensen's duct (parotid)

loc.
upper 2nd molar
prevention alar widening in laforte I osteotomy
alar cinch suture
most unstable orthognathic surgery
(prone to recureence)
maxillary widening
nonsyndromic unicoronal synsotosis
anterior displacement of ipslateral ear
Passavant's ridge
superior pharyngeal constrictor
residual enophthalmos post reduction

etiol
inadequate reduction
most imp. factor in bone formation with mandible dristaction
stable fixation
length of fixation post distaction
(consolidation period)
4 - 6 weeks
rate of distraction
1-2 mm/day
ear development
1st(mand arch) 3 hillocks
anterior tragus, root helix
supreior helix

2nd(hyoid arch) posterior
antitragus, lobule
antihelix and
posterior helix
opening eustachian tube
both levator and tensor veli palatini
Gille's elevation zygomatic arch
between deep temporalis fascia and temporalis muscle
foramen rotundum
sphenoid bone

V2 into pterygopaltine fossa
hypoglossal nerve

rel'n to carotid arteries
lateral to both int annd ext carotid arteries
hypoglossal nerve

rel'n to digastric muscle an stylohyoid muscle
deep
chin with vertical excess and horizontal deficiency

rx
jumping genioplasty
cleft palate

failure fusion
lateral and medial palatine processes
maxillary advancement

risk of vpi
cleft palate
Tessier cleft

most common
No. 7
rhomberg's hemifacial atrophy

rx
ftt with bulk (deipithelialized)

await stabilization
metachronous ca with scc h&n

%?
40%
synchronous ca with scc h&n

%?
5-7%
max/mand distraction

latency period
1 week
parotidectomy/facial nerve dissection

safest landmark
tempanomastoid suture
(6-8 mm inferior)
Laforte I osteotomy

arterial supply to maxilla
ascending pharyngeal
pleomorphic adenoma parotid

rx
superficial parotidectomy
anterior frontal sinus fracture with no csf leak

rx
fixation ant. table fragments
LaFort I frx in child

tooth at most risk
canine
gustatory sweating (frey syndrome)

nerve
auriculotemporal (regen. to sweat glands)
great auricular nerve
emerges from behind the scm muscle 9 cm caudal to the lobule
10 yr. old with rt. side open bite post chin trauma
left subcondylar fracture
anterior fontanelle

closes
24 months
ca tongue
tumor size
<2cm
2-4 cm
>4cm
invades adjacent structures
T1 = <2cm
T2 = 2-4 cm
T3 = >4 cm
T4 = invades ...
tongue ca
ln mets
single <3cm
single 3-6cm
multiple <6cm
multiple >6cm
N1 = single <3cm
N2a = single 3-6cm
N2b = multiple <6cm
N2c = multiple >6cm
mand frx assoc with growth disturbance in children
condyle
frontal sinus fracture

complication
mucocele
mandible reconstruction

best flap
ftt fibula +/- cutaneous
scc sinus

most common
maxillary sinus
1st pemanent teeth
1st molar
lateral radiographs skull

cranial base plane
Sella-nasion plane
lateral orbital wall

bones
zygoma & greater wing sphenoid
superior oblique muscle globe

action
depression/abduction/intorsion
pan-facial frx

risk of c-spine frx
10%
4.5 cm scc lip with extension to mandible but no invasion
exc + marginal mandible resection + neck dissection (bilateral suprahyoid)
scm muscle

artery
three equally dominant souirces
occipital
sup thyroid
thyrocerical trunk
which site is not osteotomized in monoblock advancement vs la fort I
frontozygomatic suture
porous polyethylene prosthesis

tissue response
ingrowth
baker classification
I = normal
II = minimal contracture
III = moderate, distortion is visable
IV = distorted, hard, cool, and painful
SMAS continous with
temporal fascia

platysma
poor snap test
remember lateral canthopexy and lid shortenting
advantage of augmentation when added to mastopexy
increased upper pole volume
immediate post op n.a.c. congestion

Rx
remove sutures and explore pedicle
pre tip hump deformity
cause = inadequate resection of dorsal septum

(be careful some want the answer to be tip graft to raise the tip)
chemosis
conjunctival swelling post blepharoplasty

Rx = cortisone ointment
beveled incisions in scalp
preserve follicles and permit hair growth across the scar
sudden unilateral breast enlargement in 15 y.o.
fibroadenoma
causes of promintent ear

most common

second
loss of antihelical fold

hypertrophy of conchal bowl
gynecomastia in adult with increased beta-human chorionic gonadotropin
germ cell neoplasm testicle
gynecomastia in adult without increased beta-human chorionic gonadotropin
pituitary tumor ?
retrobulbar hematoma

Rx
lateral canthotomy

poss also release septum orbitalae
brow lift - nerve most at risk with dissection medial to temporal/frontal periosteum
supraorbital
glabella pain

nerve?
nasopalatine
nasal reconstruction post moh's
remember to resect the remaining subunit

(test answer)
prosthesis placement for cosmetic facial rejuv.
submalar over the upper masseter

(test answer)
wrestler's ear (hematoma)

Rx
drain and tie through bolster
botox units for glabella
15 - 20 units
hematoma 3 days post rhytidectomy
remove it
intra nasal spreader grafts
increase nasal dorsum

(test answer)
"non-healing" abdomenal wound post bariatric surgery
nutritional supplement

(test answer)
brow lift

release of
orbital retaining ligament
age related (progressive) drooping of nasal tip loss of support of
lower lateral cartilages
epiphora in 13 month old
since birth

Rx
probe lacrimal duct
difficulty breathing in bell's palsy

muscle
nasalis
right eye closing with eating post bell's recovery

Dx
Rx
synkinesis

botox to orbicularis
ptosis upper lid with absent levator function

Rx
frontalis sling (fascia graft)
tumescent technique

% aspirate = blood
1%
cleft lip

failure fusion of ?
medial nasal process &

maxillary process
pterygomalillary fissure
maxillary artery and veins

important in la forte I ostetomy - sep'n of max. from pterigoid plates
ameloblastoma

Rx
enucleate except when involves soft tissue then segmental resection
incision for orif subcondylar fracture
retromandibular
ext. carotid artery

second artery after superior thyroid
ascending pharyngeal, lingual, occipital, facial
tumor invading nerve resulting in numbness in medial cheek
infraorbital nerve

foramen rotundum
VPI with poor lateral wall motion

Rx
sphyncter pharyngoplasty
closure of oral cavity from oropharynx

muscle?
palatoglossus
urgent repair of orb floor frx

indication
entrapped rectus muscle
risk of second child cleft
4% with normal parents

17% with one involved parent
open parasymphysis frx with subcondylar
orif parasymph + intermax fix for 2 weeks
numb tongue

nerve
lingual
metopic suture fusion
trigonocephaly
bleeding post la fort I
internal max

branch = descending palatine
midline nasal mass with no bone defect
glioma

(most common however is dermoid)
spinal acc nerve XI
jugualar foramen
bet int carotid and int jug v.
emerges post border scm muscle
enters psot triangle deep to
investing fascia
la fort I advancement > 10mm
distraction
saggital split osteotomy

incidence of numb lower lip
90%

12% in one year
palate fusion

gestational age
8 weeks
lip fusion

gestional age
4 weeks
medial canthal repair in naso-orbital-ethmoid frx
transnasal canthopexy
medial displacement condyle

muscle?
lat. pterygoid
papilla parotid duct

adjacent to ? tooth
second molar
encephalocele vs glioma
defect in cranium
tessier clefts
picture
foramen rotundum
V2
foramen ovale
V3
congenital bilateral facial palsy
mobius syndrome
harlequin deformity
coronal suture
champy's principles
mandible fractures
place miniplates along lines of tension
monocortical screws
not compression
la fort I osteotomy for long face =
widened alar base
C flap in millard repair =
columellar lengthening
infection post madibular fracture

tooth responsible
2nd or 3rd molar
locking reconstruction plate
easier to contour than non-locking
maxillary expansion
lateral nasal walls don't need osteotomy
20 y.o. normal snb angle
mandible is normal position
tmj dislocation

Rx
closed reduction with sedation
rheumatoid arthritis with open bite

rx
max impaction
nerves to block the anterior maxillary teeth
nasopalatine

anterior superior alveolar
bilateral parasymphysis fracture

muscle causing displacement
geniohyoid
tessier cleft that displaces the medial canthus
no. 3
appropriate Rx of thin, wide phyltrum in bilateral cleft lip (repaired)
abbe flap
muscle used in sphyncter pharyngoplasty
palatopharyngeus
nasa glioma - characteristics
off midline, non-pulsatile, does not transilluminate
eye muscle involved with coronal synostosis
superior oblique
(shortened orb roof)
nasal alar displacement in cleft lip
lateral, inferior, posterior
auriculotemporal nerve
area innervated
tagus, eac, temmporal skin
hemifacial microsomia

1st correction
macrostomia
foramen ovale
V3
foramen rotundum
V2
eac develops from
1st branchial groove
# of hillocks
6
3 on 1st (mandibular arch)
3 on 2nd (hyoid arch)
ear develops by the _ week gestation
8th
temporalis muscle innervation
V3 (trigeminal)
hyphema
blood in anterior chamber
max. osteotomy
max. bone defect not requiring bone graft
5 mm
most common site for mand. frx
angle
not sure review course listed body at 21%
Angle most common site of infection. old questions list angle also as most common site of fx
Rx of parotid mass (with indeterminate bx)
superficial parotidectomy
suture in scaphocephaly
saggital
decreased sna
max. retrusion
decreased snb
mand. retrusion
progressive frontal mass causing diplopia (no trauma)
fibrous displasia

most others found at birth or have trauma
careful with "appearance of mandibular prognathism"
probably want you to Rx as true mand prognathism
most com, cause of post trauma enophthalmos
increased orbital volume
structures spared in "functional neck dissection"
spinal acc nerve
scm muscle
int jug vein
intra op management of malocclusion post rigid fixation
remove plates and reposition
frx fragments
binder's syndrome
isolated nasomaxillary hypoplasia
usually with class III occl.
origin of tragus and helical root
1st branchial arch
origin antitragus, antihelix, lobule
2nd branchial arch
mechel's cartilage
1st branchial arch
(malleus, incus, mandible)
reichert's cartilage
2nd branchial arch
(stapes, syloid process, portion of hyoid)
rate of distraction in child
1mm/day

(some are doing 2mm/day in infants)
7 y.o. with avm

Rx
embolization and excision
osteoinduction
bone morphogenic protein is stimulated to induce transformation of mensenchyme cells (pericytes) into osteoprogenitor cells
pericytes
def.
perivascular mesenchyme-like cells
osterchondrosis
group of ossification disorders in children
osteoconduction
def.
the process of tissue ingrowth fron the host into recipient bed
2 cm scc lip
Rx radiation only - the % of complete tumor regression
90%
6 cm scc lip
Rx
pre op radiation the excision
la fort I osteotomy

tooth at greatest risk
canine
length tip of crown to root = 27mm
medial orbital wall

which bone
ethmoid
lingual nerve

branch of ?
mandibular branch of trigeminal (V3)
mental nerve

location below which tooth
second bicuspid
parotid (stenson's) duct

location
within the buccal space
buccal space
def.
orb. oris, masseter, zyg. maj., buccinator attach to manible
frankfort horizontal
def.
line between porion-orbitale
coronoid fracture

Rx
intermax. fixation

(brief interval)
chylous fistula post rad neck

Rx
low fat diet
closed suction
crouzon's

relation to upper ext defect
none
vertical intercisal distance
(mouth opening)
40 - 50 mm
second most common fracture in childres
mandible

most common = condylar fx

2 nd most common = nasal fx
parotid duct near what tooth
second max. molar
muscle displacing zygomatic fracture
masseter
Rx of rhynophyma
tangential excision
optic nerve passes through which bone in orbit
sphenoid
Radical Neck Dissection

indication
large tumor
failed radiation
involvement spinal acc. nerve
4.1 cm scc floor of mouth

Rx
T4

excision and radiation even with neg nodes
T3 floor of mouth with pos. nodes
post op radiation
Carpenter syndrome
autosomal recessive
advantage of plate and screw fixation of mid face fracture
maintain mid face height
supraorbital dermoid

next step Dx or RX
surgical excision
indications for removing teeth from fracture site
displace or comminuted frx containing tooth
frx tooth or root
periodontal disease
functionless tooth with no opposing tooth
velocardiofacial syndrome

concern with pharyngeal surgery for vpi
carotid artery position
ant 1/3 tongue scc, met to ?
submental nodes
most effective bone for alveolar grafting
cancellous
Albright syndrome
polyosteotic fibrous dysplasia

(they will name multiple sites of boney prominences)
blood supply to the tongue
ventral 1/3 through ipsilateral lingual artery
most common site of scc in oral cavity
tongue
witch's chin

bone involvement?
none

ptosis of chin
frontal sinus fracture

most important determining factor for urgent surgery
posterior wall fracture
unilateral cleft lip

tooth most likely to be involved
cleft side canine
craniofacial microsomia


nerve most often involved
facial (VII)
best determining factor for maxillomandibular relationship in le forte II fracture
occlusion

(even with dentures)
increased lower face height with microgenia

Rx
jumping geniopolasty
cause of enophthalmus with orbital fracture
increased orbital volume
cervical branch of facial nerve

functional deficiet
retraction and depression of lower lip
Rx of naso-orbital-ethmoid fracture
reduction - fixation of fracture fragments

(with comminuted fragments then transnasal wiring - if the fragment is large enough to reduce and fix, that is the correct answer)
post orbital rim fracture lower lid ectropion

Rx
observation early

release, graft, lid tightening
age for ear reconstruction (microtia)
7 years
inferior meatus beneath inferior concha
nasolacrimal duct
middle meatus beneath the middle concha
nasofrontal duct, maxillary sinus, and anterior ethmoid air cells
sphnoid sinus drains
superior to superior concha
retromolar trigone scc drains to
jugular digastric (level II)
sensation to lower lip
inferior aveolar (V3)
Gilles approach to zygomatic arch fracture

between which structures
deep temporalis fascia and temporal muscle
most common malignancy of parotid
mucoepidermoid
Rx of maxillary hypoplasia in cleft palate patient with normal mandible
la forte I osteotomy

advancement <10mm
distraction > 10mm
orbital floor fracture with immediate diplopia

cause
edema

also can be eom parasis

mechanical (entrapment and displacement0 are the least common causes
maxillary collapse in cleft palate

initial Rx
orthodontia (when permanent dentition permits)
frontal sinus fracture involving the nasofrontal duct

Rx
orif with removal of sinus mucosa
orif alone when duct is intact
Rx of nondisplaced zygoma fracture with no visual impairment
obxervation
success of bone grafting in cleft children

most related to
patient age

optimal if done at time of mixed dentition (usually age 8 - 10 yrs)
post traumatic scalp abcess

layer located
subgaleal
facial nerve (VII) derived from which branchial arch
second
"mild" mri changes and "mild" symptoms of TMJ

Rx
nonoperative
risk of children having cleft lip

single parent affected
4%
van der woude syndrome

risk of children
(lip pits)

50%
two muscles that may be divided to access a "high bifurcation" carotid artery
(ftt recepient artery)
posterior belly digastric nd stylohyoid
traumatic optic neuropathy post fracture

cause?
shear force on optic nerve
facial muscles receiving innervation on superficial surface
mentalis, buccinator, levator anguli oris

(there may be some dispute here)
Rx of condylar neck fractures with dislocation out of the glenoid fossa
orif of that condyle
length of la forte I advancement beyond which need diatraction
10mm
most commonly affected in craniofacial microsomia
mandible and ear
complete gestational age development

lip
palate
lip = 4 weeks

palate = 8 weeks
overbite

overjet

def;
overbite or underbite = veritcal postion

overjet or underjet = horizontal (a.p.) position
condylar neck fractures result in what bite deformity
anterior open bite
submucus cleft palate

muscle responsible for vpi
levator

(only 10% have vpi)
frankfort horizontal

def
porion to orbitale
most common site for encephaloceles
occiput
noe fracture
direction of transnasal wire
posterior-superior
hypertrophy of coronoid process

causes
slow progressive reduction in mandible opening
most common parotid tumor in infancy
hemangioma
albright syndrome affect what electrolyte
calcium and phosphorus
premature closure of lambdoidal suture = dx

rx
plagiocephaly

rx = remodelling (otherwise results in inc. intracranial pressure)
plagiocephaly secondary to deformation forces

rx
helmet or position remolding

(must operate if the plagiocephaly is caused by suture closure)
5mm horizontal deficiency of mentum

thickness of implant
6 mm
binder syndrome
nasomaxillary hypoplasia
innervation tip of nose
anterior ethmoid
prevertebral fascia invelopes which muscles
all scalene, and parvertebral muscles
superficial fascia neck invelopes which muscles
scm, trapezius, suprahyoid
pretracheal fascia invelopes which muscles
none
thyroid and trachea
is post fracture immediate diplopia without evidence of muscle intrapment an indicaiton for orbital floor surgery
no

may be muscle injury and may recover
absolute indicaiton for orbital floor surgery post fracture
size of defect
this question sugested 50% of floor others defect size of 2cm
(?both in my experience)
oral tumor greater than 2 less than 4 cm
stage = ?
T2
osteronecrosis related fracture in patient treated for osteopenia and malignancy
cause = ?
biphosphonate-related ostenecreosis

(BRON)
Rx of patients with established BRON
resect sequestra
abiotic Rx
poss segmental resection and vascularized bone transfer
frontal branch facial nerve

temporal region (location)
within superficial temporal fascia
coding for flap closure, can the resection and the flap defect be adden to the final defect size
yes
optic nerve passes through which bone
sphenoid
what deformational characteheristics are assoc. with posterion deform. plagiocephaly
anterior displace ipsilat ear
horizontal and level skull base
ipsilat. occipital flatening\parallelogram-shaped head
angel mandible fracture with displacement results in what bite deformity
contralateral posterior open bite
sudden onset of facial paralysis post uri

Dx and Rx
Bell's palsy
observation, steroids, antiviral
how long after onset of Bell's palsy is emg valuable
14 - 21 days
when repairng the medial canthal tendon, where should drill holes be placed in relation to lacrimal fossa,
posteriora and superior
ameloblastoma mandible

Rx
segmental resect with wide margins and vasc. bone graft

(this is for multicystic, some sugest curretage for unicystic lesions)
Rx for bilat. subcondylar frx in 5 year old
intermax. fix for 2 weeks
poss. indications for open Rx of condylar frx
almost always in adule
displace into mid cran fossa
unstable occlusion post imf
lateral extra capsular displac
invasion by B.B
innervaiton levator veli palatine
vagus (X)
cause of and Rx for left anterior plagiocephaly

at age 6 months
left unilateral coronal synostosis

Rx = fronto-orbital advancement
Crouzon
hemifacial microsom'
pfeiffer
saethre-chotzen
velocardiofacial
which = nasal speech
velocardiofacial syndrome
subcondylar fractures = what maloclusion
anterior open bite
with nasal bones resected what reconstruction necessary to provide nasal support
cantelever bone graft
what is the most likely cause of fullness in neck months afeter reconstruction of esophagus
salivary fistula
muscle displacing the concyle forward, post subcondylar frx
lateral pterigoid, also displaces medially
dryness eyes, mouth, xerostomia, firm parotid gland
Dx =
confirmeing test
Sjogren sync=drome
Bx. of minor saliv. glend
asymmtric weakness facial nerve with parotid mass

Dx =
malignant neoplasm
most common cause of post orbit fracture enophthalmos
increased orbital volume
epibulbar dermoid assoc with which hemifacial microsomia
Goldenhar syndrome (oculoauriculovertebral syndrome)
which cranial suture is firse to undergo closure
metopic (2yrs)

all others close much later 22 - 35 years)
last is squamosal
nasolacrimal duct drains into ?
inferior meatus
Angle classification of mid face hypoplasia
Class III
rhynophyma is related to what disorder
rosacea
4 y.o. lateral orbital mass noted at 3 mo age increasing size, mobile and distinct margins
Dx and first step in management
Dermoid

excision (no tests necessary)
what nerve exits the EAC and gives sensation to ear
Auricular branch of Vagus (X)

need to block in addition to ring block of ear
Stickler syndrome

association with cleft palate
25%
adult male with bilateral parotid masses and no facial weakness Dx
Warthins
child with progressive unilateral facial assymetry
Rhomberg's
genetic cleft lip and palate risk
norm parents w 1 child = 4 %
norm par. 2 pos chld = 9%
affected par w 0 child = 4%
affected par w 1 child = 17%
microtia and treacher collins syndrome
all
microtia and
Binder syndrome
none
microtia and Crouzon syndrome
none
rhynophyma is related to what disorder
rosacea
4 y.o. lateral orbital mass noted at 3 mo age increasing size, mobile and distinct margins
Dx and first step in management
Dermoid

excision (no tests necessary)
what nerve exits the EAC and gives sensation to ear
Auricular branch of Vagus (X)

need to block in addition to ring block of ear
Stickler syndrome

association with cleft palate
25%
adult male with bilateral parotid masses and no facial weakness Dx
Warthins
child with progressive unilateral facial assymetry
Rhomberg's
genetic cleft lip and palate risk
norm parents w 1 child = 4 %
norm par. 2 pos chld = 9%
affected par w 0 child = 4%
affected par w 1 child = 17%
microtia and treacher collins syndrome
all
microtia and
Binder syndrome
none
microtia and Crouzon syndrome
none
microtia and Pfeiffer syndrome
none
macrostomia
which Tessier cleft
crosses which anatomic loc.
Tessier 7

maxillary second molar
80% resection of lower lid

RX
lining (usually composite gft)

cheek advancement flap
cause of lower dental show post saggital split osteotomy
failure to reapproximate the mentalis muscle
innervation mylohyoid
mandiblular (V)
most imp. muscle to approximate in cl pal.
levator veli palatini
overjet def.
horizontal relationship
overbite
vertical relationship
normal SNA -SNB with acute SN-Pogonion angle
genioplasty
congential midline defect mandible and neck = failure of fusion of
2nd branch arch
location sural nerve at ankle
lateral adjacent to achilles
mental nerve
supplies lower lip medial to commisure
located level of 1st and 2nd bicuspid
Rx of resected lower lip including commisure
Estlander flap
most imp. clinical measurement when planning vertical maxillary changes
upper incisor show in repose
muscles of mastication are derived from which branchial arch
1st
painless mass floor of mouth increasing size, blue anc cystic
ranula
acute csf rhymorrhea post trauma
bedrest

7-10 days then craniotomy and dural repair/gft
combined mandibular resection with large mandible defect
free fibula
inferior alveolar nerve furthest from the outer cortex
level of 1st molar
indications for emergent surgery on orbital floor
muscle entrapment
oculocardiac reflex
nausea and vomiting
Kasabach-Merrit syndrome
platelet consumptive coagulopathy

accompanies kaposiform hemangioendothelioma
median cleft of nose
tessier cleft
failure which prominences to merge
Tessier 0 cleft

median nasal prominences
Treacher collins
oblique mandibular plane
Tessier 6,7,8
coloboma
marfan syndrome
facial deformity
high narrow palate
cross bite, needs max osteotomy and max expansion
tmj disc abnormality preventing jaw opening
anterior dislocaiton without reduction
mand frx in child probably
condylar neck
ossicles form from which arches
malleus and incus = 1st
stapes = 2nd
normal parents with cleft child
risk of second
4%
one affected parent with one effected child
17%
one affected parent with no affected children
4%
tnm class of tongue cancer 3 cm lesion
T2
tnm class of tongue cancer with 34 cm node
n2a
max sinus drains into
middle meatus
failure of closure of ? results in dermoid cysts, anterion encephalocele, and nasal glioma
fonticulus frontalis
maxillary impaction results in what change to nose
increases nasal base width
most common facial fracture in children other than mandible
nasal
medial canthal tendon reattachment - direction
posterior and superior
sequence of phases of healing in distraction
latency 1-7 days
activaton length of distraction
consolidation - twice the distraction time
highest incidence of fracture in adult mandible
angle
most common malignancy of parotid
mucoepidermoid
interorbital distance is best measured between
anterior lacrimal crest
metopic suture closure without hypertelorism, forehead deformity, and normal development Rx
observation
Tessier cleft nasal ala and medial canthus
No. 3
Cherubism
fibro-osswoud process mandible and maxilla
blue buldge on septum
Dx
RX
septal hematoma
drain
pierre robin mandible displacement and tongue diformity
micrognathia with tongue posteriorly displaced as the tongue follows the chin via attachment of genioglossus
medial canthal tendon fractures
when bone fragments large enough = plate

comminuted = trans nasal wire
initial cell in cascade of bone healing
platelet
Apert's syndrome

growth factor involved
FGF - fibroblast growth factor
muscle causing depression and protrusion of mandible
lateral pterygoid
normal mandiblar opening in adult
41 - 50 mm
nerve to superior medial ear
auriculotemporal
painless swelling maxilla
think of torus palatinus
child with progressive proptosis post orbit fracture
"growing frcture" displacement of "not healed' orbital fracture, by pulsitile brain herniation
2 mm of max incisor show is
normal
1-4mm = normal
success of radio Rx of lower lip SCC < 2m
95%