ABPS ABPS Craniofacial & Pediatric Plastic Surgery 1 — Questions and Answers
Question 1: Which suture is prematurely fused in scaphocephaly (dolichocephaly)?
- Coronal suture
- Metopic suture
- Sagittal suture (Correct answer)
- Lambdoid suture
Correct answer: Sagittal suture
Premature fusion of the sagittal suture restricts lateral skull growth, producing a long, narrow head shape called scaphocephaly.
Question 2: Tessier's classification system organizes craniofacial clefts along which anatomical axes?
- Embryological fusion lines only
- Numbered clefts 0–14 running through soft tissue and skeleton (Correct answer)
- Vascular territories of the face
- Dermatomal distribution of the trigeminal nerve
Correct answer: Numbered clefts 0–14 running through soft tissue and skeleton
Tessier numbered craniofacial clefts 0–14, describing their paths through both soft tissue and the underlying skeletal structures.
Question 3: In unilateral cleft lip repair, the Millard rotation-advancement technique primarily achieves lip length by which mechanism?
- Z-plasty transposition of the philtral column
- Rotating the medial lip element down and advancing the lateral flap (Correct answer)
- Lengthening the columella with a V-Y plasty
- Borrowing tissue from the nasal floor
Correct answer: Rotating the medial lip element down and advancing the lateral flap
The Millard technique rotates the medial lip element inferiorly and advances the lateral flap into the gap to restore normal lip height.
Question 4: Velopharyngeal insufficiency (VPI) following cleft palate repair is best evaluated with which study?
- CT scan of the skull base
- Nasopharyngoscopy and nasometry (Correct answer)
- Lateral cephalogram only
- Electromyography of the levator veli palatini
Correct answer: Nasopharyngoscopy and nasometry
Nasopharyngoscopy visualizes velopharyngeal closure directly, while nasometry objectively measures nasal air emission during speech.
Question 5: Apert syndrome is caused by a mutation in which gene?
- TWIST1
- FGFR2 (Correct answer)
- MSX2
- RUNX2
Correct answer: FGFR2
Apert syndrome results from gain-of-function mutations in FGFR2 (fibroblast growth factor receptor 2), causing craniosynostosis and syndactyly.
Question 6: Which surgical procedure is used to address midface hypoplasia in Crouzon syndrome?
- Fronto-orbital advancement
- Le Fort III osteotomy (Correct answer)
- Mandibular distraction osteogenesis
- Malar augmentation with implants
Correct answer: Le Fort III osteotomy
Le Fort III osteotomy advances the entire midface as a unit, correcting the midface retrusion and exorbitism seen in Crouzon syndrome.
ABPS ABPS Craniofacial & Pediatric Plastic Surgery 1
Which suture is prematurely fused in scaphocephaly (dolichocephaly)?