Test on Bilateral Cleft Lip and Nose Repair

Question 1: Nasal tip protrusion and columellar length are considered fast-growing nasolabial features, attaining more than 75% of adult dimensions by age 5 years.

A. Ano

B. Ne

Explanation: Nasal tip protrusion and columellar length are classified as slow-growing features, achieving only approximately two-thirds of adult size by age 5 years, not more than 75%.

Question 2: According to the study materials, why is primary muscular closure of the orbicularis oris important in bilateral cleft lip repair?

A. It minimizes fourth-dimensional distortions like lateral drift of the alar bases and widening of the philtrum.

B. It prevents inhibition of premaxillary growth by joining muscle from the lateral elements across the midline.

C. It enables the child to whistle and permits normal labial function by creating a complete oral ring.

D. It eliminates lateral bulges that appear on each side of the lip when the child puckers.

Explanation: Primary muscular closure is necessary to minimize fourth-dimensional distortions, such as lateral drift of the alar bases and widening of the philtrum. Construction of a complete oral ring permits normal labial function and eliminates the lateral bulges. It also allows the child to whistle. The text notes that Manchester held the belief that joining muscle across the midline would inhibit premaxillary growth, which is contrary to the benefits of muscular closure.

Question 3: Gingivoperiosteoplasties are typically performed without any consideration for the premaxillary blood supply.

A. Ano

B. Ne

Explanation: Gingivoperiosteoplasties should be delayed in order to preserve premaxillary blood supply, indicating that their impact on blood supply is a significant consideration. Only a bilateral narrow isthmus of septal mucosa nourishes the premaxilla after the mucosal incisions and elevation necessary for alveolar gingivoperiosteoplasties.

Question 4: Can premaxillary ostectomy and set-back be considered as a first-stage procedure if the premaxilla is procumbent?

A. Ano

B. Ne

Explanation: If the premaxilla is procumbent, a first-stage premaxillary ostectomy and set-back can be considered, along with closure of the alveolar clefts and closure of the defect at the anterior edge of the hard palate.

Question 5: According to the study materials, what are the primary functions of a Logan bow during the postoperative care period after bilateral cleft lip repair?

A. To provide gentle pressure on the premaxilla.

B. To protect the labial repair and hold an iced-saline sponge over the wound.

C. To secure the nostril stents in place for 48 hours.

D. To assist in the removal of percutaneous sutures.

Explanation: The study materials state: 'A Logan bow is taped to the cheeks: (1) to protect the labial repair and (2) to hold an iced-saline sponge over the wound for 24 h postoperatively.'