Intraparotidal branching patterns of the facial nerve and it’s surgical significance

Year 2024, Volume: 29 Issue: 3, 329 - 335, 23.09.2024

Kamil Gokce Tulacı

https://doi.org/10.21673/anadoluklin.1471734

Abstract

Aim: The aim of this study is to investigate the intraparotidal branching patterns, anastomoses, and anatomical variations of the facial nerve and to emphasize the surgical importance of branching patterns.

Methods: This study included patients who underwent total or superficial parotidectomy for parotid mass between 2018 and 2023 and had available photographs taken at the end of the surgery showing the intraparotid facial nerve course from the main trunk. Classification of facial nerve branching and anastomosis was performed according to the classification of Katz and Catalano and analyzed accordingly.

Results: Forty-eight patients who met the inclusion criteria were included in the study. 18 of the patients were women and 30 were men. The average age of the patients was 57.37. When facial nerve branching patterns were analyzed, the most common branching pattern was type 1 (41.6%). The second most common branching pattern was type 2 (27.08%). Type 3 branching pattern was seen in 20.83% of the patients and type 4 was seen in 6.25% of the patients. The least common type was type 5 (4.16%).

Conclusion: This is the first study in our country to investigate the intraparotidal branching pattern of the facial nerve in adults. As a result of the study, it was observed that the most common branching pattern was type 1. It is thought that surgeons dealing with the parotid gland may benefit from being familiar with intraparotid facial nerve branching patterns in order to perform a successful and uncomplicated surgery.

Keywords

Facial nerve, parotid region, facial nerve diseases

Fasiyal sinirin intraparotidal dallanma paternleri ve cerrahi önemi

Abstract

Amaç: Bu çalışmanın amacı fasiyal sinirin intraparotidal dallanma paternlerini, anastomozlarını ve anatomik varyasyonlarını araştırmak ve dallanma paternlerinin cerrahi önemini vurgulamaktır.

Yöntemler: Bu çalışmaya 2018-2023 yılları arasında parotis kitlesi nedeniyle total veya yüzeyel parotidektomi uygulanan ve ameliyat sonunda intraparotidal fasiyal sinirin ana trunkustan itibaren seyrini gösteren fotoğrafları mevcut olan hastalar dâhil edildi. Hastaların fasiyal sinir dallanma ve anastomoz sınıflaması Katz ve Catalano’nun sınıflamasına göre yapıldı ve buna göre analiz edildi.

Bulgular: Çalışmaya dâhil edilme kriterlerini sağlayan 48 hasta dâhil edildi. Hastaların 18 tanesi kadın, 30 tanesi erkek idi. Hastaların yaş ortalaması 57,37 idi. Fasiyal sinir dallanma paternleri analiz edildiğinde en sık olan dallanma paterninin tip 1 olduğu görülmüştür (%41,6). İkinci sıklıkta ise tip 2 (%27,08) dallanma paterni görülmüştür. Tip 3 dallanma hastaların % 20,83’ünde, tip 4 ise hastaların %6,25’inde görülmüştür. En az görülen tipin ise tip 5 dallanma paterni olduğu bulunmuştur (%4,16).

Sonuç: Bu çalışma ülkemizdeki erişkinlerde yapılan, kadavra çalışması olmayan ve fasiyal sinirin intraparotidal dallanma paternini araştıran ilk çalışmadır. Çalışma sonucunda en sık görülen dallanma paterninin tip 1 dallanma paterni olduğu görülmüştür. Parotis bezi cerrahisi ile uğraşan hekimlerin fasiyal sinir intraparotidal dallanma paternlerine hâkim olmasının, başarılı ve komplikasyonsuz bir cerrahi gerçekleştirilebilmesi için önemli olabileceği düşünülmüştür.

Keywords

Fasiyal sinir, parotis bölgesi, fasiyal sinir hastalıkları

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