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Craniofacial

plastics review

QuestionAnswer
Tessier Cleft Number 0 involves what? midline deformities of the upper lip and nose
Tessier cleft No. 3 manifests as defect of the lower eyelids medial to the punctum, displacement of the medial canthus of the eyelid and hypoplasia of the medial canthal tendon
Which facial cleft is the most common sporadic facial cleft? Tessier Cleft Number 7- macrostomia and absence of the zygomatic arch
Unilateral cleft lip results from malunion of medial nasal and maxillary nasal prominence
What percent of isolated cleft palates will be associated with other anomalies 50%
primary cleft palate results from malunion of medial palantine process and lateral palantine process
Secondary cleft palate results from malunion of lateral palantine process
levator veli pallatini muscular diastasis is also called submucosal cleft- 15% associated with VPI
Diagnostic triad for the diagnosis of submucosal cleft Zona pellucida, Bifid nasal spine, bifid uvula
Alveolar clefts are repaired by bone graft at ages 8-10years old
levator veli palatini innervation and function pharyngeal plexus, a derivative of the vagus (X) nerve, pharyngeal closure
tensor veli palatini innervation and function tense and lower the soft palate, and opens the eustachian tube, V2 of trigeminal nerve
Describe angle's classification of mandibular occlusion Class I, normal occlusion. ,Class II, retroocclusion or mandibular deficiency. C: Class III, prognathic occlusion (maxillary deficiency or mandibular access).
Overbite distance b/t maxillary and mandibular incisors in vertical plane
Overjet distance b/t maxillary and mandibular incisors in horizontal plane
Aplasia Cutis Congenita Scalp defect most commonly occurring in midline of the vertex Associated with skull defect, +/- exposure of dura
Treatment of Aplasia Cutis Congenita Spontaneous resolution frequent Treatment = silvadene dressing changes to prevent dessication and infection
Nerve at greatest risk during excision of Congenital Branchial Sinus/Fistula hypoglossal nerve CN XII
Velocardiofacial Syndrome is also called Shprintzen Syndrome
Velocardiofacial Syndrome- genetics Autosomal dominant Deletion of long arm of chromosome 22, detected with FISH test
Features of Velocardiofacial Syndrome cleft palate, Velopharyngeal insufficiency, Cardiac abnormalities in 80%, 40-50% with microcephaly, Abnormalities of internal carotid arteries
Pierre Robin Sequence- triad micrognathia, cleft palate, and retroglossoptosis
Stickler's Syndrome features Autosomal dominant, Myopia in infancy, Retinal detachment Progressive blindness, +/- cataracts, Pierre robin Sequence
Van der Woude’s Syndrome Autosomal dominant with variable penetrance,Cleft lip or palate Lip pits seen in 80% (represents accessory salivary glands) May be missing central or lateral incisors No other significant associated craniofacial anomalies
Gorlin Syndrome Autosomal dominant,Nevoid basal cell carcinoma syndrome,Multiple basal cell carcinomas appear early in adolescence, Skeletal anomalies, calcification of the falx cerebri, and nasal deformities Palmar and plantar pits
Gardner Syndrome Autosomal dominant Colon polyps Desmoid tumors Osteomas of the skull and mandible
Ollier’s Disease ascular malformations Multiple enchondromas in hands and long bones Enchondromas may undergo sarcomatous degeneration
Apert Syndrome genetics Autosomal dominant Associated with abnormality of FGFR2
Apert Syndrome features Turribrachycephaly – (coronal sutures most commonly involved) Midface hypoplasia High arched palate +/- cleft Hypertelorism Flat elongated forehead Bitemporal widening Severe complex syndactyly – involves middle three digits of hands and feet
Crouzon Syndrome genetics Autosomal dominant Associated with abnormality of FGFR2
Crouzon Syndrome features Craniosynostosis with variable involvement of Coronal, Sagittal, and Lambdoid sutures Turribrachycephaly is most common Midface hypoplasia Nystagmus Strabismus Optic nerve atrophy Conductive hearing loss Axial skeletal deformities
Pfeiffer Syndrome features Craniosynostosis – turribrachycephaly most common Mild cutaneous syndactyly of second and third digits Distinguished by presence of enlarged bulbous thumbs and halluces
Pfeiffer Syndrome Genetics Autosomal dominant Associated with FGFR1 and FGFR2 genes
7 bones of the orbit frontal bone, maxilla, zygoma, ethmoid, lacrimal, palatine, sphenoid
Most common mandible fracture in adults? Angle (35%), then parasymphysis (24%), then body (18%)
Most common mandible fracture in children? Condylar Fractures
Indications for Open Reduction of Condyle Displacement into the middle cranial fossa Impossibility of obtaining adequate dental occlusion by closed Lateral extracapsular displacement of the condyle Invasion by a foreign body (e.g.. a bullet from a gunshot wound)
Created by: sschulzdoc