Anomalous Location of Facial Nerve Deep to Parotid Gland

Abstract

The knowledge of normal and variant anatomy of the facial nerve is essential for safe surgery of the parotid gland. The location of a parotid mass in relation to the course of the facial nerve determines whether superficial or total parotidectomies should be performed. The variant course of the facial nerve within the parotid may endanger the nerve during parotid surgeries. The present report is an attempt to help the surgeons to minimize the error that can damage the nerve without previous knowledge of such type of rare variation.

Anatomic variation of the relation between the facial nerve and the retromandibular vein during superficial parotidectomy: A rare case report

“…Hence, the cornerstone for a safe and adequate operation is giving emphasis to the exact, detailed description of the anatomy of the facial nerve and its branching pattern. There are several anatomic landmarks for the intraoperative identification of the FN, such as the stylomastoid foramen, the tympanomastoid fissure, the posterior belly of the digastric muscle, the tragal pointer and the retromandibular vein (RMV) [7] , [8] .…”

Facial Nerve Anomaly in a Patient With a Parotid Tumor

“… 3 Therefore, understanding surgical landmarks for the facial nerve is essential for safe and effective parotid surgery. 4 The most commonly used surgical landmarks are the stylomastoid foramen, the tympanomastoid suture, the posterior belly of the digastric muscle, the tragal pointer, and the retromandibular vein. 1 , 2 , 4 , 5 Among these landmarks, the retromandibular vein is most commonly used to locate lesions and the facial nerve.…”

“… 4 The most commonly used surgical landmarks are the stylomastoid foramen, the tympanomastoid suture, the posterior belly of the digastric muscle, the tragal pointer, and the retromandibular vein. 1 , 2 , 4 , 5 Among these landmarks, the retromandibular vein is most commonly used to locate lesions and the facial nerve. 1 , 5 Several reports have found that the retromandibular vein is medial to the facial nerve in up to 90% of cases.…”

“…The branching pattern of the facial nerve varies among individuals. 4 The most common branching pattern is cerviocofacial and temporofacial divisions. 4 However, we observed 2 unusual nerves connecting the temporofacial division in the present case.…”

“… 4 The most common branching pattern is cerviocofacial and temporofacial divisions. 4 However, we observed 2 unusual nerves connecting the temporofacial division in the present case. These 2 nerves were confirmed to be the facial nerve using an NIM system.…”