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Morphological evaluation of terminal branches of the facial nerve within the parotid gland in fetus cadavers

Year 2019, Volume: 44 Issue: 2, 509 - 516, 30.06.2019
https://doi.org/10.17826/cumj.440731

Abstract

Purpose: The aim of present study was to describe the branching pattern of the facial nerve according to interconnections between the branches, to examine the number of terminal branches, to determine anatomical variations and to emphasize the importance of these in terms of pediatric parotid surgery.

Materials and Methods: Thirty-two parotid regions from eight female and eight male fetus cadavers (gestational ages between 21.0 and 35.5 weeks according to foot lengths) were dissected. The branching pattern of the facial nerve, terminal branch numbers and interconnections between the branches were examined and described.  In present study, the facial nerve was classified using Davis et al.’ classification. But, we encountered interconnections between facial nerve branches that were not mentioned previously and the branching patterns formed by these interconnections were named as Type x and Type y.

Results: Out of the total 32 cases, 13 (40.63 %) were Type I, 7 (21.88 %) were Type II, 3 (9.38 %) were Type III and 5 (15.63 %) were Type VI. Type IV and Type V were not encountered. Type x were in 2 (6.25 %) cases and Type y were in 2 (6.25 %) cases. The mean total number of nerve terminal branches was 7.90 ± 1.49.

Conclusion: Investigation outcomes presented in this study have defined branching pattern and anatomical variations of the facial nerve branches and can be assist with the protection of the nerve during surgical procedures and prevent surgery-associated damage to the nerve, and thus facial paralysis.


References

  • References
  • 1) Gasser RF. The early development of the parotid gland around the facial nerve and its branches in man. Anat Rec. 1970; 167:63-77.
  • 2) Cannon CR, Replogle WH, Schenk MP. Facial nerve in parotidectomy: a topographical analysis. Laryngoscope. 2004; 114:2034-2037.
  • 3) Greyling LM, Glanvill R, Boon JM, Schabort D, Meiring JH, Pretorius JP et al. Bony landmarks as an aid for intraoperative facial nerve identification. Clinical Anatomy. 2007; 20:739-744.
  • 4) Kim D, Nam S, Nam Y, Lee K, Chung R, Han S. The marginal mandibular branch of the facial nerve in Koreans. Clinical Anatomy. 2009; 22:207-214.
  • 5) Farahvash MR, Yaghoobi A, Farahvash B, Farahvash Y, Abiyaneh SH. The extratemporal facial nerve and its branches: analysis of 42 hemifacial dissections in fresh Persian (Iranian) cadavers. Aesthetic Surgery Journal. 2012; 33:201-208.
  • 6) Katz AD, Catalano P. The clinical significance of the various anastomotic branches of the facial nerve. Arch Otolaryngol Head Neck Surg. 1987; 113:959-962.
  • 7) De Ru JA, Van Benthem PPG, Bleys RLAW, Lubsen H, Hordijk G. Landmarks for parotid gland surgery. The Journal of Laryngology and Otology. 2001; 115:122-125.
  • 8) Farrior JB, Santini H. Facial nerve identification in children. Otolaryngology Head and Neck Surgery. 1985; 93:173-176.
  • 9) Gardetto A, Kovacs P, Piegger J, Rainer C, Meirer R, Piza-Katzer H. Direct coaptation of extensive facial nerve defects after removal of the superficial part of the parotid gland: an anatomic study. Head and Neck. 2002; 24:1047-1053.
  • 10) Davis RA, Anson BJ, Budinger JM, Kurth LRE. Surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial halves. Surgery, Gynecology and Obstetrics. 1956; 4:385-412.
  • 11) Alkan S, Seven H, Şan B, Turgut S. Erişkinlerde fasiyal sinirin parotis bezi içindeki dallanma paterni ve retromandibüler venle ilişkisinin incelenmesi. Turkish Archives of Otolaryngology. 2002; 40:48-52.
  • 12) Tzafetta K, Terzis JK. Essays on the facial nerve: part I. microanatomy. Plastic and Reconstructive Surgery. 2010; 125:879-889.
  • 13) Bernstein L, Nelson RH. Surgical anatomy of the extraparotid distribution of the facial nerve. Arch Otolaryngol. 1984; 110:177-183.
  • 14) Sekercioglu N. Problems and solutions involving the facial nerve in parotid gland surgery. Turkiye Klinikleri J Surg Med Sci. 2007; 3:37-41.
  • 15) Park IY, Lee ME. A morphological study of the parotid gland and the peripheral branches of the facial nerve in Koreans. Yonsei Medical Journal. 1977; 18:45-51.
  • 16) Mercer BM, Sklar S, Shariatmadar A, Gillieson MS, D’Alton ME. Fetal foot lenght as a predictor of a gestational age. Am J Obstet Gynecol. 1987; 156:350-355.
  • 17) Kitamura T, Yamazaki H. The distribution of the facial nerve in the parotid gland. Jap J Otol. 1958; 61:141-144.
  • 18) Gataa IS, Faris BJM. Patterns and surgical significance of facial nerve branching within the parotid gland in 43 cases. Oral Maxillofac Surg. 2016; 20: 161-165.
  • 19) Kopuz C, Turgut S, Yavuz S, Ilgi, S. Distribution of facial nerve in parotid gland: analysis of 50 cases. Okajimas Folia Anat Jpn. 1994; 70:295-300.
  • 20) Ekinci N. A study on the branching pattern of the facial nerve of children. Acta Anat Nippon. 1999; 74:447-450.
  • 21) Kwak HH, Park HD, Youn KH, Hu KS, Koh KS, Han SH et al. Branching patterns of the facial nerve and its communication with the auriculotemporal nerve. Surgical and Radiologic Anatomy. 2004; 26:494-500.
  • 22) Ishikawa Y. An anatomical study on the distribution of the temporal branch of the facial nerve. J Cranio-Max-Fac Surg. 1990; 18:287-292.
  • 23) Schmidt BL, Pogrel MA, Hakim-Faal Z. The course of the temporal branch of the facial nerve in the periorbital region. J Oral Maxillofac Surg. 2001; 59:178-184.
  • 24) Hwang K, Cho HJ, Chung IH. Pattern of the temporal branch of the facial nerve in the upper orbicularis oculi muscle. The Journal of Craniofacial Surgery. 2004; 15:373-376.
  • 25) Dingman RO, Grabb WC. Surgical anatomy of the mandibular ramus of the facial nerve based on the dissection of 100 facial halves. Plastic and Reconstructive Surgery. 1962; 29:266-272.
  • 26) Basar R, Sargon MF, Tekdemir Y, Elhan A. The marginal mandibular branch of the facial nerve. Surgical and Radiologic Anatomy. 1997; 19:311-314.
  • 27) Woltmann M, Faveri R, Sgrott EA. Anatomosurgical study of the marginal mandibular branch of the facial nerve for submandibular surgical approach. Braz Dent J. 2006; 17:71-74.
  • 28) Saylam C, Ucerler H, Orhan M, Uckan A, Ozek C. Localization of the marginal mandibular branch of the facial nerve. The Journal of Craniofacial Surgery. 2007; 18:137-142.
  • 29) Schwember G, Rodriguez A. Anatomic surgical dissection of the extraparotid portion of the facial nerve. Plastic and Reconstructive Surgery. 1988; 81:183-188.
  • 30) Erbil KM, Uz A, Hayran M, Mas N, Senan S, Tuncel M. The relationship of the parotid duct to the buccal and zygomatic branches of the facial nerve; an anatomical study with parameters of clinical interest. Folia Morphol. 2007; 66:109-114.

Fetus kadavralarında parotid bez içerisindeki fasiyal sinirin terminal dallarının morfolojik değerlendirilmesi

Year 2019, Volume: 44 Issue: 2, 509 - 516, 30.06.2019
https://doi.org/10.17826/cumj.440731

Abstract

Amaç:Bu çalışma fasiyal
sinirin dallanma şeklini dalları arasındaki bağlantılara göre tanımlamak, terminal
dal sayısını incelemek, anatomik varyasyonlarını belirlemek ve parotid
cerrahisi açısından önemini vurgulamak için yapılmıştır.

Gereç ve Yöntem:8 kadın ve 8 erkek fetus kadavrasının (ayak
uzunluklarına göre, yaşları 21.0 ile 35.5 gestasyonel hafta arasında) 32
parotid bölgesi diseke edildi. Fasiyal sinirin dallanma şekli, terminal dal
sayısı ve dalları arasındaki bağlantılar incelendi, tanımlandı. Bu çalışmada,
fasiyal sinir Davis ve ark.’nın sınıflandırmasına göre sınıflandırıldı. Fakat,
fasiyal sinirin dalları arasında daha önce bahsedilmeyen bağlantılarla
karşılaşıldı ve bu bağlantıların oluşturduğu dallanma şekilleri Tip x ve Tip y
olarak adlandırıldı.
  

Bulgular:Davis ve ark.’nın sınıflandırmasına göre, 32 vakanın 13
(%40.63)’ü Tip I, 7 (%21.88)’si Tip II, 3 (%9.38)’ü Tip III ve 5 (%15.63)’I Tip
VI idi. Tip IV ve Tip V tanımlanmadı. Tip x, 2 (%6.25) vakada ve Tip y de 2
(%6.25) vakada tanımlandı. Fasiyal
sinirin terminal dallarının ortalama sayısı
7.90 ± 1.49
(6-11) idi.

Sonuç:Çalışmadan elde
edilen araştırma sonuçları fasiyal sinirin dallanma şeklini ve anatomik
varyasyonlarını tanımlayarak cerrahi müdahalelerde sinirin korunmasına yardımcı
olabilir, cerrahi ile ilişkili sinir hasarını ve dolayısıyla da fasiyal
paraliziyi önleyebilir.

References

  • References
  • 1) Gasser RF. The early development of the parotid gland around the facial nerve and its branches in man. Anat Rec. 1970; 167:63-77.
  • 2) Cannon CR, Replogle WH, Schenk MP. Facial nerve in parotidectomy: a topographical analysis. Laryngoscope. 2004; 114:2034-2037.
  • 3) Greyling LM, Glanvill R, Boon JM, Schabort D, Meiring JH, Pretorius JP et al. Bony landmarks as an aid for intraoperative facial nerve identification. Clinical Anatomy. 2007; 20:739-744.
  • 4) Kim D, Nam S, Nam Y, Lee K, Chung R, Han S. The marginal mandibular branch of the facial nerve in Koreans. Clinical Anatomy. 2009; 22:207-214.
  • 5) Farahvash MR, Yaghoobi A, Farahvash B, Farahvash Y, Abiyaneh SH. The extratemporal facial nerve and its branches: analysis of 42 hemifacial dissections in fresh Persian (Iranian) cadavers. Aesthetic Surgery Journal. 2012; 33:201-208.
  • 6) Katz AD, Catalano P. The clinical significance of the various anastomotic branches of the facial nerve. Arch Otolaryngol Head Neck Surg. 1987; 113:959-962.
  • 7) De Ru JA, Van Benthem PPG, Bleys RLAW, Lubsen H, Hordijk G. Landmarks for parotid gland surgery. The Journal of Laryngology and Otology. 2001; 115:122-125.
  • 8) Farrior JB, Santini H. Facial nerve identification in children. Otolaryngology Head and Neck Surgery. 1985; 93:173-176.
  • 9) Gardetto A, Kovacs P, Piegger J, Rainer C, Meirer R, Piza-Katzer H. Direct coaptation of extensive facial nerve defects after removal of the superficial part of the parotid gland: an anatomic study. Head and Neck. 2002; 24:1047-1053.
  • 10) Davis RA, Anson BJ, Budinger JM, Kurth LRE. Surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial halves. Surgery, Gynecology and Obstetrics. 1956; 4:385-412.
  • 11) Alkan S, Seven H, Şan B, Turgut S. Erişkinlerde fasiyal sinirin parotis bezi içindeki dallanma paterni ve retromandibüler venle ilişkisinin incelenmesi. Turkish Archives of Otolaryngology. 2002; 40:48-52.
  • 12) Tzafetta K, Terzis JK. Essays on the facial nerve: part I. microanatomy. Plastic and Reconstructive Surgery. 2010; 125:879-889.
  • 13) Bernstein L, Nelson RH. Surgical anatomy of the extraparotid distribution of the facial nerve. Arch Otolaryngol. 1984; 110:177-183.
  • 14) Sekercioglu N. Problems and solutions involving the facial nerve in parotid gland surgery. Turkiye Klinikleri J Surg Med Sci. 2007; 3:37-41.
  • 15) Park IY, Lee ME. A morphological study of the parotid gland and the peripheral branches of the facial nerve in Koreans. Yonsei Medical Journal. 1977; 18:45-51.
  • 16) Mercer BM, Sklar S, Shariatmadar A, Gillieson MS, D’Alton ME. Fetal foot lenght as a predictor of a gestational age. Am J Obstet Gynecol. 1987; 156:350-355.
  • 17) Kitamura T, Yamazaki H. The distribution of the facial nerve in the parotid gland. Jap J Otol. 1958; 61:141-144.
  • 18) Gataa IS, Faris BJM. Patterns and surgical significance of facial nerve branching within the parotid gland in 43 cases. Oral Maxillofac Surg. 2016; 20: 161-165.
  • 19) Kopuz C, Turgut S, Yavuz S, Ilgi, S. Distribution of facial nerve in parotid gland: analysis of 50 cases. Okajimas Folia Anat Jpn. 1994; 70:295-300.
  • 20) Ekinci N. A study on the branching pattern of the facial nerve of children. Acta Anat Nippon. 1999; 74:447-450.
  • 21) Kwak HH, Park HD, Youn KH, Hu KS, Koh KS, Han SH et al. Branching patterns of the facial nerve and its communication with the auriculotemporal nerve. Surgical and Radiologic Anatomy. 2004; 26:494-500.
  • 22) Ishikawa Y. An anatomical study on the distribution of the temporal branch of the facial nerve. J Cranio-Max-Fac Surg. 1990; 18:287-292.
  • 23) Schmidt BL, Pogrel MA, Hakim-Faal Z. The course of the temporal branch of the facial nerve in the periorbital region. J Oral Maxillofac Surg. 2001; 59:178-184.
  • 24) Hwang K, Cho HJ, Chung IH. Pattern of the temporal branch of the facial nerve in the upper orbicularis oculi muscle. The Journal of Craniofacial Surgery. 2004; 15:373-376.
  • 25) Dingman RO, Grabb WC. Surgical anatomy of the mandibular ramus of the facial nerve based on the dissection of 100 facial halves. Plastic and Reconstructive Surgery. 1962; 29:266-272.
  • 26) Basar R, Sargon MF, Tekdemir Y, Elhan A. The marginal mandibular branch of the facial nerve. Surgical and Radiologic Anatomy. 1997; 19:311-314.
  • 27) Woltmann M, Faveri R, Sgrott EA. Anatomosurgical study of the marginal mandibular branch of the facial nerve for submandibular surgical approach. Braz Dent J. 2006; 17:71-74.
  • 28) Saylam C, Ucerler H, Orhan M, Uckan A, Ozek C. Localization of the marginal mandibular branch of the facial nerve. The Journal of Craniofacial Surgery. 2007; 18:137-142.
  • 29) Schwember G, Rodriguez A. Anatomic surgical dissection of the extraparotid portion of the facial nerve. Plastic and Reconstructive Surgery. 1988; 81:183-188.
  • 30) Erbil KM, Uz A, Hayran M, Mas N, Senan S, Tuncel M. The relationship of the parotid duct to the buccal and zygomatic branches of the facial nerve; an anatomical study with parameters of clinical interest. Folia Morphol. 2007; 66:109-114.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research
Authors

Canan Ertemoğlu Öksüz 0000-0002-2020-7661

Ahmet Kalaycıoğlu This is me 0000-0002-0031-1971

Özlem Uzun 0000-0002-9875-0605

Şahi Nur Kalkışım 0000-0003-2248-5558

Publication Date June 30, 2019
Acceptance Date October 27, 2018
Published in Issue Year 2019 Volume: 44 Issue: 2

Cite

MLA Ertemoğlu Öksüz, Canan et al. “Morphological Evaluation of Terminal Branches of the Facial Nerve Within the Parotid Gland in Fetus Cadavers”. Cukurova Medical Journal, vol. 44, no. 2, 2019, pp. 509-16, doi:10.17826/cumj.440731.