In obstetrical brachial plexus palsy (OBPP):
The Oberlin’s transfer can be a useful procedure. Narakas has classified obstetric brachial palsy into the following four groups:
Classical Erb’s palsy involves only C5/C6 (c.50%) but it is also common to have C5/C6/C7 involvement. A recent study has shown that 91% of palsies fall into these categories. In group 1, approximately 90% proceed to full recovery, with some evidence of recovery by 3 months. Biceps and brachialis are innervated by C5/C6 and so elbow flexion is absent. Branches of the posterior cord are affected, particularly the branches of the axillary nerve (C5/C6). The Oberlin’s transfer involves moving a fascicle from the ulnar nerve to the motor branch to biceps and can be useful in C5/C6 avulsion.
A simple ‘ridge’ of mucosa created on the back of the pharynx of cleft patients to try and reduce nasal escape is sometimes called after a surgeon. Who was he?
Passavant. Gustav Passavant (1813-1893) attempted to reduce nasal escape by making a ridge of mucosa from a quadrilateral flap on the back wall of the palate in 1878 but its effects were short lived. Passavant’s ridge can be a naturally occurring phenomenon due to constriction of the levator veli palatini and superior constrictors.
Classifications, scoring systems and syndromes that are relevant to cleft lip and palate and its management include all except:
Kubitza’s scale. This is incorrect. GOSPAS is the Great Ormond Street Hospital Speech Assessment tool. Kernahan and Stark described the striped Y classification for cleft lip and palate assessment. Catch-22 syndrome is synonymous with Di George syndrome, velocardofacial syndrome and Shprintzen’s syndrome and is due to a deletion at the 22q11.2 chromosome locus. The LAHSHAL classification of clefts was described by Kriens.
Which is true regarding pilomatrixoma (calcifying epithelioma of Malherbe)?
They are fixed to overlying skin. These common benign tumours are mainly seen in children and are benign. They are common on the face and are usually less than 1cm in size. There is calcification and substantial keratinisation on histology.
‘Straight-line’ techniques for the repair of cleft lip include those described by:
None of the above.
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