Reconstruction

Question 1

The morbidity associated with the lateral approach to the anterior ilium is due to reflection of which muscle?
(A) Iliacus
(B) Gluteus medius 
(C) Sartorius
(D) Tensor fascia lata

Answer 1

(D) Tensor fascia lata

COMSSAT: 2019
Explanation:
Source:

Question 2

Which of the following is the most important determinant in survival of a local random pattern skin flap of the face?
(A) Width of the flap base
(B) Length of the flap
(C) Perfusion pressure of nutrient vessels to the flap
(D) Amount of reactive oxygen intermediates

Answer 2

(C) Perfusion pressure of nutrient vessels to the flap

COMSSAT: 2019
Explanation:
Source:
Baker, S.R. & Swanson, N.A. (1995). Local flaps in facial reconstruction, (pp. 15-30). Mosby.

Question 3

The Abbé-Estlander flap is supplied by which of the following arteries?
(A) Labial
(B) Transverse facial 
(C) Angular
(D) Infraorbital

Answer 3

(A) Labial

COMSSAT: 2019
Explanation:
Source:
Baker, S.R. & Swanson, N.A. (1995). Local flaps in facial reconstruction, (pp. 15-30). Mosby.

Question 4

The best reconstruction for a patient with an oral cancer that requires a hemimandibulectomy and wide resection of soft tissue with planned post-operative radiation therapy is a:
(A) reconstruction plate.
(B) reconstruction plate with secondary reconstruction with nonvascularized bone graft.
(C) microvascular fibular flap with a soft tissue skin paddle.
(D) reconstruction plate with a pectoralis major flap.

Answer 4

(C) microvascular fibular flap with a soft tissue skin paddle.

COMSSAT: 2019
Explanation:
Source:
Peacock, Z.S., Pogrel, M.A. & Schmidt, B.L. (2008). Exploring the reasons for delay in treatment of oral cancer. Journal of American dental association, 139(10), (pp. 1346-52).

Question 5

In deciding when to place a nonvascularized bone graft to reconstruct the mandible, which of the following is correct?
(A) Size of the defect is not a factor in success
(B) Planned radiation therapy after grafting will not affect the outcome
(C) Defects >9 cm have a high rate of failure
(D) Defects <5 cm never need grafting

Answer 5

(C) Defects >9 cm have a high rate of failure

COMSSAT: 2019
Explanation:
Source:
Peacock, Z.S., Pogrel, M.A. & Schmidt, B.L. (2008). Exploring the reasons for delay in treatment of oral cancer. Journal of American dental association, 139(10), (pp. 1346-52).

Question 6

When placing implants into a fibular flap with soft tissue paddle, the surgeon should consider:
(A) thinning the soft tissue paddle.
(B) reducing the excessive bone height of the fibular.
(C) placing fat grafts to bulk up the soft tissues.
(D) electively tying the vascular pedicle.

Answer 6

(A) thinning the soft tissue paddle.

COMSSAT: 2019
Explanation:
Source:
Peacock, Z.S., Pogrel, M.A. & Schmidt, B.L. (2008). Exploring the reasons for delay in treatment of oral cancer. Journal of American dental association, 139(10), (pp. 1346-52).

Question 7

Which one of the following statements is correct regarding the diagnosis, evaluation and autogenous grafting of maxillary defects for rehabilitation with dental implants?
(A) Harvesting of the autogenous graft should be performed before the exposure of the recipient site
(B) Intraoral ramus grafts are associated with more resorption when compared with iliac crest grafts
(C) The decision to perform bone grafting should be driven by the requirements of the prosthesis
(D) Bone quality is the main determinant factor when selecting extraoral vs intraoral donor sites

Answer 7

(C) The decision to perform bone grafting should be driven by the requirements of the prosthesis

COMSSAT: 2019
Explanation:
Source:

Question 8

In reconstructing a mandibular defect using rh-BMP, one must depend on the chemical process of:
(A) osteocompetence. 
(B) osteoconduction. 
(C) osteogenesis.
(D) osteoinduction.

Answer 8

(D) osteoinduction.

COMSSAT: 2019
Explanation:
Source:
Marx, R. E. & Triplett, R. G. (2006). Clinical applications of recombinant bone morphogenetic protein-2 (rhBMP-2). Journal of oral and maxillofacial surgery, 64(9), (pp. 98-99).
Herford, A. S. (2005). Recombinant human bone morphogenetic protein-2 (Rh BMP-2). Journal of oral and maxillofacial surgery, 63(8), (pp. 14-15).

Question 9

A superiorly based platysma flap receives its dominant blood supply from which of the following vessels?
(A) Occipital artery
(B) Submental branch of the facial artery
(C) Transverse cervical artery
(D) Superior thyroid artery

Answer 9

(B) Submental branch of the facial artery

COMSSAT: 2019
Explanation:
Source:
Baur, D.A. (2003). The platysma myocutaneous flap. Oral and maxillofacial surgery clinics of north America, (pp. 559-564).

Question 10

A 3 cm defect is left after removing a lesion of the lower lip. This type of defect is best managed by using a/an:
(A) direct primary three layer closure. 
(B) Abbe-Estlander flap.
(C) anteriorly-based tongue flap.
(D) radial forearm free flap.

Answer 10

(B) Abbe-Estlander flap.

COMSSAT: 2019
Explanation:
Source:
Roldan, J.C., Teschke, M., Fritzer, E., Dunsche, A., Harle, F., Wilfang, J. & Terheyden, H. (2007). Reconstruction of the lower lip rationale to preserve the aesthetic units of the face. Journal of plastic
reconstructive surgery, 120(5), (pp. 1231-1239).
Calhoun, K. H. (1992). Reconstruction of small and medium-sized defects of the lower lop. American journal of orolaryngol, 13(1), (pp. 16-22).