Head & Neck Reconstruction (incl. Skin Cancers)

For a low-risk primary basal cell carcinoma (BCC) on the trunk or extremity, the recommended clinical excision margin is:

For a low-risk cutaneous squamous cell carcinoma (cSCC) on the cheek, an appropriate clinical margin is:

Which scenario is a classic indication for Mohs micrographic surgery?

Recommended wide local excision margin for melanoma in situ (non-lentigo maligna) is:

Sentinel lymph node biopsy (SLNB) is generally recommended for cutaneous melanoma when:

In parotidectomy for metastatic cutaneous SCC to intraparotid nodes, the facial nerve should be:

Most reliable anatomic landmark to locate the facial nerve main trunk in parotid surgery is the:

Best reconstruction for a 1.2–1.5 cm nasal tip defect with good adjacent skin laxity:

Full-thickness alar rim defect 1.2 cm with contour collapse—best option:

Large multi-subunit nasal defect (>2 cm) with cartilage loss—gold-standard external cover:

Subunit principle in nasal reconstruction states:

Scalp defect with exposed cortical bone lacking periosteum—most reliable immediate coverage:

High-risk cSCC with perineural invasion after excision—next best step:

Lentigo maligna (facial melanoma in situ) is best managed with:

Lower eyelid full-thickness defect involving 50% width—classic option:

Lower lip defect 40% width with good tissue quality—best option:

Mobile tongue lateral defect requiring thin, pliable lining—workhorse free flap:

Segmental mandibular defect 8 cm with skin paddle need—best flap:

Preferred reconstruction for mandibular osteoradionecrosis with pathologic fracture:

During submandibular gland excision, the nerve most at risk to cause lower lip droop is:

The most prognostically important primary melanoma feature is:

For Merkel cell carcinoma of the scalp with no palpable nodes, a key staging step is:

Best local flap for a small medial cheek defect adjacent to the nasolabial fold:

1.5–2 cm helical rim wedge defect—time-tested repair:

In involutional lower lid ectropion with lateral canthal tendon laxity, best procedure:

Typical interval before division of a staged paramedian forehead flap:

Common cause of postoperative lower lid ectropion after cheek reconstruction is:

Melanoma of the external ear, Breslow 0.8 mm without ulceration—SLNB?

Prevention of alar notching in nasal reconstruction relies on:

A 3×3 cm parietal scalp defect with intact periosteum—best single-stage option:

Lower lip defect ~60% in an elderly patient prioritizing competence and sensation:

Near-total lower lip loss with need for oral competence restoration—best single free-tissue option:

Cutaneous horn on the ear helix—oncologic concern and management:

Best first-line treatment for an infiltrative medial canthal BCC:

In head & neck melanoma, lymphatic drainage is unpredictable; therefore:

Preferred management of parotid pleomorphic adenoma:

Iatrogenic injury to the spinal accessory nerve during level V dissection typically causes:

For oral cavity SCC, a “clear” final histologic margin is commonly defined as:

A core rule in eyelid reconstruction is:

Lower eyelid full-thickness defect ~35–40% width with good lateral canthal laxity—best option:

For central lower lip defect ~30% width with intact commissures, preferred reconstruction:

Commissure-involving lower lip defect of 40% width—best option:

Early step to reduce Frey syndrome after parotidectomy:

For severe lagophthalmos from facial palsy with corneal exposure, most reliable immediate solution:

First-line static suspension for midface droop in long-standing facial paralysis:

Dynamic smile reanimation in a healthy adult with chronic palsy (>18 months) commonly uses:

Nasal valve collapse with internal valve narrowing after hump reduction—best structural graft:

External nasal valve weakness with alar collapse on inspiration—first-line structural support:

Preferred lining for full-thickness distal nasal defect with missing internal lining:

Septal cartilage harvest should preserve:

Best option for a 3×4 cm cheek defect with lower lid traction risk in an elderly patient:

For a 2 cm temple lesion after Mohs down to temporalis fascia, optimal coverage:

2.5 cm lateral canthus/upper cheek defect causing ectropion risk—key preventive step:

Scalp 5 cm parietal defect with exposed bone after periosteum loss—best reconstruction:

Segmental maxillary (palatal) defect in dentate patient—first reconstructive consideration:

Large mandibular body defect requiring height and contour with soft tissue—best osseous flap:

Complex 3D maxillary zygomatic buttress/orbital floor defect—versatile bony flap:

Mobile tongue hemiglossectomy defect requiring bulk for swallowing—workhorse soft-tissue flap:

Osteoradionecrosis (ORN) of the mandible risk is increased by:

Intraoral defect 2×3 cm of the buccal mucosa near the commissure—local option:

Parotid mass suspected pleomorphic adenoma—best preoperative evaluation:

Melanoma sentinel node positivity—appropriate next step after wide excision:

Auricular reconstruction timing for microtia with autologous costal cartilage generally:

Preferred graft for small helical rim contour support during local ear repairs:

Skin cancer high-risk site where Mohs is typically favored even for small lesions:

For lower lid posterior lamella reconstruction, the best graft is:

When thinning a paramedian forehead flap for nasal reconstruction, a safe timing is:

Merkel cell carcinoma management for negative margins and positive SLN:

A 1.8 cm lower lip SCC with depth of invasion >4 mm and perineural invasion—adjuvant plan after clear margins:

“Trapdoor” deformity after nasal flap reconstruction is primarily due to:

Postauricular (retroauricular) transposition flap is most useful for:

For forehead defects down to frontalis with exposed tendon but good vascularity, appropriate cover:

The “subunit principle” favors replacing the entire nasal tip when:

After tongue free flap, best early measure to reduce fistula and aspiration:

Facial artery identification during submandibular triangle dissection—structure crossing it near the inferior border of mandible:

First-line treatment of actinic cheilitis with focal dysplasia on the lower lip:

In a lateral oral tongue SCC (cT1–T2) with depth of invasion 5 mm and cN0 neck, optimal neck management is:

During parotidectomy a clean transection of the facial nerve main trunk leaves a 2 cm gap. Best repair?

Which statement about intraoperative facial nerve monitoring is TRUE?

A 2.2 cm full-thickness alar defect with lining loss after tumor resection—best reconstructive plan:

cSCC of the lower lip, 2.5 cm with DOI 6 mm, cN0. Recommended nodal approach?

Medial canthal BCC encroaching the lower canaliculus—best oncologic/reconstructive strategy:

Lower eyelid full-thickness defect ~80% width—preferred reconstruction:

Central lower lip loss ~80% (commissures intact). Best option:

Small helical rim avulsion ~1.2 cm with exposed cartilage—best treatment:

Through-and-through conchal bowl defect after Mohs—workhorse flap:

Best hair-bearing option for a 3 cm partial eyebrow defect:

1.8 cm nasal sidewall skin-only defect with good cheek laxity—best local flap:

Moderate floor-of-mouth mucosal defect needing thin, vascular lining with oral reach:

The vascular pedicle of the scapular tip osteocutaneous flap arises from the:

Periauricular BCC with superficial parotid involvement—recommended oncologic surgery:

Symptomatic 1 cm anterior septal perforation—best repair strategy:

Small medial canthal skin defect after Mohs—ideal local flap:

Primary sensory nerve to the lower lip is the:

Immediate management for suspected marginal mandibular branch neuropraxia after neck lift:

Metastatic cSCC to intraparotid nodes with clinically negative neck—regional treatment:

Best imaging to assess suspected perineural spread in head & neck cSCC:

Management of acute auricular hematoma to prevent “cauliflower ear”:

Standard lining of an exenterated orbit when no complex reconstruction is needed:

Lateral mandibular continuity defect 4 cm in a non-irradiated patient with minimal soft-tissue loss—reasonable option:

The donor nerve used for “masseteric nerve transfer” in facial reanimation is a branch of:

Elective neck dissection levels for lateral oral tongue cancers typically include:

Which risk factor is most strongly associated with Warthin tumor of the parotid?

Best primary treatment for microcystic adnexal carcinoma on the central face:

Suspected nasal septal hematoma after trauma—best immediate step:

Typical timing to divide a staged nasolabial interpolation flap pedicle is: