MFDS Oral Surgery 2

Question 1

A patient presents with a swelling in the floor of the mouth that is fluctuant, translucent blue, and recurrent. It collapses on aspiration and refills. What is the most likely diagnosis?

Accepted Answer

Ranula

Answer

Dermoid cyst

Answer

Sublingual gland tumour

Answer

Ludwig's angina

Question 2

What are the boundaries of the 'anatomical snuffbox' and which artery is at risk during surgical procedures in this region?

Accepted Answer

Bounded by the tendons of abductor pollicis longus/extensor pollicis brevis and extensor pollicis longus; the radial artery passes through its floor

Answer

Bounded by the masseter and medial pterygoid; the facial artery is at risk

Answer

Bounded by the sternomastoid and trapezius; the external jugular vein is at risk

Answer

Bounded by the buccinator and orbicularis oris; the buccal artery is at risk

Question 3

Which nerve is most commonly damaged during a sagittal split osteotomy of the mandible, and what are the typical symptoms?

Accepted Answer

The inferior alveolar nerve, causing altered sensation (numbness or paraesthesia) of the lower lip, chin, and teeth on the affected side

Answer

The facial nerve, causing motor paralysis of the lower lip

Answer

The lingual nerve, causing loss of taste on the anterior two-thirds of the tongue

Answer

The hypoglossal nerve, causing deviation of the tongue

Question 4

A 45-year-old patient on long-term bisphosphonate therapy for osteoporosis requires extraction of a non-restorable lower molar. What is the primary concern and how should it be managed?

Accepted Answer

Risk of medication-related osteonecrosis of the jaw (MRONJ) — assess risk factors, consider antibiotic prophylaxis, perform atraumatic extraction, and achieve primary closure

Answer

Risk of excessive bleeding — obtain a coagulation screen first

Answer

Risk of anaphylaxis to the bisphosphonate — have adrenaline available

Answer

No additional concerns — proceed with routine extraction

Question 5

What is the most appropriate management for a displaced and mobile zygomatic arch fracture causing trismus?

Accepted Answer

Closed reduction using a Gillies temporal approach with elevation of the depressed fragment

Answer

Conservative management with soft diet only

Answer

Open reduction and internal fixation with titanium plates

Answer

Intermaxillary fixation for six weeks

Question 6

Which type of incision is most commonly used for surgical removal of an impacted lower third molar, and what structures must be carefully protected?

Accepted Answer

A triangular or envelope mucoperiosteal flap with a relieving incision distal to the second molar, protecting the lingual nerve and inferior alveolar nerve

Answer

A midline mandibular incision, protecting the mental nerve

Answer

A submandibular (Risdon) incision, protecting the marginal mandibular branch of the facial nerve

Answer

A vestibular incision only, with no nerve structures at risk

A patient presents with a swelling in the floor of the mouth that is fluctuant, translucent blue, and recurrent.It collapses on aspiration and refills.What is the most likely diagnosis?

A patient presents with a swelling in the floor of the mouth that is fluctuant, translucent blue, and recurrent.
It collapses on aspiration and refills.
What is the most likely diagnosis?