Horizontal branch of the supraorbital nerve and temporal branch of the facial nerve

The aim of this article is to describe anatomical detail of the course and territory of the horizontal branch of the supraorbital nerve, which connects with temporal branch of the facial nerve. Eighteen hemifaces of Korean cadavers (11 male, 7 female) fixed in 10% formaldehyde solution were dissected. All 18 specimens had horizontal branch of the supraorbital nerve. The horizontal branch emerges out of the supraorbital foramen, runs upward about 12 mm, and then turns laterally at an angle of 104.7 degrees toward the end of the eyebrow. The average number of horizontal branches was 1.7 +/- 0.8. The skin boundary supplied by the horizontal branch was a circle with a diameter of 30 mm. The center was located at 30 mm lateral to the supraorbital foramen and 12 mm above. Grossly, the horizontal branch of the supraorbital nerve connected with the temporal branch of the facial nerve in 8 of 18 (44%) specimens. Microscopically, both nerve branches had common epineurium, but the perineuria were separated. The horizontal branch of the supraorbital nerve is in touch with the temporal branch of the facial nerve, and there are actual connections between them in 44% of cases.     

An anatomical study on the distribution of the temporal branch of the facial nerve

In an attempt to define the distribution of the temporal branch of the facial nerve, 30 facial halves of 15 Japanese cadavers were dissected. The tissue plane in which the temporal branch ran was investigated and the relationship between this nerve and the surrounding tissues observed. To quantify the distribution, the distance from the bony lateral canthus (LC) to the points where the temporal branches crossed two standard lines, (L1 and L2) were measured. These latter were determined according to the skeletal landmarks. The temporal branch consistently lay along the undersurface of the temporoparietal fascia. But its depth below the skin was not constant because the amount of overlying adipose tissue varied and it was localized within a limited area. The temporal branch generally branched into 3 or 4 rami and its trajectory was either straight or curved, depending on the relationship between the middle and the posterior ramus. The distances from LC to each point were relatively constant and there was no difference between the right and the left side. It is important for surgeons to know the quantified course of the temporal branches based on the skeletal landmarks. As a consequence of the quantification, it was possible to establish new guidelines for protection of the entire temporal branch from surgical injury.     

Pseudoaneurysm of the superficial temporal artery

A 15-year-old boy developed a superficial temporal artery pseudoaneurysm as a result of blunt trauma to the left temporal area. The diagnosis was based on the ultrasonographic appearance. The left temporal region was explored, and haemostasis resulted in complete resolution of the swelling.     

Pattern of the temporal branch of the facial nerve in the upper orbicularis oculi muscle

The purpose of this study is to clarify a pattern of the temporal branch of the facial nerve in the upper orbicularis oculi muscle (OOM) and an impact in exploiting the frontalis myofascial advancement flap. The authors investigated the pattern of the temporal branch of the facial nerve in the upper OOM in 20 cadavers. The highest and lowest level of the nerve coursing into the OOM were measured at three different sagittal/vertical planes through the lateral canthus, midpalpebral fissure, and medial canthus, respectively. The authors designate a hazard zone that delineates a circle with 1.0-cm diameter and its center located inferiorly and laterally in the direction of -15 degrees 7.5 cm from the lateral canthus. The highest level of the those twigs that entered OOM on the X-axis and Y-axis with the origin of lateral canthus is +2.51 +/- 0.23 cm, +2.70 +/- 0.35 cm, and the lowest is 0 cm, +2.68 +/- 0.32 cm, respectively. The highest level of the those twigs on the Y-axis with the origin of lateral canthus, mid-palpebral fissure, and medial canthus is +3.47 +/- 0.27 cm, +3.49 +/- 0.45 cm, and +2.97 +/- 0.35 cm, and the lowest is +1.62 +/- 0.12 cm, +1.82 +/- 0.17 cm, and +1.63 +/- 0.22 cm, respectively. Those twigs of the temporal branch of the facial nerve coursed horizontally along the fibers of OOM with interconnections but did not cross over the superior orbital rim. The authors describe details of the temporal branch of the facial nerve in the OOM and designate a hazard zone, wherein the temporal branch should be spared. They also assure that injury of the temporal branch of the facial nerve is inevitable in the procedure of the frontalis myofascial advancement flap.     

The course of the temporal branch of the facial nerve in the periorbital region.

PURPOSE: This study identified the terminal temporal and zygomatic branches of the facial nerve as they enter the orbicularis oculi muscle and related these branches to identifiable surface markings. MATERIALS AND METHODS: The temporal and zygomatic branches of the facial nerve were dissected from 5 preserved cadavers (10 sides). The most superior temporal branch entering the orbicularis oculi muscle was identified and related to the lateral canthus of the eye. A vertical line was passed through this point so that the line was equidistant from the nasal tip and chin point. A line perpendicular to the vertical line through the lateral canthus served as the horizontal scale. Vertical and horizontal lines through the lateral canthus were used to establish the anatomic relationship between the lateral canthus and the branch of the temporal nerve entering the orbicularis oculi muscle. RESULTS: The temporal branch was an average of 2.85 +/- 0.69 cm superior to the lateral canthus and an average of 2.54 +/- 0.43 cm lateral to the lateral canthus as it courses into the orbicularis oculi muscle. At the lateral border of the orbicularis oculi muscle, where the temporal and zygomatic nerves insert into the muscle, the mean vertical distance between the temporal and zygomatic nerves was 1.72 +/- 0.62 cm. CONCLUSION: Incisions superior or inferior and parallel to the course of the facial nerve, can provide access to the fronto zygomatic suture and the superior and lateral orbit without damaging its branches.     

Traumatic pseudoaneurysm of the superficial temporal artery

Pseudoaneurysm of the superficial temporal artery is rare. It is typically caused by blunt force to the temporal region, and presents as a painless, preauricular, pulsatile mass during the following weeks. We think that its infrequent incidence and unusual presentation warrants an increase in awareness to aid accurate and timely diagnosis. We present a case that developed a few weeks after a head injury, and its subsequent management.     

Relation of mental nerve with mandibular branch of the facial nerve

The aim of this study is to elucidate the detailed anatomical relation of mental nerve with marginal mandibular branch of the facial nerve. Twenty-three hemi-faces of adult Korean cadavers (11 Male and 7 female) were dissected. All locations of crossing (C) of marginal mandibular branch of the facial nerve and mental nerve were measured below the inferior verge of the lower vermillion (V): a vertical distance (V-Gn) between V and gnathion (Gn) and horizontal distance (V-OC) between V and oral commissure (OC). The mental foramen located at 19.8 +/- 4.4 mm below the inferior verge of the lower vermillion (V) and 34.3 +/- 5.2 mm laterally from the midline. In all specimens there were found interconnections between marginal mandibular branch of the facial nerve and mental nerve. The number of connecting site was 8.26 +/- 2.49. Microscopically, both of the nerve branches had a common epineurium, but the perineurium separated. V-Gn and the vertical distance between V and the connecting point (C) was in the ratio of approximately 2:1, and V-OC and the horizontal distance from V:C was an equal ratio. The proximity of the mental nerve and marginal mandibular branch of the facial nerve to each other draws an attention as operating the mental area.     

Iatrogenic arteriovenous fistula of the superficial temporal artery

INTRODUCTION: The temporal artery courses superficially over the temporal bone and thus can be vulnerable to trauma. Although traumatic lacerations of this vessel are indeed common, trauma-induced arteriovenous fistulae involving the temporal artery are relatively rare. Arteriovenous fistulae caused by iatrogenic injury to the temporal artery are rarer still. DISCUSSION AND CONCLUSION: We report a case of an ateriovenous fistula involving the superficial temporal artery which developed after surgical repair of trauma to the vessel following a blunt head injury. Ultimately, the lesion was successfully treated with complete excision.     

Localization of the marginal mandibular branch of the facial nerve

The aim of this study was to observe the course of the marginal mandibular branch of the facial nerve (MMBFN) in relation to the inferior border of the mandible and parotid gland and its relevance to surgical procedures such as rhytidectomy and parotid gland surgery. In this study, 50 specimens were dissected. The relationships between the MMBFN and the inferior border of the mandible were recorded and analyzed. We found that posterior to the facial artery, the MMBFN ran above the inferior border of the mandible in 37 (74%) of the specimens. In 11 (22%) specimens, below the inferior border of the mandible it was divided into two branches at the crossing point with the facial artery. In 2 (4%) specimens the MMBFN divided into two branches at the point of emergence from the parotid gland. There were no statistical differences between the left and right sides, and both sexes. The MMBFN is one of the most vulnerable branches to surgical injury because of its location. For this reason, the surgeons who are willing to operate on this area, especially for the rhytidectomies, should have a true knowledge about the anatomy of this branch.     

Conservation of salivary secretion and facial nerve function in partial superficial parotidectomy

Conventional total superficial parotidectomy (TP) has commonly been used, but partial superficial parotidectomy (PP) offers the possibility of better preserving glandular function and avoiding palsy of the facial nerves. In this study, the extent to which saliva secretion and facial nerve function were conserved in patients who received TP vs. PP was compared. Data were collected from patients who received a PP (n = 163) or a TP (n = 105) for benign primary tumours in the superficial lobe of the parotid glands between 1995 and 2009 at a single hospital. The incidence of transient facial paralysis was significantly lower in patients who received PP than in those who received TP. Secretory function was preserved for patients with a conserved Stensen's duct, whereas patients in whom the duct had been ligated lost secretory function. Partial superficial parotidectomy reduces the incidence of postoperative facial nerve dysfunction and is conducive to preserving Stensen's duct and saliva secretion.     

经颞浅动脉灌注氟尿嘧啶和卡铂治疗舌癌

目的探讨术前联合应用氟尿嘧啶、卡铂诱导化疗治疗舌癌的临床效果。方法20例舌癌患者经颞浅动脉插管连续顺序灌注氟尿嘧啶和卡铂,比较化疗前、后原发肿瘤灶的大小,并记录化疗的主要不良反应。结果完全缓解(CR)18例(90%),部分缓解(PR)2例(10%),总有效率(CR+PR)100%;不良反应轻微。结论经颞浅动脉插管灌注氟尿嘧啶和卡铂是治疗舌癌的一种有效方法,不良反应发生率低且轻。     

The risk of damage to facial nerve, superficial temporal vessels, disk, and articular surfaces during arthroscopic examination of the temporomandibular joint

The risk of complications occurring during arthroscopic examination of the temporomandibular joint is not well documented. We therefore performed arthroscopic examinations of the upper compartment of the temporomandibular joint of fresh cadavers and during subsequent dissection studied possible damage to the facial nerve, superficial temporal vessels, disk, and articular surfaces. Damage to the facial nerve was not seen in any joint. The distance between the puncture site and any branch of this nerve was 3 mm or more in all but one of the specimens. The puncture site was repeatedly located immediately adjacent to the superficial temporal vessels, but damage to these vessels was not seen in any case. Scratch marks on the articular surfaces resulting from intra-articular manipulations with the instrument were seen in more than half of the joints. It was concluded that the risk of damage to the facial nerve or the superficial temporal vessels during arthroscopy of the temporomandibular joint is small. There is, however, a risk of damage to the articular surfaces. The frequency of this type of injury can probably be reduced in patients by sufficiently distending the joint before the instrument is inserted.     

护理干预对颞浅动脉置管围管期并发症的影响

目的 研究改良的护理干预方法对因化疗需要行颞浅动脉逆行置管患者的围管期并发症发生率和护理工作效率的影响.方法 纳入2014年1月至2019年12月期间我科使用植入式动脉输液港埋置于颞浅动脉的患者46例,采用随机数字表法分为试验组(n=23)和对照组(n=23).对照组术后采取常规护理方法.试验组患者在对照组基础上接受改...     

腮腺区手术中寻找面神经的新方法——面神经颞面干解剖法

目的：通过对面神经颞面干与面后静脉解剖关系研究，为临床提供解剖学基础。方法：采用成人尸头５具１０侧进行面神经解剖学观察。在临床上并以面后静脉为标志，在寻找、显露、保护面神经的前提下，实施腮腺上极、颞下颌关节及颧面区手术３８例３８侧。结果：４６例面后静脉位于面神经颞面干内侧（９４．７％），仅１例２侧面后静脉位于面神经颞面干外侧。结论：腮腺及耳颞区手术以面后静脉为标志，容易寻找面神经，并可减少并发症。     

Location of the mandibular branch of the facial nerve according to the neck position

ABSTRACT: The aim of this study was to elucidate the exact location of the mandibular branch of the facial nerve according to different neck positions.Twenty-two hemifaces of 11 fresh human cadavers were used (age range, 53-89 y; mean age, 72.3 ± 10.5 y; 8 men and 3 women). Working through skin windows, the distance from the mandibular border to the mandibular branch of the facial nerve (border-nerve distance or BND) was measured at 3 points: (1) the mandible angle (gonion or Go point), (2) the point where the mandibular branch of the facial nerve crosses the facial artery (FA point), and (3) the one-fourth point from the gonion to the menton (1/4 point). Threads were hung on the skin windows along the mandibular border. With the neck in the neutral position and then full flexion (15 degrees), extension (15 degrees), and left and right rotations (30 degrees), the distance of the mandibular branch from the thread of the mandibular border was measured using calipers.In the neutral position, the mandibular branch was 3.50 ± 2.82 mm above the mandibular border at the Go point, 5.34 ± 2.98 mm above the mandibular border at the FA point, and 5.28 ± 1.86 mm above the mandibular border at the 1/4 point. At all 3 points, flexion or extension of the neck did not significantly move the mandibular branch. At the Go point and FA point, there was no significant difference between the ipsilateral rotation position and the contralateral rotation. Yet at the1/4 point, the BND decreased (4.32 ± 2.60 mm) with the neck in ipsilateral rotation and the BND increased (5.97 ± 2.62 mm) with the neck in contralateral rotation. There was a significant difference between the ipsilateral rotation position and the contralateral rotation position (P = 0.020, t-test).Surgeons should keep in mind that at the 1/4 point, the mandibular branch of the facial nerve moves downward 1.10 ± 1.42 mm with the neck in ipsilateral rotation and moves upward 0.49 ± 1.84 mm with the neck in contralateral rotation.