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

OBJECTIVETo study the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region based on quantitative measurements, and provide reliable anatomic data for selecting surgical approach individually and protecting the function of important structures.

METHODSThe complete approach of the suboccipital far-lateral approach and the postauricular transtemporal approach were reproduced in twelve (twenty-four sides) head-neck specimens of adults be fixed in 10% formalin. The exposure area to the jugular foramen region was obtained using a stereotactic device, and the length of exposure of the clivus and the trigeminal nerve were measured using a vernier caliper.

RESULTSIn the suboccipital far-lateral approach, the significant increase in exposure was noted after removal of the jugular process and partial resection of occipital condyle. In the postauricular transtemporal approach, the exposure increased significantly after complete retrolabyrinthine approach, partial labyrinthectomy and transcochlear approach.

CONCLUSIONSResection of jugular process is the key to expose the jugular foramen through the far-lateral approach. The infralabyrinthine approach and the partial labyrinthectomy approach are ideal approaches to expose the jugular foramen region laterally.

Adult ; Cadaver ; Craniotomy ; methods ; Humans ; Jugular Veins ; Occipital Bone ; anatomy & histology ; innervation ; surgery ; Skull Base ; anatomy & histology ; innervation ; surgery ; Temporal Bone ; anatomy & histology ; innervation ; surgery

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 study the anatomy of mandibular bone flap pedicled with temporal muscle for midfacial bone defects.

METHODSThe shape and blood supply of the temporal muscle and mandibular ramus, as well as their relationship, were observed and measured in 30 sides of adult head specimens.

RESULTSThe temporal muscle has a fan-shaped main portion, then is scattered into three bundles as anterolateral, anteromedial, posterior bundles, which end respectively at anterior border of ramus, the temporal ridge and posterior portion of coronoid process. Then the muscle goes downward until it reaches the distal side of the third medial surface molar and attaches the 3/4 of medial surface of anterior portion of ramus. The blood supply of temporal muscle includes the medial temporal artery with external diameter of (0.76 +/- 0.20) mm, the anterior deep temporal arteries with external diameter of (0.79 +/- 0.21) mm, posterior deep temporal arteries with external diameter of (0.98 +/- 0.64) mm, the accessory deep temporal artery formed by many little branches. The anterior part of ramus is supplied by the periosteal arteries and the bony perforator of the deep temporal arteries. Rectangular ramus of mandible was divided into anterior portion and posterior portion by the line linking the lowest point of mandibular notch, mandibular foramen and mandibular canal. Anterior portion can supply a bone flap with a size of (46.67 +/- 6.85) mm x (17.98 +/- 2.64) mm x (11.49 +/- 0.99) mm.

CONCLUSIONSThe mandibular bone flap pedicled with temporal muscle has a reliable blood supply and abundant bone volume. It is feasible to design a mandibular bone flap pedicled with temporal muscle for midfacial bone defect.

Adult ; Bone Transplantation ; Female ; Humans ; Male ; Mandible ; anatomy & histology ; surgery ; Surgical Flaps ; Temporal Muscle ; anatomy & histology ; blood supply ; innervation

Adult ; Endoscopy ; Female ; Humans ; Maxillary Sinus ; Neurilemmoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery ; Temporal Bone ; innervation

OBJECTIVE: To provide the anatomic data for operation on the middle ear through the observation and measurement of related anatomic structure. METHOD: Forty human temporal bones of 20 voluntary bone donors were dissected, relative anatomical data of operation were observed and measured under operating microscope through posterior tympanum approach entering posterior tympanum. RESULT: The average distances from suprameatal spine to short crus of incus, pyramid segment of facial canal were 19.14 mm, 16.30 mm, respectively. The average distances from pyramid segment of facial canal to the surface of mastoid, crotch of chorda tympani nerve, posterior wall of auditory meatus were 20.84 mm, 11.28 mm, 4.40 mm, respectively. The average length of facial nerve in the horizontal segment, the perpendicular paragraph was about 11.60 mm, 15.30 mm, respectively. The average distance from pyramidal eminence to the anterior lip of round window niche, from oval window to round window niche, from incudostapedial joint to round window niche was 4.46 mm, 3.74 mm, 3.80 mm, respectively. The included angle of facial nerve in the horizontal segment and chorda tympani nerve with facial nerve in the perpendicular paragraph was 110.4 degrees, 24.8 degrees, respectively. Horizontal semicircular canal and facial nerve in the level paragraph was 17.5 degrees, long process of incus and incus buttress was 46.0 degrees. CONCLUSION The position of anatomic structure in middle ear was constant and the relationship including distance and angle between anatomic structures changed in limited region. The anatomical parameters provide a reference value for avoiding the injury during the operation.
Adult ; Chorda Tympani Nerve ; anatomy & histology ; Ear, Middle ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; Female ; Humans ; Male ; Round Window, Ear ; anatomy & histology ; surgery ; Temporal Bone ; anatomy & histology ; innervation

OBJECTIVE: To retrospectively analysis the clinical data of facial nerve defects repair with greater auricular nerve graft. METHOD: The transmastoid approach was adopted to repair the facial nerve defects by means of nerve grafting. Preoperative and postoperative facial nerve functions were graded according to the House-Brackmann scale. RESULT: The patterns of temporal bone fracture in the 8 patients were longitudinal, most lesions occurred in the region of the second genu and its surrounding, preoperatively, all patients had Grade VI function. In 3 patients of facial nerve tumors, the tumors involved multiple nerve segments, and histologic results were all schwannomas, preoperatively, 1 case had Grade III function, 2 cases had Grade V function. In 2 patients of iatrogenic trauma of the facial nerve, the primary disease was chronic otitis media with cholesteatoma, the lesions were localized at the mastoid segment and the second genu respectively. In 1 patient of molten steel burn, the lesions was localized at the tympanic segment, preoperative facial nerve function was Grade VI. In addition to 3 cases lost to follow-up, the remaining patients, 4 recovered to a Grade III, 3 to a Grade VI, 2 to a Grade V and 2 remained at Grade VI. CONCLUSION In present study, the most common cause of facial nerve transection was temporal bone fracture. Facial nerve reconstruction by means of greater auricular nerve grafting was a practical and effective method, the best postoperative recovery of facial nerve function was Grade III.
Adult ; Cranial Nerves ; transplantation ; Ear ; innervation ; Facial Nerve Injuries ; surgery ; Facial Paralysis ; surgery ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Nerve Regeneration ; Neurosurgical Procedures ; methods ; Retrospective Studies ; Temporal Bone ; injuries ; surgery ; Young Adult