Head and Neck Surgery — MCQs

Q: The most common site for a thyroglossal cyst is

Subhyoid. ***Subhyoid*** - The **thyroglossal duct** normally descends from the foramen cecum at the base of the tongue to the future thyroid gland location, usually in front of the trachea [1], [2]. - The most common site for a **thyroglossal cyst** to persist due to incomplete regression of this duct is in the **subhyoid region**, just below the hyoid bone. - Accounts for approximately **65-75%** of all thyroglossal cysts. *Suprahyoid* - While thyroglossal cysts can occur anywhere along the embryological descent path of the thyroid gland, the **suprahyoid region** (above the hyoid bone) is the second most common location, accounting for about 20-25% of cases [2]. - Cysts in this region might be closer to the base of the tongue but are not the most frequent site. *Floor of mouth* - A thyroglossal cyst would be an **extremely rare finding** in the floor of the mouth, as this is significantly higher than the typical path of the thyroglossal duct [3]. - Lesions in the floor of the mouth are more commonly ranulas or dermoid cysts. *Level of cricoid* - Cysts at the **level of the cricoid cartilage** would be considered a less common presentation for a thyroglossal cyst. - This location is lower than the usual subhyoid presentation, although still along the general path of the descending thyroid gland.

Q: Which of the following rods is not used with a dental surveyor in prosthodontics?

Incisal guide pin. ***Incisal guide pin*** - An **incisal guide pin** is used with an **articulator** to maintain the vertical dimension of occlusion and guide incisal movements, not with a dental surveyor. - Its purpose is to control the separation of the casts during articulation, unrelated to identifying undercuts or path of insertion. *Analyzing rod* - The **analyzing rod** is a component of a dental surveyor used to visually determine the **undercuts** and the most favorable path of insertion/removal for a removable partial denture. - It is typically a straight, tapered rod that helps in identifying desirable and undesirable undercuts on abutment teeth and soft tissues. *Carbon marker* - The **carbon marker** (or marking rod) is used with the dental surveyor to **mark the height of contour** on the abutment teeth. - This line indicates where the retentive arm of a clasp assembly will be placed relative to the non-retentive arm and helps design the denture base. *Surveying table* - The **surveying table** is not a rod but rather the **platform on which the cast is mounted and tilted** during surveying. - It allows for precise angulation of the cast to establish the desired path of insertion and removal for the prosthesis.

Q: If posterior epistaxis cannot be controlled, which artery is ligated?

Sphenopalatine artery. ***Sphenopalatine artery*** - The **sphenopalatine artery** is the primary blood supply to the posterior nasal cavity, making its ligation highly effective for persistent **posterior epistaxis**. - It is a terminal branch of the **maxillary artery** and enters the nasal cavity through the sphenopalatine foramen. *Maxillary artery* - While the **maxillary artery** is the parent vessel of the sphenopalatine artery, ligating it further upstream can be more invasive and carry higher risks. - Ligation of the **sphenopalatine artery** directly addresses the most common source of posterior bleeding with less morbidity. *External carotid artery* - The **external carotid artery** is the main source of blood for the internal maxillary artery which gives origin to the sphenopalatine artery. - Ligation at this level is a more proximal and generalized intervention that might not be specific enough for intractable posterior epistaxis and can affect other vascular territories. *Posterior ethmoidal artery* - The **posterior ethmoidal artery** supplies a smaller, more superior portion of the posterior nasal cavity and is less frequently the primary source of severe posterior epistaxis. - Ligation of the ethmoidal arteries is typically reserved for cases where anterior or superior bleeding is refractory, not standard posterior epistaxis.

Practice by Chapter

Salivary Gland Diseases

Practice Questions

Thyroid Gland Disorders

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Parathyroid Gland Disorders

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Neck Masses Evaluation

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Oral Cavity Lesions

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Laryngeal Disorders

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Head and Neck Cancer

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Reconstructive Techniques in Head and Neck Surgery

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Surgical Management of Sleep Apnea

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Airway Management in Head and Neck Surgery

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Surgical Approaches to the Neck

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Neck Dissection Techniques

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