Facial Nerve: Vascular-Related Anatomy at the Stylomastoid Foramen

Bourdon, N.; Babin, E.; Moreau, S.; Salamé, Ephrem; Valdazo, A; Rugy, M. Goullet De; Delmas, P

doi:10.1177/000348940010900912

Cited by 23 publications

(6 citation statements)

References 5 publications

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“… 10) However, the PAA supplies not only the skin of the auricle and the postauricular skin, but also the extracranial facial nerve in the stylomastoid foramen area. 11 , 12) The PAA gives rise to the stylomastoid artery toward the facial nerve trunk in 70–80% of individuals. Therefore, surgeons must exercise great care when harvesting the artery.…”

Section: Discussionmentioning

confidence: 99%

Posterior Auricular Artery-Middle Cerebral Artery Bypass: A Rare Superficial Temporal Artery Variant with Well-developed Posterior Auricular Artery–Case Report

Tokugawa

Nakao

Kudo

et al. 2014

Neurol. Med. Chir.(Tokyo)

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The posterior auricular artery (PAA) is one of the branches of the external carotid artery, but is usually too small for use as a donor artery for middle cerebral artery (MCA) territory revascularization. An extremely unusual case of PAA-MCA anastomosis was performed in a patient requiring MCA territory revascularization because the superficial temporal artery (STA) parietal branch was absent and the PAA was large enough. A 65-year-old man developed mild motor weakness in the right extremities caused by multiple small infarctions. Single photon emission computed tomography (CT) revealed deterioration of the vascular reserve capacity in the left MCA area. Cerebral angiography showed severe stenosis in the C2 portion of the left internal carotid artery, absence of the parietal branch of the left STA, and a well-developed PAA extending to the parietal area. The patient underwent STA (frontal branch)-MCA and PAA-MCA double anastomosis, and has suffered no stroke or transient ischemic attack. The STA with no bifurcation is known as a rare variation. The PAA also occurs with size variations but well-developed PAA is thought to be extremely rare. PAA can be used as a donor artery for MCA territory revascularization if the vessel size is suitable. Preoperative evaluation of the anatomy is mandatory for harvesting the arteries.

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Section: Discussionmentioning

confidence: 99%

Posterior Auricular Artery-Middle Cerebral Artery Bypass: A Rare Superficial Temporal Artery Variant with Well-developed Posterior Auricular Artery–Case Report

Tokugawa

Nakao

Kudo

et al. 2014

Neurol. Med. Chir.(Tokyo)

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“…In one study of 30 hemifacial dissections in 15 cadavers from Moreau et al, the SMA originated from the posterior auricular artery (PAA) in 70% of cases, the occipital artery (OA) in 20%, and directly from the ECA in 10% of cases. 1 Upile and colleagues conducted a combined clinical and cadaveric study of the SMA in relation to the facial nerve. 2 In observing 100 routine parotidectomies, they were able to identify the origin of the SMA in 56 of these patients, with 82% originating from the occipital artery and 18% originating from the posterior auricular artery.…”

Section: Discussionmentioning

confidence: 99%

“…Based on cadaveric anatomic studies, 1 the stylomastoid artery (SMA)—a terminal branch of the external carotid artery (ECA)—is the vessel most closely associated with the main trunk of the facial nerve as it enters the stylomastoid foramen, providing blood supply to the facial nerve, tympanic cavity, mastoid antrum, and semicircular canals 2,3 . Thus, for the purposes of this discussion, we refer to the artery piercing the facial nerve in our patients near the stylomastoid foramen as the SMA, though we did not dissect the artery to its origin to definitively determine the source artery as it was not surgically necessary and would have risked unnecessary injury to the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have demonstrated variability in the vessel from which the stylomastoid artery originates. In one study of 30 hemifacial dissections in 15 cadavers from Moreau et al, the SMA originated from the posterior auricular artery (PAA) in 70% of cases, the occipital artery (OA) in 20%, and directly from the ECA in 10% of cases 1 . Upile and colleagues conducted a combined clinical and cadaveric study of the SMA in relation to the facial nerve 2 .…”

Section: Discussionmentioning

confidence: 99%

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Fenestration of the facial nerve by the stylomastoid artery

Zhou,

DeVore,

Juliano

et al. 2024

Head & Neck

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BackgroundAnatomic landmarks such as the tympanomastoid suture line, posterior belly of the digastric muscle, tragal pointer, and styloid process can assist the parotid surgeon in identifying and preserving the facial nerve. Vascular structures such as the posterior auricular artery and its branch, the stylomastoid artery, lay in close proximity to the facial nerve and have been proposed as landmarks for the identification of the facial nerve. In this case report, we describe an anatomic variation in which the stylomastoid artery has fenestrated the main trunk of the facial nerve, dividing it in two.MethodsTwo patients underwent parotidectomy (one for a pleomorphic adenoma, the second for a parotid cyst) through a standard anterograde approach with identification of the usual facial nerve landmarks.ResultsThe appearance of the main trunk of the facial nerve was unusual in both patients due to its being fenestrated by the stylomastoid artery. The stylomastoid artery was divided, and the remainder of the facial nerve dissection was performed uneventfully with subsequent resection of the parotid mass in both patients.ConclusionsIn rare instances, the stylomastoid artery can penetrate through the common trunk of the facial nerve. This is an important anatomic variant for the parotid surgeon to be aware of, as it can increase the difficulty of facial nerve dissection.

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“…The stylomastoid artery, which emerges from the stylomastoid foramen together with the facial nerve's trunk, masks the facial nerve, making the surgical approach difficult during parotidectomy (16).…”

Section: Discussionmentioning

confidence: 99%

The Precise Location of the Stylomastoid Foramen and Clinical Implication for Facial Nerve Block

et al. 2022

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Aim: The aim of the study is to develop linear regression formulas for determining the precise localization of the stylomastoid foramen on the base of the morphometric features of the person's own skull. Material and Method: The study was carried out on 22 stylomastoid foramina (11 skulls). The 10 parameters determined for the stylomastoid foramen were measured on the photographs taken from the skull base and the 17 parameters determined for the morphometric features of the skull were measured on the photographs taken from the anterior plane, lateral plane, and posterior plan using Image J measurement software. The data obtained from the measurements were evaluated with SPSS 20.0 statistical software. Results: To determine the morphometric and topographic features of the stylomastoid foramen the equations have been developed such as; P1 (The distance between stylomastoid foramen and root of the zygomatic arch) = 18.758 + (0.472 x P12) - (2.092 x P16) + (0.831 x P17) – (0.390 x P18) – (0.101 x P20); Adjusted R2= 0.865, Standard Error of the Estimation= 1.389. Conclusion: Mean values can give misleading information in determining the topographical relationship between the stylomastoid foramen and the surrounding anatomical structures. We have developed regression formulas that will determine the precise location of the stylomastoid foramen and the accurate distances between other surrounding anatomical structures, taking into account the morphometric characteristics of the person's own skull.

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Facial Nerve: Vascular-Related Anatomy at the Stylomastoid Foramen

Cited by 23 publications

References 5 publications

Posterior Auricular Artery-Middle Cerebral Artery Bypass: A Rare Superficial Temporal Artery Variant with Well-developed Posterior Auricular Artery–Case Report

Posterior Auricular Artery-Middle Cerebral Artery Bypass: A Rare Superficial Temporal Artery Variant with Well-developed Posterior Auricular Artery–Case Report

Fenestration of the facial nerve by the stylomastoid artery

The Precise Location of the Stylomastoid Foramen and Clinical Implication for Facial Nerve Block

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