Facial Plastic and Reconstructive Surgery Questions

November 23rd, 2022

Which statement regarding blepharoplasty is false?

A.  Skin, fat, and muscle can be removed during blepharoplasty
B.  Opening a patient’s mouth assists in determining how much skin to excise in lower blepharoplasty
C.  Blepharoplasty is not performed under local anesthesia
D.  Transconjunctival blepharoplasty does not require sutures for closing the incision

  • Quiz Answer: C

    A: While fat pads removal and skin tightening are commonly associated with blepharoplasty, muscle can also be trimmed during the procedure, since with age orbicularis oculi can become hypertrophied and result in fuller appearance of the eyelids. P.S. Excision of the muscle cannot be performed in the transconjunctival approach.

    B: Since opening of the mouth pulls the lower eyelid down, it is one of the methods, in conjunction with upward gaze, that is used during lower blepharoplasty procedures to prevent over excision of the skin and subsequent ectropion (outward turning of the lower eyelid).

    C: Blepharoplasty can be performed under general anesthesia or local anesthesia (1% lidocaine with 1:100,000 epinephrine) with IV sedation.

    D: In the transconjunctival blepharoplasty, the incision site can either be closed with sutures or left open. The latter approach does not impede wound closure while allowing for fluid drainage.

    Reference: https://www.ncbi.nlm.nih.gov/books/NBK538152/

April 15th, 2022

A 24-year-old man is brought to the ED 30 minutes after being involved in a high-speed motor vehicle collision. You suspect a Le Fort fracture after his physical exam shows facial distortion and swelling. Which bone is fractured in all types of Le Fort facial fractures?
 

A. Ethmoid bone
B. Nasal bone
C. Zygoma
D. Pterygoid plates

February 25th, 2022

An otherwise healthy 10-month-old infant is scheduled to undergo cleft palate repair. As the resident, you understand that a rare but potential complication of the procedure is eustachian tube dysfunction from injury to the tensor veli palatini muscle. This muscle is innervated by which of the following cranial nerves?

A. X
B. VII
C. IX
D. V2
E. V3

February 11th, 2022

A 38-year-old female presents to the Otolaryngology clinic with a case of idiopathic facial nerve paralysis. On a physical exam, forehead motion is weak but discernible. Uncontrollable muscle spasms are visible when the patient tries to move her facial muscles. The patient’s eyes do not close completely. What grade of facial paralysis is this patient presenting with?

A. House-Brackmann Grade II
B. House-Brackmann Grade III
C. House-Brackmann Grade IV
D. House-Brackmann Grade V
E. House-Brackmann Grade VI