Background Parotidectomy is one of the most frequent modes to treate tumors of parotid gland. Previous studies documented a variation in the facial nerve branching which might risk facial nerve injury during Parotidectomy. Aim of study To make a new classification system that includes a new branching pattern of facial nerve trunk that has not been described before, also to mention a simple method of how to identify the facial nerve trunk, all that will help the new surgeon in performing parotidectomy with less complications and unpredictable outcome. Methods A prospective cross sectional study on 460 patients underwent partial or total parotidectomy for different pathologies were enrolled during the period January 2004 till September 2020. Three investigations were considered; the anatomy of the facial nerve trunk (FNT), exact site of facial nerve trunk in relation to fixed landmarks, finally we observed any communications between the branches. We made a new classification based mainly on the anatomical variations in the branching pattern of the FNT; namely, types (I, II and III). Each type subdivided according to the length of facial nerve trunk and also according to the communication between the branches. Results Type I reported in majority of cases; 78.26%. type II (15.2%) which is the newly discovered branching pattern, and type III (6.6%). Total FNT length was 1–10 mm in more than half (54.35%) of cases. In 64.35% of cases FNT was in the midpoint between the tragal pointer (TP) and tip of mastoid's process (TMP). In 50 (10.87%) of the cases there was anastomotic connection between the buccal and mandibular branches, and in 20(4.34%) the communication was always a loop between the upper and lower divisions of FNT. Conclusion There is a profound variation in the facial nerve branching pattern that has not been previously reported. Awareness about differences in the anatomy of the facial nerve assisted useful information to surgeon to preserve FN during parotidectomies.

Background: The evolving increase in incidence of end stage renal disease in Iraq leading to higher need for live donor kidney transplant that is facing big challenge of live donation shortage which acquire re-evaluation for live donation exclusion criteria. Aim of study: To assess whether kidney transplantation using grafts with multiple vessels is associated with higher rate of complications than single vessel. Patients & methods: A retrospective cross sectional review study carried at Renal Transplant Center-Medical City teaching hospital and Private Hospitals in Baghdad-Iraq, during the period from 1st of June 1997 to 1st of June 2017 on convenient sample of 2674 live donor transplant patients. The patients were classified first into two groups (single renal vessel vs. multiple renal vessels) and second into four groups: Group A: 1837 grafts with a single artery single anastomosis. Group B: 483 grafts with multiple arteries single anastomosis, Group C-1,2,3: 202 grafts with multiple arteries multiple anastomosis, Group D: 152 grafts with multiple veins multiple anastomosis. Results: The vascular reconstruction of renal artery for transplant patients was either single renal vessel (68.7%) or multiple renal vessels (31.3%). No significant differences were observed between transplant patients with single renal vessel and patients with multiple renal vessels regarding survival duration, outcome, graft survival and graft survival duration. There was a highly significant association between younger age transplant patients and single renal vessel graft (p < 0.001). Conclusions: The long term outcomes of patients transplanted with single vessel live donor allograft kidney and patients transplanted with multiple vessels live donor allograft kidney are not obviously different. Highlights

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