ABOHNS Plastic Surgery Within the Head and Neck flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Polly beak deformity

Supratip fullness after rhinoplasty caused by inadequate dorsal reduction or over-resection of the caudal septum, producing a convex profile at the supratip break.

Spreader grafts

Cartilage grafts placed between the upper lateral cartilages and septum to widen the middle vault, prevent valve collapse, and restore dorsal aesthetic lines in rhinoplasty.

SMAS

Superficial musculoaponeurotic system, a fibromuscular layer continuous with the platysma; elevation during facelift provides durable lifting while protecting facial nerve branches.

Frontal branch landmark

The frontal branch of the facial nerve runs along a line from the tragus to a point 1.5 cm above the lateral brow, within the superficial temporal fascia.

Radial forearm flap

A fasciocutaneous free flap based on the radial artery, thin and pliable, useful for oral cavity and pharyngeal defects; requires Allen test before harvest.

Fibula free flap

An osteocutaneous free flap based on the peroneal artery, providing up to 25 cm of bone for mandibular reconstruction; requires assessment of peroneal artery dominance.

Pectoralis major flap

A pedicled myocutaneous flap based on the thoracoacromial artery, used for large head and neck defects; reliable but bulky and limits shoulder mobility.

Free flap monitoring

Hourly assessment of color, temperature, capillary refill, and Doppler signal for the first 24 hours; arterial failure is pale and cool, venous failure is congested.

Rule of 10s

Criteria for cleft lip repair: weight greater than 10 pounds, hemoglobin greater than 10 g/dL, and age greater than 10 weeks, ensuring safe anesthesia.

Furlow Z-plasty

A double-opposing Z-plasty technique for cleft palate repair that lengthens the palate and reorients the levator veli palatini muscle for improved speech.

Velopharyngeal insufficiency

Inadequate closure of the velopharyngeal port causing hypernasal speech and nasal emission; treated with pharyngeal flap or sphincter pharyngoplasty.

Scaphocephaly

Premature fusion of the sagittal suture producing a long, narrow skull; the most common form of craniosynostosis, often treated with cranial vault remodeling.

Pierre Robin sequence

A triad of micrognathia, glossoptosis, and cleft palate causing airway obstruction; management ranges from prone positioning to mandibular distraction.

Breslow thickness margins

Melanoma excision margins: 0.5 cm for in situ, 1 cm for tumors up to 1 mm, 1-2 cm for 1-2 mm, and 2 cm for tumors greater than 2 mm.

Morpheaform basal cell carcinoma

An aggressive subtype of basal cell carcinoma with ill-defined borders and sclerotic stroma, requiring wide margins or Mohs surgery due to high recurrence.

Sentinel lymph node biopsy

A staging procedure for melanoma indicated when Breslow thickness exceeds 1 mm, or exceeds 0.75 mm with ulceration or mitoses.

Keloid

A scar that extends beyond the original wound margins and recurs after excision; more common in darker skin and in certain anatomic sites.

Nasolabial angle

The angle between the columella and upper lip, normally 90-95 degrees in men and 95-110 degrees in women; guides tip rotation in rhinoplasty.

Facial thirds

Vertical facial proportions divided into equal thirds from trichion to glabella, glabella to subnasale, and subnasale to menton, used in aesthetic planning.

Deep plane facelift

A rhytidectomy technique elevating the SMAS with the skin in a single composite flap, providing durable correction of midface and jawline aging.

Le Fort II fracture

A pyramidal midface fracture extending through the nasal bones, medial orbital walls, and zygomaticomaxillary buttresses, separating the maxilla from the skull base.

Orbital blowout fracture

Fracture of the orbital floor with herniation of orbital contents; inferior rectus entrapment causes diplopia and restricted upgaze, requiring urgent repair.

House-Brackmann scale

A six-grade clinical scale of facial nerve function, from grade I (normal) to grade VI (total paralysis), used to document facial nerve outcomes.

Neck dissection levels

Surgical anatomic levels I through VI: submental/submandibular, upper jugular, mid jugular, lower jugular, posterior triangle, and anterior compartment.

Adenoid cystic carcinoma

A salivary malignancy characterized by perineural invasion, indolent growth, and late pulmonary metastasis, requiring long-term follow-up.

Elective neck dissection

A neck dissection performed for a clinically node-negative neck when occult metastasis risk exceeds 15-20%, as in oral cavity squamous cell carcinoma with depth invasion.

Paramedian forehead flap

An interpolated axial flap based on the supratrochlear artery, used for large nasal defects and typically divided in a second stage after 2-3 weeks.

Bilobed flap

A double transposition flap with two lobes sharing a pivot point, used for nasal tip defects of 1-2 cm to distribute tension and reduce standing cone deformity.

Nasoseptal flap

A vascularized pedicled flap based on the posterior septal artery, used for endoscopic endonasal reconstruction of skull base dural defects.

Cranialization

Obliteration of the frontal sinus by removing the posterior table and mucosa, allowing the frontal lobe to expand into the sinus space after severe fractures.

Caprini risk assessment

A validated venous thromboembolism risk model used to guide prophylaxis; head and neck surgery patients are typically moderate to high risk.

Rhytidectomy hematoma

The most common early complication of facelift, presenting with swelling and pain; urgent evacuation is required to prevent skin necrosis and flap loss.