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Poutoglidis A, Triaridis S, Paraskevas GK, Karamitsou P, Mykoniatis I, Langas G, Tsiakaras S, Galanis N, Lazaridis N. The Relationship Between the Retromandibular Vein and the Extratemporal Segment of the Facial Nerve: A Prospective Cadaveric Study of 24 Hemifaces. Cureus 2024; 16:e59637. [PMID: 38832166 PMCID: PMC11146465 DOI: 10.7759/cureus.59637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have been proposed and widely utilized, temporal or permanent postoperative FN palsy is still a significant comorbidity of parotid surgery. Therefore, the literature must fully elucidate the consistency of the anatomical relationship between the FN and the retromandibular vein (RMV). METHODS We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side. RESULTS Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV. CONCLUSION The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.
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Affiliation(s)
- Alexandros Poutoglidis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Stefanos Triaridis
- First Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, GRC
| | - George K Paraskevas
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Paraskevi Karamitsou
- Department of Otorhinolaryngology-Head and Neck Surgery, 'G. Papanikolaou' General Hospital, Thessaloniki, GRC
| | - Ioannis Mykoniatis
- First Department of Urology, School of Medicine, Aristotle University of Thessaloniki, 'G. Gennimatas' General Hospital, Thessaloniki, GRC
| | - Georgios Langas
- First Department of Urology, School of Medicine, Aristotle University of Thessaloniki, 'G. Gennimatas' General Hospital, Thessaloniki, GRC
| | - Stavros Tsiakaras
- First Department of Urology, School of Medicine, Aristotle University of Thessaloniki, 'G. Gennimatas' General Hospital, Thessaloniki, GRC
| | - Nektarios Galanis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Nikolaos Lazaridis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Amin Patigaroo S, Tabassum A, Dar NH, Showkat SA, Latoo MA. Retromandibular Vein, Digastric Muscle, and Greater Auricular Nerve in Superficial Parotidectomies for Patients with Pleomorphic Adenoma-A Surgical Experience. Indian J Otolaryngol Head Neck Surg 2023; 75:2035-2041. [PMID: 37636781 PMCID: PMC10447747 DOI: 10.1007/s12070-023-03815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/17/2023] [Indexed: 08/29/2023] Open
Abstract
Retromandibular vein (RMV) and posterior belly of digastric muscle are among the landmarks used to identify facial nerve in parotid surgery. This observational cross-sectional study was done in the Department of ENT &HNS at a tertiary care teaching hospital for a period of 8 years with the aim to aware young otorhinolaryngologist about the relationship of posterior belly of digastric muscle & retromandibular vein with facial nerve and share our experience about preservation of posterior branch of greater auricular nerve. A total of 34 cases of superficial parotidectomies done for pleomorphic adenoma were included in this study. Relationship of facial nerve with retromandibular vein and posterior belly of digastric muscle was noted. Greater auricular nerve was identified, and every attempt was made to preserve its posterior branch. Retromandibular vein was medial to the trunks of facial nerve in 33 (97%) patients. It was lateral to lower division and medial to upper division in one case. Greater auricular nerve was seen to bifurcate into two branches (Anterior and posterior) in 21 (62%) cases while in one case(3%) three branches were seen emerging from main trunk and in another case(3%) first two branches were seen emerging and then anterior branch was further dividing into two. Preservation of posterior branch of greater auricular nerve was possible in 23 (68%) of patients. Posterior belly of digastric muscle was seen as a reliable and constant landmark. Facial nerve was seen superior to upper border of posterior belly of digastric muscle in all cases (100%). No anatomical variation of posterior belly was seen. Retromandibular vein is invariably seen medial to the trunks of facial nerve. Facial nerve is always seen superior to upper border of posterior belly of digastric muscle in almost all cases. Preservation of posterior branch of greater auricular nerve is possible in majority of the cases.
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Affiliation(s)
| | - Amrin Tabassum
- Department of ENT, Government Medical College, Srinagar, JK India
| | | | | | - Manzoor A. Latoo
- Department of ENT, Government Medical College, Srinagar, JK India
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Khan R, Wani AA, Rehman A. Unusual Relation of Facial Nerve and Retromandibular Vein in Parotid Surgeries: a Case Series. Indian J Otolaryngol Head Neck Surg 2022; 74:5959-5963. [PMID: 36742484 PMCID: PMC9895731 DOI: 10.1007/s12070-021-02631-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/10/2021] [Indexed: 02/07/2023] Open
Abstract
The relation between the facial nerve and the retromandibular vein is of paramount clinical significance during the parotid surgery for the protection of all the facial nerve branches as these two anatomic structures are always in close proximity. However, variations in the relationship of the facial nerve with the retromandibular vein, as presented in this paper complicate parotid surgery and increase the potentiality of unexpected bleeding and injury to the facial nerve injury. This study was conducted in a tertiary care teaching hospital. 4 cases with unusual relation of facial nerve and retromandibular vein in parotid surgeries were studied & included in this study. Out of 70 parotid surgeries which were performed, 4 variations of the retromandibular vein in relation to facial nerve were encountered. With a meticulous dissection the facial nerve branches were separated from the retromandibular vein without causing any injury to the neurovascular structures and functional deficit. Knowledge of normal anatomy of the extra cranial facial nerve and its relation with the retromandibular vein along with the probable anatomical variations leads to a safe parotid surgery.
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Affiliation(s)
- Raphella Khan
- Department of ENT and Head and Neck Surgery, SKIMS MCH, Bemina, Srinagar, Jammu and Kashmir India
| | - Asef Ahmed Wani
- Department of ENT and Head and Neck Surgery, SKIMS MCH, Bemina, Srinagar, Jammu and Kashmir India
| | - Ayaz Rehman
- Department of ENT and Head and Neck Surgery, SKIMS MCH, Bemina, Srinagar, Jammu and Kashmir India
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Cheah PF, Punithamalar K, Kong LSS, Goh LC, Yeoh AG, Mohd Razif MY. Reliability of the 'M-Line' in the Prediction of the Facial Nerve Position in Patients with Parotid Neoplasms. Indian J Otolaryngol Head Neck Surg 2022; 74:6032-6038. [PMID: 36742789 PMCID: PMC9895135 DOI: 10.1007/s12070-021-02680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023] Open
Abstract
Preoperative radiological assessment of parotid tumours represents a crucial step in the planning of a parotidectomy in order to avoid post-operative facial nerve paralysis. The purpose of this study is to determine the reliability of the novel 'M-line' in predicting the facial nerve position and compare it to various radiological methods in the same context. 66 patients whom had underwent parotidectomy for parotid tumours from January 2012 to February 2021 were analyzed. Parotid tumour location were identified using the retromandibular vein, facial nerve line, Conn's arc, Utrecht line and the 'M'-line were compared to the intraoperative location of parotid tumours.The 'M'-line is a novel hypothetical line (drawn between the lateral surface of the mandible to the lateral border of the mastoid process) used to identify the location of the facial nerve radiologically. The 'M-Line' and other methods of radiological assessments were associated with statistical significance in predicting if the parotid tumours were superficial or deep to the facial nerve (p-value < 0.05).The 'M-line' had demonstrated a sensitivity of 73.6% and 92.3% specificity.It had also yielded the highest accuracy (77.3%) in the prediction of the parotid tumour location in relation to the facial nerve. While the radiological lines represented by the Retromandibular vein,facial nerve line,Utrecht line and Conn's arc were statistically significant in predicting the location of the parotid tumour in relation to the facial nerve, the M-line was the most accurate and sensitive predictor in our study.The M-Line is a potentially useful tool to predict the location of the facial nerve in relation to a parotid tumour.
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Affiliation(s)
- Pei Fen Cheah
- Department of Otorhinolaryngology, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor Malaysia
- Department of Otorhinolaryngology, University of Malaya Medical center, Kuala Lumpur, Malaysia
| | - Krishnan Punithamalar
- Department of Otorhinolaryngology, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor Malaysia
| | | | - Liang Chye Goh
- Department of Otorhinolaryngology, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor Malaysia
| | - Aik Guan Yeoh
- Department of Radiology, Hospital Sultanah Aminah, Johor Bahru, Johor Malaysia
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Liu M, Tong L, Xu M, Xu X, Guo H, Xu S, Peng H. Posterior auricular artery as a novel anatomic landmark for identification of the facial nerve: A clinical study. Laryngoscope Investig Otolaryngol 2022; 7:1441-1447. [PMID: 36258872 PMCID: PMC9575092 DOI: 10.1002/lio2.894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In our previous cadaveric study, we highlighted the posterior auricular artery (PAA) as a potential landmark for early identification of facial nerve (FN) when performing parotidectomy. However, further clinical study is critically needed before this landmark could be applied in clinical practice. METHODS For 31 patients enrolled, we tried to identify the FN by the guide of the PAA during parotidectomy. Additionally, the FN function was evaluated during follow-up. RESULTS PAA could be exposed in 28 out of 31 (90.3%) patients during parotidectomy. Moreover, the FN trunk could be identified by the guide of the PAA in all these 28 patients with identifiable PAA. Furthermore, no iatrogenic FN damage happened in this study and the transient FN dysfunction rate was 5.7%. CONCLUSION The PAA is an ideal landmark for early identification of the FN trunk when performing parotidectomy.
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Affiliation(s)
- Muyuan Liu
- Department of Head and NeckCancer Hospital of Shantou University Medical CollegeShantouChina
| | - Litian Tong
- Department of AnesthesiologyCancer Hospital of Shantou University Medical CollegeShantouChina
| | - Manbin Xu
- Department of Head and NeckCancer Hospital of Shantou University Medical CollegeShantouChina
| | - Xiang Xu
- Department of AnesthesiologyCancer Hospital of Shantou University Medical CollegeShantouChina
| | - Haipeng Guo
- Department of Head and NeckCancer Hospital of Shantou University Medical CollegeShantouChina
| | - Shaowei Xu
- Department of Head and NeckCancer Hospital of Shantou University Medical CollegeShantouChina
| | - Hanwei Peng
- Department of Head and NeckCancer Hospital of Shantou University Medical CollegeShantouChina
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6
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Li L, London NR, Kim LR, Prevedello DM, Carrau RL. Endonasal access to the lateral poststyloid space: Far lateral extension of an endoscopic endonasal corridor. Head Neck 2022; 44:2342-2349. [PMID: 35766255 PMCID: PMC9543384 DOI: 10.1002/hed.27135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/09/2022] [Accepted: 06/16/2022] [Indexed: 12/20/2022] Open
Abstract
The styloid process constitutes the posterolateral boundary for an endonasal exposure of the infratemporal fossa. This study aims to explore the feasibility of a far-lateral extension to the lateral poststyloid space via an endonasal corridor. An endonasal dissection was performed on six cadaveric specimens (12 sides). Following an endoscopic endonasal access to the parapharyngeal space, the styloid process and the tympanic portion of the temporal bone were removed to reveal the jugular bulb and the extratemporal facial nerve. Distances from the anterior nasal spine to the relevant landmarks were measured using a surgical navigation device. Through an endonasal corridor, only the anteroinferior aspect of the jugular bulb was exposed. Conversely, the extratemporal facial nerve could be sufficiently exposed, and the deep temporal nerve could be transposed to the stylomastoid foramen. The average horizontal distances from the nasal spine to the posterior tract of V3 , styloid process, and facial nerve were 79.33 ± 3.41, 97.10 ± 4.74, and 104.77 ± 4.42 mm, respectively. Access to the lateral poststyloid space via an endonasal corridor is feasible, potentially providing an alternative approach to address select lesions extending to this region. The deep temporal nerve has a similar diameter to that of the facial nerve; thus, providing potential reinnervation of the facial nerve.
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Affiliation(s)
- Lifeng Li
- Department of Otolaryngology - Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Department of Otolaryngology - Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio
| | - Nyall R London
- Department of Otolaryngology - Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio.,Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Leslie R Kim
- Department of Otolaryngology - Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio
| | - Daniel M Prevedello
- Department of Otolaryngology - Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio.,Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio
| | - Ricardo L Carrau
- Department of Otolaryngology - Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio.,Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio
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7
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Prevost A, Cavallier Z, Alshehri S, Delanoe F, Lauwers F, Lopez R. The external jugular vein axis: a new anatomical landmark for pre-operative prediction of the location of parotid gland tumours. Int J Oral Maxillofac Surg 2021; 51:481-486. [PMID: 34474953 DOI: 10.1016/j.ijom.2021.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/16/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
The relationships between parotid tumours and the facial nerve determine duration of surgical procedure and risks involved. As the division of the facial nerve is not visible using standard imaging techniques, other anatomical landmarks are used to determine the pre-operative location of tumours. This retrospective study aimed to evaluate reliability of the 'external jugular vein axis' compared with other landmarks generally used in imaging, such as the retromandibular vein, Conn's arc, the facial nerve line and the Utrecht line. Forty-eight pre-operative imaging exams of patients who underwent parotid benign tumour surgery between 2010 and 2016 were examined. We determined the location of tumour using the five markers. A pre-operative simulation was compared with the description given by the surgeon intraoperatively, in terms of sensitivity and specificity for each marker. External jugular vein axis and retromandibular vein are the most sensitive markers for locating suprafacial tumours (Se = 1). External jugular vein axis and Conn's arc are the most specific markers for locating suprafacial tumours (Spe = 0.92). External jugular vein axis is reproducible and present on all radiological sections, thereby overcoming any anatomical and nomenclature variations. This landmark appears to be the most representative marker of the dividing branches of the facial nerve.
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Affiliation(s)
- A Prevost
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France.
| | - Z Cavallier
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - S Alshehri
- Otolaryngology, Head & Neck Surgery, King Khalid University, Kingdom of Saudi Arabia
| | - F Delanoe
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - F Lauwers
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - R Lopez
- Anatomy Laboratory, Paul Sabatier-Toulouse III University, Toulouse, France
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Zourntou SE, Makridis KG, Tsougos CI, Skoulakis C, Vlychou M, Vassiou A. Facial nerve: A review of the anatomical, surgical landmarks and its iatrogenic injuries. Injury 2021; 52:2038-2048. [PMID: 34074487 DOI: 10.1016/j.injury.2021.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/09/2021] [Accepted: 05/16/2021] [Indexed: 02/02/2023]
Abstract
Facial nerve iatrogenic injuries are serious and can negatively affect the quality of life of the patients. Due to the properties of the nerve, the complications are devastating involving the aesthetic appearance and the function of the face. Moreover, the multiple branches of the nerve increase the risk of an iatrogenic injury making the detailed knowledge of the anatomical correlations around them critical. In this review, a meticulous analysis was performed including the surgical procedures posing the greater risk of an iatrogenic injury as well as the full description of all the reported anatomical landmarks involving the extracranial course of the facial nerve.
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Affiliation(s)
| | | | | | - Charalampos Skoulakis
- Otolaryngology Department Neurology & Sensory Organs, Faculty of Medicine, University of Thessaly, Larissa, Greece.
| | - Marianna Vlychou
- Radiology Department Clinical and Laboratory Research, Faculty of Medicine, University of Thessaly, Larissa, Greece.
| | - Aikaterini Vassiou
- Anatomy Department Morphology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
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Badger CD, Michel MC, Goodman JF, Thakkar P, Joshi AS. Minimum fascia tumor distance for selection of extracapsular dissection for benign parotid tumors: A preliminary study. Am J Otolaryngol 2021; 42:102776. [PMID: 33125903 DOI: 10.1016/j.amjoto.2020.102776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There is increasing literature supporting the use of extracapsular dissection (ECD) for the treatment of select superficial lobe parotid tumors, though no objective criteria for selection has been proposed. Prior studies have suggested the minimum distance between the parotideomasseteric fascia and the tumor edge or minimum fascia-tumor distance (MFTD) as a useful measurement for the identification of superficial parotid tumors. The objective of this study is to demonstrate the utility of the minimum fascia-tumor distance in selecting candidates for extracapsular dissection of benign parotid tumors. METHODS This is a retrospective case-control study at a tertiary academic otolaryngology clinic. Twenty-three patients with prior surgical excision of benign parotid tumors that underwent surgeon-performed ultrasonography prior to excision of tumor were identified. Ultrasound images were reviewed and the minimum fascia-tumor distance was recorded and categorized by less than 3 mm or as 3 mm or greater. The primary outcome was successful completion of extracapsular dissection versus more extensive resection. RESULTS Thirteen patients had a minimum fascia-tumor distance less than 3 mm; eleven of thirteen (84.6%) successfully underwent extracapsular dissection. Ten patients had a minimum fascia-tumor distance of 3 mm or greater; one of ten (10%) successfully underwent extracapsular dissection. A minimum fascia-tumor distance less than 3 mm was sensitive, specific, and accurate in predicting successful ECD at 91.7%, 81.8%, and 87.0% respectively (OR 49.5, 95% CI 3.4-573.2). CONCLUSION Minimum fascia-tumor distance may be a useful measurement in identifying candidates for removal of benign parotid tumors with extracapsular dissection.
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Sugahara K, Matsunaga S, Yamamoto M, Noguchi T, Morita S, Koyachi M, Koyama Y, Koyama T, Kasahara N, Abe S, Katakura A. Retromandibular vein position and course patterns in relation to mandible: anatomical morphologies requiring particular vigilance during sagittal split ramus osteotomy. Anat Cell Biol 2020; 53:444-450. [PMID: 33214345 PMCID: PMC7769106 DOI: 10.5115/acb.20.236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 10/29/2020] [Indexed: 11/27/2022] Open
Abstract
Major bleeding associated with sagittal split ramus osteotomy (SSRO) involves vessels such as the inferior alveolar, facial, and maxillary arteries and veins, and the retromandibular vein (RMV). The present study aimed to clarify and classify the three-dimensional variations in RMV position and course direction in relation to the mandible. Specimens comprised a total of 15 scientific cadavers, and the relationship between RMV and the mandible lateral and posterior views was observed. We identified 3 patterns on the lateral view, the mean distance between the RMV and the posterior border of the ramus was 3.9 mm at the height of the lingula. A total of five course patterns were identified on the posterior view. In no course pattern, the RMV inferior to the lingula was lateral to its position superior to the lingual. The present findings suggest that it may be possible to predict correlations with intraoperative bleeding risk. Further study is planned using contrast computed tomography in patients with jaw deformity for skeletal classification.
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Affiliation(s)
- Keisuke Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | | | - Taku Noguchi
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | | | - Masahide Koyachi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Yu Koyama
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Takumi Koyama
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Norio Kasahara
- Department of Forensic Odontology and Anthropology, Tokyo Dental College, Tokyo, Japan
| | - Shinichi Abe
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
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Feasibility of Using Posterior Auricular Artery as Landmark for Identification of Facial Nerve Trunk in Parotid Surgery: A Cadaver Study. J Craniofac Surg 2020; 32:1832-1835. [PMID: 33086304 DOI: 10.1097/scs.0000000000007222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Despite good surgical knowledge of the anatomy of parotid gland and meticulous surgical technique, the incidence of facial palsy in parotid surgeries is up to 26.7% transient and 1.7% complete facial palsy(1). The risk of facial palsy increases further in malignant and revision cases. METHOD Superficial parotidectomy was done in 14 cadaveric hemi faces in 10 cadavers. Posterior auricular artery and its stylomastoid branch was dissected and facial nerve trunk was identified in all cases. The relationship of posterior auricular artery along with its stylomastoid branch with the facial nerve trunk was studied and recorded. RESULT Posterior auricular artery was found running inferior to the facial nerve trunk in 12 cadaveric dissection while the posterior auricular artery was found crossing below the main trunk of facial in 2 cadaver dissection. The average distance between PAA and facial nerve trunk was 7 mm (2-14 mm) Stylomastoid artery was found arising from Posterior auricular artery in 12 of 14 and it was found running medial to the facial nerve trunk in all the 8 cadavers. CONCLUSION Post auricular artery can be used as another landmark for identification of the main trunk of facial nerve in parotid surgeries.
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Lee MK, Choi Y, Jang J, Shin NY, Jung SL, Ahn KJ, Kim BS. Identification of the intraparotid facial nerve on MRI: a systematic review and meta-analysis. Eur Radiol 2020; 31:629-639. [PMID: 32857205 DOI: 10.1007/s00330-020-07222-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/03/2020] [Accepted: 08/21/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Accurate preoperative localization of the intraparotid facial nerve (IFN) on MRI could reduce intraoperative injury. This study aimed to assess the detection rate of the IFN and its branches on MRI. METHODS PubMed-MEDLINE and Embase databases were searched for articles published up to October 2019. The inclusion criteria were (a) adults, (b) MRI-based identification of IFN by radiologists, (c) original articles, and (d) detailed results to assess the proportion of visible IFN. Two radiologists reviewed the original articles. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to determine the quality of the selected studies. The DerSimonian-Laird random effects model was utilized to calculate the pooled estimates. Between-studies heterogeneity was evaluated using the chi-squared statistic test and Higgins' inconsistency index (I2). A subgroup meta-regression was performed to explore the factors causing study heterogeneity. RESULTS Nine original articles with 209 subjects were included. MRI reported a high pooled detection rate of 99.8% (95% CI, 98.4-100%) for the main trunk of the IFN. The pooled rates for the temporofacial and cervicofacial branches were 90.4% (95% CI, 84.1-96.7%) and 96.3% (95% CI, 96.1-99.5%), respectively. Heterogeneity was detected only in the temporofacial branch (I2 = 83%) as a result of both slice thickness and the use of steady-state sequences with diffusion-weighted imaging (DWI) implementation. CONCLUSIONS MRI showed an overall high detection rate of the IFN and its branches. Furthermore, an increased identification was observed in studies that used a slice thickness of < 1 mm and steady-state sequences with DWI implementation. KEY POINTS • MRI showed an overall high detection rate of the intraparotid facial nerve and its branches. • Higher detection rate was observed in studies that used a slice thickness of < 1 mm and steady-state sequences with diffusion-weighted imaging.
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Affiliation(s)
- Min-Kyung Lee
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Yangsean Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Na-Young Shin
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - So-Lyung Jung
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Kook-Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Bum-Soo Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
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Khoa TD, Bac ND, Luong HV, Anh TN, Phuong NT, Nga VT, Dinh TC. Anatomical Characteristics of Facial Nerve Trunk in Vietnamese Adult Cadavers. Open Access Maced J Med Sci 2019; 7:4230-4238. [PMID: 32215069 PMCID: PMC7084012 DOI: 10.3889/oamjms.2019.366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND: In medical literature, there are few studies provided a precise and detailed description of the facial nerve rami and its branches. AIM: Identify several practical anatomic landmarks related to the facial nerve main trunk and its rami. METHODS: A descriptive study, 30 cadavers in the anatomy department of UPNT from October 2012 to April 2015. RESULTS: The average distance from the mandibular angle to the division of the facial nerve is 40.8 mm, and is 86.6% from range 36 – 50 mm. There is 86.7% case in which the facial nerve is in the lateral of the retromandibular vein, and there is a significant difference about both sides. Eighty percent of the case has the superior and inferior ramus in the lateral to the retromandibular vein. There are 2 cases in which the superior ramus makes the circle of the vein. Eighty percent of the facial nerve is in the lateral to the external carotid artery. CONCLUSION: The distance from the mandibular to the division of the facial nerve is longer. The relationship between the superior/inferior ramus and the retromandibular vein maybe not the same in both sides. In some cases, it makes the circle of the vein to cause some complication in the parotid gland surgery.
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Affiliation(s)
- Tran Dang Khoa
- Department of Anatomy, Pham Ngoc Thach University of Medicine (PNTU), Ho Chi Minh City, Vietnam
| | - Nguyen Duy Bac
- Department of Anatomy, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Hoang Van Luong
- Department of Anatomy, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Tran Ngoc Anh
- Department of Anatomy, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Nguyen Thi Phuong
- NTT Hi-tech Institute, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Vu Thi Nga
- Institute for Research and Development, Duy Tan University, Danang, Vietnam
| | - Toi Chu Dinh
- Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
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An Unusual Position of Retromandibular Vein in Relation to Facial Nerve: A Rare Case Report. Case Rep Otolaryngol 2018; 2018:3919762. [PMID: 30533238 PMCID: PMC6247713 DOI: 10.1155/2018/3919762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/11/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022] Open
Abstract
Knowledge of different anatomical structures is very important in parotid surgery to preserve facial nerve. Retromandibular vein is one of the landmarks used to identify facial nerve. So, the relation of the vein with facial nerve is very important in parotid surgery. The typical position of RMV is deep to facial nerve in almost 88% of cases reported in various literatures. Here, we present an unusual position of RMV found during parotid surgery for pleomorphic adenoma.
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Mahore D, Mangalgiri AS, Namdev LN, Kapre M. Variations of Retromandibular Vein and Its Relation to Facial Nerve Within Parotid Gland. Indian J Otolaryngol Head Neck Surg 2018; 70:395-397. [PMID: 30211096 DOI: 10.1007/s12070-018-1389-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 04/30/2018] [Indexed: 11/27/2022] Open
Abstract
Maxillary vein and superficial temporal vein unite to form the retromandibular vein in the parotid gland. The facial nerve lies lateral to external carotid artery and retromandibular vein. Identifying and preserving the facial nerve is the prime motto during parotidectomy. So the variations of facial nerve and the retromandibular vein should be known so as to avoid injury to both. The variations we encountered during parotid surgery will be helpful in avoiding unexpected bleeding and injury to facial nerve.
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Affiliation(s)
- Devendra Mahore
- Department of ENT, Government Medical College, Chandrapur, India
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Liu M, Wang SJ, Benet A, Meybodi AT, Tabani H, Ei-Sayed IH. Posterior auricular artery as a novel anatomic landmark for identification of the facial nerve: A cadaveric study. Head Neck 2018; 40:1461-1465. [PMID: 29566447 DOI: 10.1002/hed.25127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 11/15/2017] [Accepted: 01/26/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite preservation techniques, performing a parotidectomy carries a transient facial nerve dysfunction rate in up to 65% of cases and a permanent facial nerve weakness rate of 4%-7%. METHODS The lateral aspect of the face and neck was exposed in 5 cadaveric heads (10 sides). The relationship of the posterior auricular artery (PAA) and the facial nerve was studied and recorded and descriptive measurements were taken. RESULTS In all specimens, the facial nerve trunk crossed the PAA inferior to the stylomastoid foramen and could be identified precisely by tracing the PAA proximally. The distance from the cross point of the PAA and the facial nerve to the external meatal cartilage was 5.2 ± 0.2 mm. CONCLUSION The PAA represents a potential new anatomic landmark for facial nerve identification at the main trunk.
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Affiliation(s)
- Muyuan Liu
- Department of Head and Neck, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Steven J Wang
- Department of Otolaryngology - Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona
| | - Arnau Benet
- Skull Base and Cerebrovascular Laboratory, University of California San Francisco, San Francisco, California
| | - Ali Tayebi Meybodi
- Skull Base and Cerebrovascular Laboratory, University of California San Francisco, San Francisco, California
| | - Halima Tabani
- Skull Base and Cerebrovascular Laboratory, University of California San Francisco, San Francisco, California
| | - Ivan H Ei-Sayed
- Skull Base and Cerebrovascular Laboratory, University of California San Francisco, San Francisco, California
- Otolaryngology Minimally Invasive Skull Base Center, Department of Otolaryngology Head and Neck Surgery, University of California San Francisco, San Francisco, California
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18
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Zoulamoglou M, Zarokosta M, Kaklamanos I, Piperos Τ, Flessas I, Kakaviatos D, Kalles V, Bonatsos V, Sgantzos M, Mariolis-Sapsakos T. Anatomic variation of the relation between the facial nerve and the retromandibular vein during superficial parotidectomy: A rare case report. Int J Surg Case Rep 2017; 41:124-127. [PMID: 29073548 PMCID: PMC5655409 DOI: 10.1016/j.ijscr.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 12/04/2022] Open
Abstract
The facial nerve (FN) and the retromandibular vein (RMV) are anatomical structures in close proximity. Anatomic variations of their relationship complicate parotid surgery and increase the potentiality of nerve injury or bleeding. The true prevalence of such kind of variations seems to be underestimated, since the literature is restricted. Novel variations of the relationship of the FN with the RMV are probable. Therefore, surgeons’ knowledge and perpetual awareness are fundamental and essential in order to perform safe parotid surgery.
Introduction Identification and preservation of the facial nerve (FN) is a major challenge when performing parotidectomy. Anatomic variations of the relation between the FN and the retromandibular vein (RMV) pose a high risk of nerve injury and bleeding during the operation. Presentation of case An unusual anatomic variation of the relation between the FN and the RMV was unexpectedly detected during superficial parotidectomy. The operation was uneventful. A meticulous review of the recent literature was conducted as well. Discussion Variations of the relation between the FN and the RMV are mainly identified during the operation, since when performing parotidectomy, surgeons typically detect all the FN branches by locating the RMV. Such kind of variations, are not as rare as considered and their presence complicates parotid surgery and increases the potentiality of nerve injury and hemorrhage. Conclusion Surgeons’ deep knowledge and perpetual awareness concerning the probable anatomic variations of the relation between the FN and the RMV combined with detailed exposure of the operative field and of the relationship between these adjacent anatomical structures lead to safe parotid surgery.
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Affiliation(s)
- Menelaos Zoulamoglou
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Maria Zarokosta
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece; Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece.
| | - Ioannis Kaklamanos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Τheodoros Piperos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece; Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece
| | - Ioannis Flessas
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece; Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece
| | - Dimosthenis Kakaviatos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Vasileios Kalles
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Vasileios Bonatsos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Markos Sgantzos
- Anatomy Laboratory, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Theodoros Mariolis-Sapsakos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece; Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece
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Bendella H, Spacca B, Rink S, Stoffels HJ, Nakamura M, Scaal M, Heinen H, Guntinas-Lichius O, Goldbrunner R, Grosheva M, Angelov DN. Anastomotic patterns of the facial parotid plexus (PP): A human cadaver study. Ann Anat 2017; 213:52-61. [DOI: 10.1016/j.aanat.2017.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
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Saravanam PK, Manimaran V. An unusual position of retromandibular vein: a surgical challenge in parotid surgeries. BMJ Case Rep 2017; 2017:bcr-2017-219562. [PMID: 28578308 DOI: 10.1136/bcr-2017-219562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 44-year-old man presented with swelling in the left parotid region. The swelling was firm and Fine Needle Aspiration Cytology report proved pleomorphic adenoma. In the CT scan, the tumour was confined to the superficial lobe of parotid. So, left superficial parotidectomy was planned. Modified Wilson Blair's incision was used. On course of identifying the facial nerve, a large calibre vein was identified running vertically through the parotid substance. Assuming it as retromandibular vein, further dissection was carried out more meticulously. Marginal mandibularbranch of facial nerve was identified near the angle of mandible and retrograde dissection showed the cervicofacial division running medial to retromandibular vein with the main facial nerve trunk lying unusually medial and posterior to it. Adding to it, the temporofacial division was found 'forked' between the branches of retromandibular vein. These variations in head and neck venous channels are not that rare as we believe. All these variations have an embryological basis. Therefore, knowledge and understanding of this complex anatomy will help us preventing devastating complications like bleeding and facial nerve injury in such cases.
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Affiliation(s)
- Prasanna Kumar Saravanam
- Department of ENT, Head and Neck Surgery, Sri Ramachandra University Medical College, Chennai, Tamil Nadu, India
| | - Vinoth Manimaran
- Department of ENT, Head and Neck Surgery, Sri Ramachandra University Medical College, Chennai, Tamil Nadu, India
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Relations of Facial Nerve With Retromandibular Vein in Human Fetuses. J Craniofac Surg 2017; 28:1096-1098. [PMID: 28145923 DOI: 10.1097/scs.0000000000003415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The relationship of facial nerve (FN) and its branches with the retromandibular vein (RMV) has been described in adults, whereas there is no data in the literature regarding this relationship in fetuses. The study was conducted to evaluate the anatomic relationships of these structures on 61 hemi-faces of fetuses with a mean age of 26.5 ± 4.9 weeks with no visible facial abnormalities. The FN trunk was identified at its emergence at the stylomastoid foramen. It was traced till its ramification within the parotid gland. In 46 sides, FN trunk ramified before crossing RMV and ran lateral to it, while in 8 sides FN trunk ramified on the lateral aspect of the RMV. In 3 sides, FN trunk ramified after crossing the RMV at its medial aspect. In only 1 side, FN trunk trifurcated as superior, middle, and inferior divisions and RMV lied anterior to FN trunk, lateral to superior division, medial to middle and inferior divisions. In 2 sides, FN trunk bifurcated as superior and inferior divisions. Retromandibular vein was located anterior to FN trunk, medial to superior division, lateral to inferior division in both of them. In 1 side, RMV ran medial to almost all branches, except the cervical branch of FN. Variability in the relationship of FN and RMV in fetuses as presented in this study is thought to be crucial in surgical procedures particularly in early childhood.
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Haidar YM, Moshtaghi O, Mahmoodi A, Helmy M, Goddard JA, Armstrong WB. The Utility of In-Office Ultrasound in the Diagnosis of Parotid Lesions. Otolaryngol Head Neck Surg 2017; 156:511-517. [DOI: 10.1177/0194599816687744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To determine whether the use of in-office ultrasound (US) by a head and neck surgeon is a useful adjunct to clinical assessment of parotid lesions and decrease the need of additional imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT). Study Design Case series with chart review. Setting Tertiary care academic center. Subjects Seventy patients presenting with a parotid lesion who obtained an in-office US and ultrasound-guided fine-needle aspiration (USGFNA) from a head and neck surgeon from 2006 to 2015. Methods US images were retrospectively reviewed for 70 patients and characterized by a radiologist and a head and neck surgeon. Results Of the 70 patients, 6 had US characteristics that demonstrated a statistically significant association with a benign/malignant diagnosis: depth from surface; irregular borders; presence of calcifications, which included either micro- or macro-calcifications; posterior echogenicity enhancement; irregular shape; and homogeneous/heterogeneous echotexture. Imaging was performed prior to referral in 25 cases (35.7%); of those, 17 (68%) were for superficial, small (<2 cm) tumors where prereferral imaging studies did not provide additional information to that obtained with US. Of the 55 patients without MRI or CT performed prior to referral, MRI or positron emission tomography–CT scan was obtained in only 4 patients (7.3%) in cases involving recurrent parotid lesions, large tumors, or workup of a malignant neoplasm. Conclusions Several US characteristics individually assist in lesion characterization. In-office US and USGFNA are an appropriate first-line modality in the assessment of parotid lesions, can allow for immediate parotid lesion assessment, and can decrease the need for additional imaging.
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Affiliation(s)
- Yarah M. Haidar
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine Medical Center, Irvine, California, USA
| | | | - Amin Mahmoodi
- Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Mohammad Helmy
- Department of Radiology, University of California, Irvine Medical Center, Irvine, California, USA
| | - Julie A. Goddard
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - William B. Armstrong
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine Medical Center, Irvine, California, USA
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Abstract
The branching pattern of the facial nerve varies among individuals. These variations increase the risk of facial nerve injury during parotid surgery. We report a new variation of the facial nerve and an unusual relationship with the retromandibular vein during parotid surgery.Clinicians should recognize this facial anomaly and the unusual relationship with the retromandibular vein to avoid injuring the facial nerve during parotid surgery.
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Affiliation(s)
- Dong Hoon Lee
- From the Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, South Korea
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Kuan EC, Mallen-St. Clair J, St. John MA. Evaluation of Parotid Lesions. Otolaryngol Clin North Am 2016; 49:313-25. [DOI: 10.1016/j.otc.2015.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Touré G, Anzouan-Kacou E. The styloauricular muscle: clinical relevance and literature review of this rare muscle. Surg Radiol Anat 2016; 38:983-6. [PMID: 26846137 DOI: 10.1007/s00276-016-1633-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 01/18/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE In humans, the styloauricularis is a rare muscle extending from the tragal cartilage of the auricle to the styloid process. When it contracts, by bearing on the styloid process, it increases the cephalo-auricular angle. It can be a landmark for the facial nerve. We report a case with bilateral presence of the styloauricularis. METHODS Bilateral presence of the styloauricularis was discovered during routine dissection of the head and neck. RESULTS In the presented case, styloauricularis muscles arose from the cartilage of the external acoustic meatus on both sides of the head, crossing halfway along the facial nerve trunk and inserting the styloid process. Both muscles were vascularized by a branch of the posterior auricular artery, and innervated by the facial nerve. CONCLUSIONS The ventral auricular muscle, formed by the auricular parotid and the styloauricular muscles, is a muscle that lowers and abducts the auricle in animals. There is generally considered to be no equivalent for these muscles in humans, however, this bilateral case reveals evidence to the contrary. There is a dearth of scientific literature about the styloauricularis. The study of this muscle demonstrated the usefulness of comparative anatomy in understanding its action in increasing the cephalo-auricular angle.
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Affiliation(s)
- Gaoussou Touré
- Department of Maxillofacial Surgery (Head), CHI Villeneuve-Saint-Georges, 40 allée de la source, 94195, Villeneuve-Saint-Georges Cedex, France. .,Research and Development Unit, Imaging and Anatomy (URDIA EA 4465), Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France.
| | - Evelyne Anzouan-Kacou
- Department of Maxillofacial Surgery (Head), CHI Villeneuve-Saint-Georges, 40 allée de la source, 94195, Villeneuve-Saint-Georges Cedex, France.,Department of Stomatology and Maxillofacial Surgery, CHU de Treichville, Abidjan, Ivory Coast
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Skin reference point for the zygomatic branch of the facial nerve innervating the orbicularis oculi muscle (anatomical study). Surg Radiol Anat 2012; 35:259-62. [DOI: 10.1007/s00276-012-1023-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 09/12/2012] [Indexed: 12/11/2022]
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Domenick NA, Johnson JT. Parotid tumor size predicts proximity to the facial nerve. Laryngoscope 2011; 121:2366-70. [DOI: 10.1002/lary.22335] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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