The treatment plan of facial neuritis in Evidence-based Guidelines of Clinical Practice in Acupuncture and Moxibustion (2011 edition) is discussed, and case information of facial neuritis during the recent five years in department of acupuncture and moxibustion, PLA General Hospital, is retrospectively analyzed. In accordance with anatomy of the facial nerve to form the acupuncture prescription, the detailed diagnosis and treatment method for facial neuritis are introduced. The advantages of the diagnosis and treatment method for facial neuritis are summarized, hoping to establish a more comprehensive, standardized and unified treatment plan.
Acupuncture Points ; Acupuncture Therapy ; standards ; Evidence-Based Medicine ; standards ; Facial Nerve ; anatomy & histology ; Facial Nerve Diseases ; therapy ; Humans ; Moxibustion ; standards ; Practice Guidelines as Topic

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

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

OBJECTIVE: To provide the anatomic data for the correlated otologic microsurgery by the microdissection of temporal bone through facial recess approach. METHOD: Sixteen human temporal bones of eight adult cadaveric heads were dissected under surgical microscope through facial recess approach, and the relative anatomic structures were observed and measured, such as the bony entrance of facial recess approach, facial nerve, stapes, round window, round window niche, pyramidal eminence, cochleariform process, etc. The data were analyzed statistically. RESULT: The width of the bony entrance of facial recess approach was (2.94 +/- 0.32) mm, the height was (8.83 +/- 0.84) mm, the depth was (3.51 +/- 0.17) mm. The distances from stapes to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, cochleariform process and anterior ligament of malleus were (1.38 +/- 0.21) mm, (6.94 +/- 0.47) mm, (3.60 +/- 0.55)mm, (2.23 +/- 0.33)mm, (4.93 +/- 0.61) mm, respectively. The distances from pyramidal eminence to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, round window niche and cochleariform process were (1.05 +/- 0.09) mm, (5.63 +/- 0.41) mm, (3.01 +/- 0.34) mm, (3.29 +/- 0.44) mm, (4.13 +/- 0.51) mm, respectively. The distances from round window to cochleariform process and tympanic segment of facial nerve were (5.11 +/- 0.61) mm and (3.97 +/- 0.61) mm. The distances from round window niche to tympanic segment of facial nerve and mastoid segment of facial nerve were (4.13 +/- 0.38) mm and (7.28 +/- 0.29) mm. CONCLUSION The facial recess approach played an important role in modern otologic microsurgery. The position of anatomical structure was constant relatively, including short crus of incus, stapes, pyramidal eminence and cochleariform process, etc. These could be used as reference marks for otologic microsurgery.
Adult ; Ear, Middle ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; surgery ; Humans ; Microsurgery ; Round Window, Ear ; anatomy & histology ; surgery ; Stapes ; anatomy & histology ; Temporal Bone ; anatomy & histology ; surgery

OBJECTIVETo validate the previous anatomic study result about angle nerve of facial nerve through 3-dimensional (3-D) visualization technique, so as to provide theory basis for clinic treatment of nerve loss.

METHODThe full-thickness soft tissue at internal side of inner canthus was harvested from adult cadaveric head. The skin was 3 cm in length and 1 cm in width, with 2 parallel cut lines as location markers. The specimen was sliced continuously into 120 slices, with 10 microm in thickness for every slice, 0.25 mm apart. The slices underwent HE staining and 2-D digital image was gained by high resolution scanner. Then 3-D reconstruction was performed.

RESULTS(1) It showed the 3-D structures and routes of angle nerve, as well as the relationship between angle nerve and angle arteriovenous. All the reconstructed structures can be displayed together or separately, also from any angles. (2) It confirmed the accuracy of microscopic anatomy study about angle nerve. (3) The 3-D reconstruction of angle nerve, as well as the surrounding structure could be very useful for clinical application.

CONCLUSIONBased on the histologic study and computer technology, the 3-D reconstruction of angle nerve could provide accurate basis for the feasibility of clinic treatment of angle nerve loss.

OBJECTIVE: To investigate the related parameters of temporal bone structure in the surgery of cochlear implantation through facial recess approach so as to offer a theoretical reference for the avoidance of facial nerve injury and the accurate localization. METHOD: In a surgical simulation experiment, twenty human temporal bones were studied. The correlation parameters were measured under surgical microscope. RESULT: Distance between suprameatal spine and short process of incus was (12.44 +/- 0.51) mm. Width from crotch of chorda tympani nerve to stylomastoid foramen was (2.67 +/- 0.51) mm. Distance between short process of incus and crotch of chorda tympani nerve was (15.22 +/- 0.83) mm. The location of maximal width of the facial recess into short process of incus, crotch of chorda tympani nerve were (6.28 +/- 0.41) mm, (9.81 +/- 0.71) mm, respectively. The maximal width of the facial recess was (2.73 +/- 0.20) mm. The value at level of stapes and round window were (2.48 +/- 0.20 mm) and (2.24 +/- 0.18) mm, respectively. Distance between pyramidalis eminence and anterior round window was (2.22 +/- 0.21) mm. Width from stapes to underneath round window was (2.16 +/- 0.14) mm. CONCLUSION These parameters provide a reference value to determine the position of cochlear inserting the electrode array into the scale tympani and opening facial recess firstly to avoid potential damage to facial nerve in surgery.
Anatomic Landmarks ; anatomy & histology ; Chorda Tympani Nerve ; anatomy & histology ; Cochlea ; anatomy & histology ; Cochlear Implantation ; methods ; Ear, Middle ; Facial Nerve Injuries ; prevention & control ; Humans ; Incus ; anatomy & histology ; Organ Sparing Treatments ; methods ; Round Window, Ear ; anatomy & histology ; Stapes ; anatomy & histology ; Temporal Bone ; anatomy & histology ; Tympanic Membrane ; anatomy & histology

INTRODUCTION: To correct the facial asymmetry by mandibular jaw surgery, it is important to know the anatomy of the mandible including the mandibular canal positioning of patients with facial asymmetry. This study was performed to evaluate the differences in the cross-sectional surface in the body of the mandible between the deviated side and opposite side in patients with facial asymmetry. MATERIALS AND METHODS: The study was conducted on 37 adult patients composed of 2 groups, the asymmetry group (n=20) and non-asymmetry group (n=17). Using the cross-sectional computed tomography (CT) images, the distance from the buccal aspect of the mandibular canal to the outer aspect of the buccal cortex, distance from the buccal aspect of the mandibular canal to the inner aspect of the buccal cortex, distance from the inferior aspect of the mandibular canal to the inferior border of the mandible, thickness of the mandible, and cross-sectional surface area of the mandible were measured in each side of the mandible. RESULTS: The cross-sectional area of the mandible including the mandibular canal positioning in the deviated side was not statistically different from the opposite side in the asymmetry group. Only the distance from the inferior aspect of the mandibular canal to the inferior border of the mandible in the ramus area of the deviated side was significantly longer than opposite side. On the other hand, the bucco-lingual width of the asymmetry group was thinner than the non-asymmetry group. CONCLUSION: The cross-sectional area including the mandibular canal of the mandible did not appear to be modified by the facial asymmetry.
Adult ; Anatomy, Cross-Sectional ; Facial Asymmetry ; Hand ; Humans ; Mandible ; Mandibular Nerve ; Orthognathic Surgery

OBJECTIVE: In order to provide help for preoperative assessment of cochlear implantation, related dissection of temporal bone was conducted guided by high resolution computerized tomography (HRCT) in accordance to the main steps of cochlear implantation, and was compared to HRCT measurements on a viewing workstation. METHOD: Six temporal bones were dissected according to the main steps of cochlear implantation and scanned in axial and semilongitudal planes by HRCT to observe the relationship between anatomy and HRCT. RESULT: The width of facial recess in dissection was (3.13 +/- 0.34) mm at the level of round window, and (4.12 +/- 0.44) mm at the level of oval window. The width of facial recess in HRCT was (3.20 +/- 0.38) mm at the level of round window, and (4.14 +/- 0.47) mm at the level of oval window. The whole course of facial nerve was visualized clearly in semilongitudal plane. No statistically significant differences were found between the results of dissection and HRCT. CONCLUSION The distance in axial between facial nerve and posterior wall of external auditory canal and the distance from facial nerve to round window in semilongitudal plane are the most important parameters which reflect the position of facial nerve. The vertical portion of facial nerve, posterior wall of external auditory canal, round window are important measurement landmarks. Related preoperative measurements of cochlear implantation by HRCT can help to guide clinic surgery.
Child, Preschool ; Cochlear Implantation ; methods ; Cochlear Implants ; Ear Canal ; anatomy & histology ; Facial Nerve ; anatomy & histology ; Humans ; Infant ; Round Window, Ear ; anatomy & histology

OBJECTIVE: To study the location of facial nerve and prevent facial nerve injury in middle ear surgery according to dissection of temporal bone and experience of middle ear surgery. METHOD: Thirty sides of temporal bones were exposed tympanic and mastoid segment of facial nerve with facial nerve decompression. The course of facial nerve was located by the markers of middle ear. RESULT: Tympanic segment of facial nerve passed between horizontal semicircular canal and stapes,then superior and anterior to the cochleariform process. Mastoid segment of facial nerve located in posterior wall of tympanic cavity. The mastoid segment of facial nerve travelled below the level of horizontal semicircular canal and annulus membrane tympani, and the extension line of its posterior margin and posterior-one-third of horizontal semicircular canal intersected to form an included angle (117.04 +/- 2.42) degrees. External genu of facial nerve located anterior and inferior to the horizontal semicircular canal. The shortest distance was (1.97 +/- 0.53) mm between middle point of horizontal semicircular canal and facial nerve, (1.03 +/- 0.29) mm between incus short process and facial nerve, (0.93 +/- 0.25) mm between cochleariform process and facial nerve, (1.18 +/- 0.42) mm between head of stapes and facial nerve, (3.08 +/- 0.28) mm between tympani sulcus and facial nerve at the vestibule window level, and (2.13 +/- 0.34) mm between tympani sulcus and facial nerve at round window level, respectively. CONCLUSION Horizontal semicircular canal carina, incus short process, stapes, annulus membrane tympani and cochleariform process are ideal landmarks of tympanic and mastoid segment of facial nerve, which are helpful in middle ear surgery.
Ear, Middle ; surgery ; Facial Nerve ; surgery ; Facial Paralysis ; prevention & control ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Mastoid ; anatomy & histology ; surgery ; Microsurgery ; methods

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