Orthognathic/Cleft/OSA

Question 1

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.

Answer 1

(B) in 5-7 days.

COMSSAT: 2019
Explanation:
Source:
Scolozzi, P., Link, II, D. & Schendel, S. (2007). Computer simulation of curvilinear mandibular distraction: Accuracy and predictability. Plastic and reconstructive surgery, 120(7), 1975-1980.

Question 2

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.

Answer 2

(B) expanding the maxilla.

COMSSAT: 2019
Explanation:
Source: Turvey, T.A., Ruiz, R.L., Costello, B.J. Surgical correction of midface deficiency in cleft lip and palate malformation. Oral and maxillofacial clinics of north America, 14 (4), 501.

Question 3

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.

Answer 3

(D) hypernasality.

COMSSAT: 2019
Explanation:
Source: Turvey, T.A., Ruiz, R.L., Costello, B.J. Surgical correction of midface deficiency in cleft lip and palate malformation. Oral and maxillofacial clinics of north America, 14 (4), 501.

Question 4

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.

Answer 4

(B) reduce the incidence of infection.

COMSSAT: 2019
Explanation:
Source: Bouloux, G.F. (2003). Complications of orthognathic surgery. Oral and maxillofacial surgery clinics of north America, (pp. 229-242).

Question 5

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.

Answer 5

(C) increases the risk of inferior alveolar nerve sensory loss.

COMSSAT: 2019
Explanation:
Source: Bouloux, G.F. (2003). Complications of orthognathic surgery. Oral and maxillofacial surgery clinics of north America, (pp. 229-242).

Question 6

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

Answer 6

(C) Maxillary superior repositioning

COMSSAT: 2019
Explanation:
Source:Bouloux, G.F. (2003). Complications of orthognathic surgery. Oral and maxillofacial surgery clinics of north America, (pp. 229-242).

Question 7

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

Answer 7

(B) Dopamine agonists

COMSSAT: 2019
Explanation:
Source: Milligan, S.A. & Chesson, A.L. (2002). Restless legs syndrome in the older adult: diagnosis and management, drugs aging, 19(10), 741-751.

Question 8

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

Answer 8

(B) Surgically assisted maxillary expansion (SAME)

COMSSAT: 2019
Explanation:
Source: 2004. Treatment of transverse (width) discrepancies in patients who require isolated mandibular surgery: the case for maxillary expansion vs. mandibular narrowing. Journal of oral and maxillofacial surgery, 62, 361-368.

Question 9

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

Answer 9

(A) muscles.

COMSSAT: 2019
Explanation:
Source:
Scolozzi, P., Link, II, D. & Schendel, S. (2007). Computer simulation of curvilinear mandibular distraction: Accuracy and predictability. Plastic and reconstructive surgery, 120(7), 1975-1980.

Question 10

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

Answer 10

(A) Hemifacial microsomia

COMSSAT: 2019
Explanation:
Source: Scolozzi, P., Link, II, D. & Schendel, S. (2007). Computer simulation of curvilinear mandibular distraction: Accuracy and predictability. Plastic and reconstructive surgery, 120(7), 1975-1980.