CCA Clinical Evaluation & Treatment Planning 3 — Questions and Answers
Question 1: A patient with a total rhinectomy defect is being evaluated for a nasal prosthesis. Which retention method is generally preferred for its superior stability and hygiene compared to adhesive retention?
- Eyeglass-supported retention
- Osseointegrated implant-retained bar and clip system (Correct answer)
- Skin adhesive tape
- Anatomical undercut engagement only
Correct answer: Osseointegrated implant-retained bar and clip system
Osseointegrated implant-retained systems provide superior stability, hygiene maintenance, and prosthesis longevity compared to adhesive-based methods.
Question 2: During treatment planning for an orbital prosthesis, the anaplastologist must assess ocular projection. Which measurement tool is most appropriate for this assessment?
- Boley gauge
- Exophthalmometer (Correct answer)
- Willis gauge
- Vernier caliper
Correct answer: Exophthalmometer
An exophthalmometer measures the degree of anterior ocular projection, providing critical data for matching the prosthetic eye position to the contralateral eye.
Question 3: A patient receiving radiation therapy to the head and neck region requires a facial prosthesis. Which timing guideline is most appropriate for initiating definitive prosthetic treatment?
- Immediately after radiation is completed
- Within 2 weeks post-radiation
- At least 6-12 months post-radiation to allow tissue stabilization (Correct answer)
- Before radiation begins only
Correct answer: At least 6-12 months post-radiation to allow tissue stabilization
Post-irradiated tissues require 6-12 months to stabilize in vascularity and volume before definitive prosthetic fabrication to ensure accurate fit.
Question 4: When performing a clinical evaluation of a residual ear defect, which assessment of the contralateral ear is most important for treatment planning?
- Auditory acuity testing
- Detailed morphological study and documentation of contralateral ear (Correct answer)
- Skin biopsy of the pinna
- Otoscopic internal canal examination
Correct answer: Detailed morphological study and documentation of contralateral ear
Detailed documentation of the contralateral ear's morphology provides the sculpting template for the prosthetic ear to achieve bilateral symmetry.
Question 5: In treatment planning for a breast prosthesis following mastectomy, which factor most directly influences the prosthesis volume prescription?
- Patient's bra band size
- Volume and dimensions of the contralateral breast (Correct answer)
- Patient's height and weight ratio
- Chest wall scar length
Correct answer: Volume and dimensions of the contralateral breast
The volume and dimensions of the contralateral breast determine the target volume and shape of the prosthetic breast to achieve symmetry.
Question 6: A patient presents with a chronic fistula adjacent to the prosthesis retention site. What is the most appropriate clinical response during the evaluation?
- Adjust the prosthesis margins to cover the fistula
- Apply topical antibiotic cream and refit the prosthesis
- Suspend prosthetic treatment and refer to the surgeon (Correct answer)
- Increase adhesive use to seal the area
Correct answer: Suspend prosthetic treatment and refer to the surgeon
A chronic fistula indicates unresolved pathology requiring surgical management before prosthetic treatment can safely continue.
Question 7: Which classification system is commonly used by anaplastologists to categorize the severity of auricular defects?
- TNM staging system
- Nagata classification of microtia (Correct answer)
- ASA physical status classification
- WHO disability classification
Correct answer: Nagata classification of microtia
The Nagata classification system categorizes microtia and auricular defect severity, guiding surgical and prosthetic treatment planning decisions.
CCA Clinical Evaluation & Treatment Planning 3
A patient with a total rhinectomy defect is being evaluated for a nasal prosthesis.
Which retention method is generally preferred for its superior stability and hygiene compared to adhesive retention?