OBJECTIVE: To provide anantomical basis for the endoscope-assisted partial superficial parotidectomy via retroauricular hairline approach (EASPRHA) and assess its feasibility and safety. METHOD: The surgical anatomy of retroauricular hairline region and parotid gland region were observed in 15 fresh human cadavers (30 halves). The EASPRHA was performed on 5 human cadavers (10 halves). After the procedure, the related vascular and neural structures were evaluated. RESULT: The retroauricular hairline region extends between superficial musculoaponeurotic system and superficial cervical fascia. On the superficial surface of the upper sternocleidomastoid lie the lesser occipital nerve, the great auricular nerve and the external jugular vein. The bifurcation of great auricular nerve is(22.85 ± 2.01) mm from the bottom of earlobe. The parotid gland region extends between parotidomassteric fascia and parotid gland parenchyma. The facial nerve emerging from the stylomastoid foramen runs across the superficial surface of base of styloid process, passes through the interspace between cartilage of external acoustic meatus and posterior belly of digastric muscle, and enters the parotid gland. The bifurcation of facial nerve trunk is (19.10 ± 3.10)mm from the mastoidale and (39.49 ± 5.78) mm from the mandibular angle. Above the posterior belly of digastric muscle, the posterior auricular artery arises from the posterior wall of the external carotid artery with its main stem running over the superficial surface of facial nerve trunk. In all endoscope-assisted operations, the partial superficial parotidectomy was successful without the need for an additional incision. No major neurovascular damage wasobserved. CONCLUSION A thorough knowledge of the surgical anatomy of retroauricular hairline region and parotid gland region is an essential requirement in performing the safe and feasible EASPRHA.
Cranial Nerves ; anatomy & histology ; Endoscopes ; Endoscopy ; methods ; Facial Nerve ; anatomy & histology ; Fascia ; Feasibility Studies ; Humans ; Male ; Neck Muscles ; anatomy & histology ; Parotid Gland ; anatomy & histology ; surgery

In this study, 45 parotid glands and 111 facial nerves were examined in adult Korean cadavers to determine the morphological relationship of the parotid gland and the peripheral facial nerve. The results are summarized below; (1) The average length of the parotid gland was 54.7mm and the width averaged 32.9mm, and the gland was slightly larger in males. (2) The shape of the parotid gland was classified into four types and the series contained 66.7% type A, 15.5% type B, 8.9% type C and 8.9% type D. Type A was the most common type. (3) The patterns of tributory ducts into Stenson's duct were divided into 5 types and the series showed 42.2% type a, 26.7% type b 4.4% type c, 4.4% type d, 22.3% type e. The frequency of occurrence of accessory glands was 22%. (4) The average distance from the external angle of the mandible to the bifurcation of the facial nerve trunk was 28.8mm. (5) A pattern of trifurcation of the main facial nerve trunk was discovered in 4.4% of the cases. (6) The pattern of anastomosis of the peripheral branches of the facial nerve was classified into six types, and the rate of occurrence of each type was type I 6.3%, type II 13.5 %, type III 33.4%, type IV 23.4%, type V 6.3%, type VI 17.1%.
Adult ; Facial Nerve/anatomy & histology* ; Female ; Human ; Korea ; Male ; Mongoloid Race* ; Parotid Gland/anatomy & histology* ; Sex Factors

OBJECTIVE: To study our experiences in anatomy of marginal mandibular branch of facial never in partial parotidectomy. METHOD: Thirty-eight cases receiving partial parotidectomy were analyzed retrospectively, and marginal mandibular branch of facial nerve were separated in all cases. RESULT: Temporary facial paralysis appeared in 2 cases and Frey's syndrome appeared in 2 cases. There was no patient appeared the recurrence in the 1-3 years followed up time. CONCLUSION Partial parotidectomy with anatomy of marginal mandibular branch of facial nerve is a safe, effective and minimally invasive therapeutic method for benign tumor on parotid gland (<5 cm).
Face ; Facial Nerve ; anatomy & histology ; Facial Paralysis ; Humans ; Mandible ; Neoplasm Recurrence, Local ; Parotid Gland ; Parotid Neoplasms ; surgery ; Postoperative Complications ; Retrospective Studies ; Sweating, Gustatory

There are several studies concerning branches of the facial nerve, but we encountered less information about the trunk of the facial nerve in the literature. During the routine dissection of a 65-yr-old Caucasian male cadaver, double facial nerve trunk emerged from the stylomastoid foramen and petrotympanic fissure were encountered. Because of an extremely rare variation, we presented this case report. In addition this cadaver had two buccal plexuses. These plexuses and other branches were formed to structures like to polygon. These anatomic peculiarities were described, photographed and illustrated. Finally, magnetic resonance imaging was performed by using 1.5T scanner to this cadaver. The facial nerve trunk can be damaged during surgical procedures of the parotid gland tumours and submandibular region. Surgeons who are willing to operate on this area should be aware of the possible anatomical variations of the facial nerve trunk.
Aged ; Cadaver ; Facial Nerve/*anatomy & histology/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Parotid Gland/innervation ; Temporal Bone/*innervation

OBJECTIVETo investigate the route and scope of the facial nerve in the temporal region for clinical applications.

METHODSTemporal region dissection was performed on 12 cadavers (24 sides) under light microscope.

RESULTSThere are two branches of the facial nerve in the temporal region from the superior margin of the parotid: the temporal branch and the zygomatic branch. Each of them has two to five branches, which run in the deep layer of the superficial temporal fascia. The temporal branch crosses the zygomatic arch to the temporal region, innervating the frontal muscle, the orbicularis oculi muscle, the corrugator supercilii muscle, and the muscle surrounding the ear, etc. The zygomatic branch goes to the lateral canthus, innervating the orbicularis oculi muscle, the upper and lower eyelid and zygomatic muscles. There are communicating branches among the temporal branches, the zygomatic branches and the supraorbital and lacrimal nerves of the ophthalmic nerve.

CONCLUSIONThe temporal branches and zygomatic branches of the facial nerve run between the deep zone of the superficial temporal fascia and the superficial layer of the profound temporal fascia, where dissection should be avoided during rhytidectomy in order not to damage the facial nerve branches.

Cadaver ; Dissection ; Eyelids ; innervation ; Facial Muscles ; innervation ; Facial Nerve ; anatomy & histology ; Fascia ; innervation ; Humans ; Parotid Gland ; anatomy & histology ; Rhytidoplasty ; Subcutaneous Tissue ; innervation ; Temporal Bone ; Zygoma