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

Khalid Hussain Al-Qahtani; Fahad Mohammad AlQahtani; Mahmoud Mohammad Muqat; Mubarak Shaie AlQahtani; Ali M Al-Qannass; Tahera Islam; Jabir Alharbi; Haneen Sebaih; Mohammad Alqarni; Hadi Hakami

doi:10.1002/lio2.431

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

Laryngoscope Investig Otolaryngol. 2020 Jul 28;5(4):689-693. doi: 10.1002/lio2.431. eCollection 2020 Aug.

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery College of Medicine, King Saud University Riyadh Saudi Arabia.
² Department of Otolaryngology, Head and Neck Surgery Prince Mohammad Bin Abdulaziz Hospital Riyadh Saudi Arabia.
³ Department of Otolaryngology, Head and Neck Surgery King Abdulaziz Medical City Jeddah Saudi Arabia.
⁴ Department of Otolaryngology, Head and Neck Surgery King Abdulaziz Medical City Abha Saudi Arabia.
⁵ Department of Otolaryngology, Head and Neck Surgery Armed Forces Hospital Khamis Mushait Saudi Arabia.
⁶ College of Medicine and Research Center, King Saud University Riyadh Saudi Arabia.
⁷ Department of Otolaryngology, Head and Neck Surgery Majmaah University Majmaah Saudi Arabia.

Abstract

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.

Keywords: anatomy; facial nerve; landmark; parotidectomy.