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512 Cards in this Set
- Front
- Back
|
Antia-Buch flap
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ear margin reconstruction
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advantage of rectus abdomenis flap in h/n recon
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bulk for tongue recon
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mandible involvement with Ca
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radical neck dissec
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nasal reconstruction/lining
turn-over flap septal mucosal flap |
<1 cm = turn-over
>1 cm = septal mucosal flap |
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palate malignancy prognosis
|
mucoeipdermoid = good
adenoid cystic = poor |
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Van der Woodes sydrome
|
mucous pits
syndactyly |
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Down's syndrome
|
variable mental function
strbismus saddle nose microgenia no cleft |
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hypertelorism
primary secondary tertiary normal |
prim = 30-35 mm
secon = 35 - 39 mm tert = >40 mm normal = 28 mm |
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cleft palate = faliure of
|
primary palate = medial paltine processes
secondary palate = lateral palatine prosesses |
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parotid Ca
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high grade poor survival
20 - 40% with ln's = 10% |
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retrobulbar hematoma
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mannitol
carbonic anhydrase inhibitor lateral canthotomy |
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Rx of lower 1/3 nasal fracture
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spreader grafts
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canine teeth erupt
|
10 - 11 yrs
|
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maxillary blood supply post laforte I
|
ascending pharyngeal
ascending branch of facial art |
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cervico-facial lymphatic anomalies
|
80% have facial bone hypertrophy
|
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blow in fractures
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proptosis
diplopia superior fissure syndrome rupture globe |
|
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zygoma fracture - diplopia
% initial % permanent |
10% initially
1/2 are permanent present 2 wks = surgery |
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cleft lip = failure
|
medial nasal prominence
maxillary nasal proninence |
|
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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 |
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cyanoacrylate
|
glue fixation provides compressive forces = plate fixation
|
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indication for mandible distraction under age 2
|
migrogenia with tongue based airway obstruction
|
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most common nonsyndromic synsotosis
|
saggital
|
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carpenter syndrome
|
bicoronal synostosis +
saggital and lambdoid polydactyly + toe syncactyly |
|
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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 |
|
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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%
|
|
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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%
|
