3plastic Surgery - Recon Flashcards
Det wc corrective surgery is to be used
CeohaloMETRIC analysis
Techniques in mgt of mandible fractures
Intermaxillary fixation
Open reduction internal fixation (orif)
Risk in mandible osteotomy
Alveolar nerve transection
Indic for sagittal splitting osteotomy
Prognathia and retrognathia
What is rigid fixation?
Place 2 bands in upper and lower fracture border
Numbness in mandible
Infraalveolar nerve injury
What class? Anterior positioning of upper to lower mandibular teeth?
Class ii
Give signs of orbital fract?
Enopthalmos Diplopia Eoms limited Inferior movt of globe Max sinus opacity
Most common orbital frac
Blow out involving medial and inf orbit
Dx for blow out fracture
Positive forced duction test
Conpression of 3,4,6nerves
Sof syndrome (sup orbital fissure)
If w blindess, orbital apex syndrome
Zygoma complex fractures?
Zygomatic arch Zygo frontal Inferior orbit rim Floor of orbit Zygomaxillary
Pterygomaxillary fissure, nasofrontal jcn, inferior orbital rim
Le fort 2
Zygoma fractures almost always accmpd by?
Numbness
Subconjunctival hematoma
What incision for orbital floor and infraorb rim fracture?
Subtarsal/ transconjunctival incision
Early tx for nasal fracture
Close reduction
What if present nasal septum hematoma
Incise drain and pack
Poor option for tip and ala recons
Skin grafting
Areas of missing cartilage nasal recon
Paramedian forehead flap
Advancement of lip mucosa used for correctn of vermillon only defect
Lip shave
Denervated lip technique
Crosslip flap
Central upper lip defect
Abbe flap
Lateral upper / lower lip defect
Estlander flap
Uses cheek tissue flaps to lip
Webster bernard technique
Used for central lower lip defect
Karapandzic tech
Most commonly used for lip microvascilar free tissue transfer
Radial forearm free flap
Defects of 1/3 of lid margin?
Primary closure
Defect gr 50% of lid
Temporal skin flap, cross lid flap
If defect 25-50% of lid
Lateral canthtotomy
Cantholysis
Causes of acquired ptosis
Neurogenic, myogenic
Trauma
Treatment od severe ptosis
Frontalis sling
Tx for moderate ptosis?
Levator is ok hence levator aponeurosis shortning proced
Vessels that supply scalp
Occipital
Post auricular
Superf temporal
T or f? Sclap is relatively elastic
F, inelastic, hence needs galeal scoring
Grafts for calvarial repair?
Rib
Calvarial din??
Flaps used in head and neck?
Detopectoral
Lats dorsi
Trapezius
Less than 25% glossectomy what repair? What if total glossectomy?
Skin graft or
Primary closure
No ideal method!!!
Dominant form of facial paralysis
Bells palsy
Gen rule for palsy?
Facial n injury w muscle atrophy that persists for more than 18montns will not regain fcn
Tx for
Nerve graft (sural nerve)
Prima closure
Nerve transfer
Diagnostic modality of choice
High res CT
Complication if rom is not resumed in mandibular fixation
Ankylosis
Lateral and inferior orbital rim fractures assoc with what kind of fracture?
Zygomaticomaxillary complex
Incision for zygomaticomaxillary buttress
Gingivobuccal sulcus
Key to successful repair of NOE fracture
Reestablish nasomax buttress
Medial canthal ligament fixation
Tx for frontal sinus fracture
Anterior orif
Keypoint in aproach to panfacial fractures
Arch and frontal bar reduced repaired
Width and frame maging okay
In nose reconstruction what in more than 50% of a subunit is damaged?
excise remainder
What subunit uses composite grafts?
Tip and alar rim
For chin afvancement
Horizontal psteotomy
Changing the size of mandibular symphysis
Osseus genioplasty
Nasal flap that requires 2 stages
Paramedian
Middle part of eyelid
Tarsus and meibomian
Contraindication in flap for breasts
Pedicled tram
Critical variable in implantation
Inframammary fold
Grade 2 ptosis
1-3 inframammary
Chest wall defects d/t
Tumor
Radiation necro
Trauma
Lower extremity wound requiring free tissue transfer
Distal 1/3
3 primary lymphedema in stages?
Milroys
Praecox
Tardum
Lymph drainage to muscle tissue
Kondoleon
Lymphaticovenous anastomoss
Sistrunk