ABPS ABPS Craniofacial & Pediatric Plastic Surgery 2 — Questions and Answers
Question 1: What is the recommended timing for primary cleft palate repair to optimize speech development?
- Within the first 3 months of life
- Between 9 and 18 months of age (Correct answer)
- At 3–4 years of age when dental eruption begins
- After age 5 when the child can cooperate
Correct answer: Between 9 and 18 months of age
Cleft palate repair between 9 and 18 months allows velopharyngeal function to develop before the critical period for speech acquisition.
Question 2: Pierre Robin sequence is defined by which triad of findings?
- Cleft palate, hypertelorism, and low-set ears
- Micrognathia, glossoptosis, and cleft palate (Correct answer)
- Macroglossia, mandibular prognathism, and open bite
- Midface hypoplasia, exorbitism, and synostosis
Correct answer: Micrognathia, glossoptosis, and cleft palate
Pierre Robin sequence classically presents with micrognathia (small jaw), glossoptosis (tongue falling back), and a U-shaped cleft palate causing airway obstruction.
Question 3: Mandibular distraction osteogenesis for severe micrognathia in neonates activates bone regeneration in which phase?
- Latency phase immediately post-osteotomy
- Distraction phase during active lengthening (Correct answer)
- Consolidation phase after distraction is complete
- Remodeling phase years later
Correct answer: Distraction phase during active lengthening
New bone forms in the distraction gap during the active distraction phase as the corticotomy segments are slowly pulled apart.
Question 4: In cranial vault remodeling for unicoronal craniosynostosis, which deformity of the orbit must be specifically corrected?
- Inferior displacement of the lateral orbital wall
- Harlequin eye deformity with elevated ipsilateral orbital roof (Correct answer)
- Hypertelorism with widened interorbital distance
- Exorbitism from shallow orbits
Correct answer: Harlequin eye deformity with elevated ipsilateral orbital roof
Unicoronal synostosis produces the characteristic harlequin eye deformity—elevation and rotation of the ipsilateral orbital roof—that requires correction during fronto-orbital advancement.
Question 5: Which vascular anomaly classification distinguishes hemangiomas from vascular malformations?
- Mulliken and Glowacki classification (Correct answer)
- Enjolras staging system
- Cohen syndrome grading
- ISSVA classification 1996 revision
Correct answer: Mulliken and Glowacki classification
Mulliken and Glowacki's 1982 biological classification distinguishes hemangiomas (proliferating endothelial cells) from vascular malformations (structural errors with normal cell turnover).
Question 6: What is the first-line medical treatment for problematic infantile hemangiomas requiring intervention?
- Intralesional corticosteroid injection
- Oral propranolol (Correct answer)
- Pulsed dye laser
- Interferon alpha
Correct answer: Oral propranolol
Oral propranolol (beta-blocker) is the FDA-approved first-line treatment for infantile hemangiomas requiring systemic therapy, replacing corticosteroids.
ABPS ABPS Craniofacial & Pediatric Plastic Surgery 2
What is the recommended timing for primary cleft palate repair to optimize speech development?