No abstract

The relationship of facial nerve (FN) and its branches with the retromandibular vein (RMV) has been described in adults, whereas there is no data in the literature regarding this relationship in fetuses. The study was conducted to evaluate the anatomic relationships of these structures on 61 hemi-faces of fetuses with a mean age of 26.5 ± 4.9 weeks with no visible facial abnormalities. The FN trunk was identified at its emergence at the stylomastoid foramen. It was traced till its ramification within the parotid gland. In 46 sides, FN trunk ramified before crossing RMV and ran lateral to it, while in 8 sides FN trunk ramified on the lateral aspect of the RMV. In 3 sides, FN trunk ramified after crossing the RMV at its medial aspect. In only 1 side, FN trunk trifurcated as superior, middle, and inferior divisions and RMV lied anterior to FN trunk, lateral to superior division, medial to middle and inferior divisions. In 2 sides, FN trunk bifurcated as superior and inferior divisions. Retromandibular vein was located anterior to FN trunk, medial to superior division, lateral to inferior division in both of them. In 1 side, RMV ran medial to almost all branches, except the cervical branch of FN. Variability in the relationship of FN and RMV in fetuses as presented in this study is thought to be crucial in surgical procedures particularly in early childhood.

Objectives: The aim of this study was to determine the relationship of the buccal branches of the facial nerve with the parotid duct, the buccal fat pad and the Zuker’s point, and reveal the incidence of the neural communications of buccal branch with the zygomatic and marginal mandibular branches of the facial nerve. Methods: Fifteen formalin-fixed cadaveric heads (8 females and 7 males) with a mean age of 73.93±14.42 years were dissected bilaterally to reveal the buccal, zygomatic and marginal mandibular branches of the facial nerve, the parotid duct and the buccal fat pad. Positional relationships of these structures and the anatomical features of buccal and zygomatic branches were evaluated. Results: The mean number of buccal and zygomatic branches was 2.40±0.62 and 1.90±0.60 respectively. Buccal branches crossed the parotid duct in 67%, formed a plexus along the parotid duct in 27% and coursed superior or inferior to the parotid duct without crossing in 6% of the dissected specimens. The mean number of intersection points of buccal branches on parotid duct was 4.03±1.03. Parotid duct crossed along the superior border of buccal fat pad in 66%, deep to buccal fat pad in 27% and between the superior and inferior lobes of buccal fat pad in 7%. Buccal branches crossed superficial to buccal fat pad in 80% and some branches passed superficial and through the buccal fat pad in 20%. Conclusion: It is essential to know the positional interrelations of the buccal branches of the facial nerve with the parotid duct and buccal fat pad for clinical implications. The relation of Zuker’s point with zygomatic and buccal branches and with parotid duct should not be overlooked.

Cerebral palsy (CP) comprises a group of permanent disorders of the development of movement and posture, which causes activity limitations. [1] Children with unilateral lesions are termed hemiparetic and children with bilateral lesions are termed diparetic. Hemiparetic group compared with the diparetic group with within the same Gross Motor Function Classification System (GMFCS) level would have better gait and lower extremity function, but worse upper extremity function. Children with hemiparetic CP tend to walk at an earlier age than those with diparetic. [2,3] The hip joint plays a key role for the lower limb alignment, and deformity of this joint gives rise to function impairments in the lower limb. [4,5] Because of the muscle impairment during the growth phase, 15-20% of overall children population affected by CP have the risk of developing hip dislocation. A high correlation of hip dislocation