Posterior auricular artery as a novel anatomic landmark for identification of the facial nerve: A cadaveric study

Liu, Muyuan; Wang, Steven J.; Benet, Arnau; Meybodi, Ali Tayebi; Tabani, Halima; Ei-Sayed, Ivan H

doi:10.1002/hed.25127

Cited by 18 publications

(32 citation statements)

References 22 publications

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“…Several surgical landmarks have been described in literature with respect to this approach, including the tragal pointer, 1 posterior belly of the digastric muscle (PBDM), 2 styloid process, 3 tympanomastoid suture (TMS), 3,4 and posterior auricular artery. 5 In our surgical experience of 10 years, we found that the FNT is located deep to the midpoint between an imaginary line joining the mastoid tip (MT) and osteocartilaginous junction of the external auditory canal (EAC), in most of our patients. The length of this imaginary line was approximately 2 cm in most patients.…”

Section: Introductionmentioning

confidence: 78%

“…A majority of surgeons use a combination of landmarks, in order to safely identify the nerve. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Some of the common landmarks are:…”

Section: Discussionmentioning

confidence: 99%

“…Several anatomical landmarks for intraoperative identification of the facial nerve during parotid surgery have been described in the literature. A majority of surgeons use a combination of landmarks, in order to safely identify the nerve 1‐15 . Some of the common landmarks are: The “cartilaginous pointer” or “tragal pointer”: the anterior tip of the tragus portion of the external ear cartilage.…”

Section: Discussionmentioning

confidence: 99%

“…However, the anterograde approach, involving the identification of the FNT, is preferred by most surgeons. Several surgical landmarks have been described in literature with respect to this approach, including the tragal pointer, 1 posterior belly of the digastric muscle (PBDM), 2 styloid process, 3 tympanomastoid suture (TMS), 3,4 and posterior auricular artery 5 …”

Section: Introductionmentioning

confidence: 99%

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A new landmark for the identification of the facial nerve during parotid surgery: A cadaver study

Al‐Qahtani

AlQahtani

Muqat

et al. 2020

Laryngoscope Investig Oto

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Objective Precise knowledge of facial nerve anatomy is crucial for parotid surgery. Although several surgical landmarks to identify the facial nerve have been described in literature, their position is variable, inconsistent, and difficult to follow in some cases. The purpose of this study was to prove that the facial nerve trunk (FNT) is located midway between the mastoid tip (MT) and osteocartilaginous junction of the external auditory canal (EAC). Methods A prospective study of 7 frozen cadaver specimens, of which 13 facial sides were dissected. The distances between the osteocartilaginous junction and the MT, between the FNT and the MT, and between the FNT and the osteocartilaginous junction were recorded, respectively. Results The distance between the osteocartilaginous junction and the MT ranged from 17 to 21 mm, with a mean of 19.5 mm (SD = ±1.19). The mean distances between the osteocartilaginous junction and the FNT and between the MT and the FNT were 9.2 mm (±1.58) and 10.3 mm (±1.79), respectively. Conclusion The FNT was consistently located close to the midpoint between mastoid tip inferiorly and bony‐cartilaginous junction of the EAC superiorly. Level of Evidence NA

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Section: Introductionmentioning

confidence: 78%

“…A majority of surgeons use a combination of landmarks, in order to safely identify the nerve. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Some of the common landmarks are:…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A new landmark for the identification of the facial nerve during parotid surgery: A cadaver study

Al‐Qahtani

AlQahtani

Muqat

et al. 2020

Laryngoscope Investig Oto

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“…The posterior auricular artery is one of them. In a study conducted in 2018 performed on 10 cadavers, it is stated that the posterior auricular artery is crossed with the facial nerve at the inferior part of the stylomandibular foramen and that by following the posterior auricular artery, the FNT can be found [15]. However, study was performed on cadavers, and it is thought that in live surgery, the posterior auricular artery is very close to the facial nerve, and bleeding and deterioration of the surgical orientation may cause facial nerve paralysis during the identi cation of the posterior auricular artery.…”

Section: Discussionmentioning

confidence: 99%

A New and Reliable Landmark in Parotid Surgery: Tragomastoid Groove (Akil Groove)

Kınış

Akıl

Yılmaz

et al. 2020

Preprint

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Background: Parotid surgery is a frequently performed surgery in otorhinolaryngology practice with many possible complications. Due to the high ratio of facial paralysis during parotid surgery, we defined a new landmark for identifying and protecting the facial nerve as early as possible during surgery. Materials and Methods: The study was designed as a prospective anatomical method. The important details and relationship of the tragomastoid groove to the facial nerve truncus were examined during surgery on 30 patients. In addition, the demographics of the patients, the type of surgery and the pathological results of surgeries were evaluated.Results: The mean distance of the tragomastoid groove to the facial nerve truncus was 20.53±1.71 mm, the mean deepness of the tragomastoid groove was 1.91+-0.26 mm, and the mean superficial part of the tragomastoid groove was 0.83±0.23 mm. The tragomastoid groove was situated either across from the facial nerve at the place where the facial nerve truncus exits the stylomastoid foramen or just inferior to the truncus in all patients. Conclusion: The tragomastoid groove was defined for the first time in the literature as a reliable landmark for identifying the facial nerve truncus easily during parotid surgery.

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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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Posterior auricular artery as a novel anatomic landmark for identification of the facial nerve: A cadaveric study

Abstract: The PAA represents a potential new anatomic landmark for facial nerve identification at the main trunk.

Cited by 18 publications

References 22 publications

A new landmark for the identification of the facial nerve during parotid surgery: A cadaver study

A new landmark for the identification of the facial nerve during parotid surgery: A cadaver study

A New and Reliable Landmark in Parotid Surgery: Tragomastoid Groove (Akil Groove)

Fenestration of the facial nerve by the stylomastoid artery

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