Anatomy of the facial nerve branching patterns, the marginal mandibular branch and its extraparotid ramification in relation to the lateral palpebral line.
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Date
2010-08
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Abstract
Background: Surgery of face and parotid gland may cause injury to branches of the facial nerve, which results in
paralysis of muscles of facial expression. Knowledge of branching patterns of the facial nerve and reliable landmarks
of the surrounding structures are essential to avoid this complication.
Objective: Determine the facial nerve branching patterns, the course of the marginal mandibular branch (MMB),
and the extraparotid ramification in relation to the lateral palpebral line (LPL).
Materials and methods: One hundred cadaveric half-heads were dissected for determining the facial nerve
branching patterns according to the presence of anastomosis between branches. The course of the MMB was
followed until it entered the depressor anguli oris in 49 specimens. The vertical distance from the mandibular angle
to this branch was measured. The horizontal distance from the LPL to the otobasion superious (LPL-OBS) and the
apex of the parotid gland (LPL-AP) were measured in 52 specimens.
Results: The branching patterns of the facial nerve were categorized into six types. The least common (1%) was
type I (absent of anastomosis), while type V, the complex pattern was the most common (29%). Symmetrical
branching pattern occurred in 30% of cases. The MMB was coursing below the lower border of the mandible in
57% of cases. The mean vertical distance was 0.91±0.22 cm. The mean horizontal distances of LPL-OBS and LPLAP
were 7.24±0.6 cm and 3.95±0.96 cm, respectively. The LPL-AP length was 54.5±11.4% of LPL-OBS.
Conclusion: More complex branching pattern of the facial nerve was found in this population and symmetrical
branching pattern occurred less of ten. The MMB coursed below the lower border of the angle of mandible with
a mean vertical distance of one centimeter. The extraparotid ramification of the facial nerve was located in the area
between the apex of the parotid gland and the LPL.
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Keywords
Branching patterns, facial nerve, lateral palpebral line, marginal mandibular branch, parotid gland
Citation
Asian Biomedicine (Research Reviews and News); Vol. 4 No. 4 Aug 2010; 603-608.