PPT - UCLA Head and Neck Surgery

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FPRS Inservice Review
2-15-12
Facial Analysis
• The Frankfort horizontal plane connects the:
A.
B.
C.
D.
Nasion and pogonion
Nasion and porion
Porion and orbitale
Stomion and rhinion
Facial Analysis
• The Frankfort horizontal plane connects the:
A.
B.
C.
D.
Nasion and pogonion
Nasion and porion
Porion and orbitale
Stomion and rhinion
Facelift
• Most commonly injured nerve:
A.
B.
C.
D.
Marginal mandibular branch
Frontal branch
Buccal branch
Great auricular nerve
Facelift
• Most commonly injured nerve:
A.
B.
C.
D.
Marginal mandibular branch
Frontal branch
Buccal branch
Great auricular nerve
Facelift
• Most commonly injured MOTOR nerve:
A.
B.
C.
D.
Marginal mandibular branch
Frontal branch
Buccal branch
Great auricular nerve
Facelift
• Most commonly injured MOTOR nerve:
A.
B.
C.
D.
Marginal mandibular branch
Frontal branch
Buccal branch
Great auricular nerve
Forehead Rhytids
• Horizontal rhytids in the glabella are cause by
contraction of which muscles?
A. Procerus
B. Corrugator supercilii
Forehead Rhytids
• Horizontal rhytids in the glabella are cause by
contraction of which muscles?
A. Procerus
B. Corrugator supercilii
Forehead Anatomy
Elevator muscle
• Frontalis
Depressor muscles:
• Procerus
• Corrugator supercilii
• Orbital portion of the
orbicularis oculi)
Unilateral Cleft Lip Nose
• Tip and columella deviate toward:
A. Cleft side
B. Non-cleft side
Unilateral Cleft Lip Nose
• Tip and columella deviate towards:
A. Cleft side
B. Non-cleft side
Unilateral Cleft Lip Nose
• Caudal septum deviates toward:
A. Cleft side
B. Non-cleft side
Unilateral Cleft Lip Nose
• Caudal septum deviates toward:
A. Cleft side
B. Non-cleft side
Unilateral Cleft Lip Nose
• Cartilaginous and bony septum deviates
toward:
A. Cleft side
B. Non-cleft side
Unilateral Cleft Lip Nose
• Cartilaginous and bony septum deviates
toward:
A. Cleft side
B. Non-cleft side
Unilateral Cleft Lip Nose
• Cleft side alar base is positioned:
A. Posteriorly, laterally and inferiorly
B. Medially and inferiorly
C. Posteriorly and medially
Unilateral Cleft Lip Nose
• Cleft side alar base is positioned:
A. Posteriorly, laterally and inferiorly
B. Medially and inferiorly
C. Posteriorly and medially
Unilateral Cleft Lip Nose
• The lower lateral cartilage on the cleft side has
an elongated:
A. Lateral crus
B. Medial crus
Unilateral Cleft Lip Nose
• The lower lateral cartilage on the cleft side has
an elongated:
A. Lateral crus
B. Medial crus
Rhinoplasty
• What incisions comprise an open rhinoplasty
incision?
A.
B.
C.
D.
Mid-columellar and rim
Mid-columellar and marginal
Mid-columellar and intracartilaginous
Mid-columellar and intercartilaginous
Rhinoplasty
• What incisions comprise an open rhinoplasty
incision?
A.
B.
C.
D.
Mid-columellar and rim
Mid-columellar and marginal
Mid-columellar and intracartilaginous
Mid-columellar and intercartilaginous
Open Rhinoplasty Incisions
Closed Rhinoplasty Incisions
Rhinoplasty Maneuvers
•
•
•
•
•
Cephalic trim / cephalic turn-in
Spreader grafts / auto-spreader grafts
Lateral crural steal / Lateral crural overlay
Tongue-in-groove
Domal sutures
Cephalic Trim (Turn-in)
(Auto) Spreader Grafts
Lateral Crural Steal
– Increases tip rotation and projection
Lateral Crural Overlay
– Increases tip rotation, decreases tip projection
Tongue-in-groove
- Introduced to treat
hanging columella
- Stabilizes tip,
prevents ptosis
- Can be used to set
tip projection
Intra/Interdomal Sutures
Dynamic Tip Ptosis
• What causes tip ptosis with smiling?
Tip Ptosis
• Depressor septi
muscle can
accentuate drooping
nasal tip and shorten
upper lip on animation
• Dissection and
transposition of muscle
during rhinoplasty can
improve tip-upper lip
relationship
What is wrong with this nose?
A. Radix too high
B. Over-rotated
C. Tension nose
deformity
D. Rhinion too low
What is wrong with this nose?
A. Radix too high
B. Over-rotated
C. Tension nose
deformity
D. Rhinion too low
Tension Nose
• Overdeveloped
quadrangular cartilage
• Tents tip away from nose
• Tethers upper lip
• Abnormal exposure of
maxillary gingiva
• Narrowed nostrils
• Increased columellar
show
Nasal Tip Defect
• 7mm defect on nasal tip. Repair with?
A.
B.
C.
D.
Bilobed flap
Primary closure
Secondary intention
STSG
Nasal Tip Defect
• 7mm defect on nasal tip. Repair with?
A.
B.
C.
D.
Bilobed flap
Primary closure
Secondary intention
STSG
Hair Transplantation
• Most common complication of follicular
unit hair transplantation?
A.
B.
C.
D.
Erythema
Cellulitis
Hair loss
Scarring
Hair Transplantation
• Most common complication of follicular
unit hair transplantation?
A.
B.
C.
D.
Erythema
Cellulitis
Hair loss
Scarring
Hair Transplantation
Hair Transplantation
Hair Transplantation
• Follicular units (as opposed to “hair plugs”)
• Telogen effluvium
• Trichophytic closure
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