Relationship between buccal branches of the facial nerve, parotid duct, buccal fat pad and Zuker’s point

Objectives: The aim of this study was to determine the relationship of the buccal branches of the facial nerve with the parotid duct, the buccal fat pad and the Zuker’s point, and reveal the incidence of the neural communications of buccal branch with the zygomatic and marginal mandibular branches of the facial nerve. Methods: Fifteen formalin-fixed cadaveric heads (8 females and 7 males) with a mean age of 73.93±14.42 years were dissected bilaterally to reveal the buccal, zygomatic and marginal mandibular branches of the facial nerve, the parotid duct and the buccal fat pad. Positional relationships of these structures and the anatomical features of buccal and zygomatic branches were evaluated. Results: The mean number of buccal and zygomatic branches was 2.40±0.62 and 1.90±0.60 respectively. Buccal branches crossed the parotid duct in 67%, formed a plexus along the parotid duct in 27% and coursed superior or inferior to the parotid duct without crossing in 6% of the dissected specimens. The mean number of intersection points of buccal branches on parotid duct was 4.03±1.03. Parotid duct crossed along the superior border of buccal fat pad in 66%, deep to buccal fat pad in 27% and between the superior and inferior lobes of buccal fat pad in 7%. Buccal branches crossed superficial to buccal fat pad in 80% and some branches passed superficial and through the buccal fat pad in 20%. Conclusion: It is essential to know the positional interrelations of the buccal branches of the facial nerve with the parotid duct and buccal fat pad for clinical implications. The relation of Zuker’s point with zygomatic and buccal branches and with parotid duct should not be overlooked.

A cadaveric study on the buccal branch of facial nerve - origin and its relation pattern to the parotid duct

Background : The knowledge of anatomy of facial nerve and its terminal branches is important for the successful outcome in facial surgeries. The buccal branch of facial nerve due to its characteristic variations in origin and diverse relationship with the parotid duct can be easily injured during parotid duct surgery, parotidectomy or face lift operations. An operating surgeon would find it helpful if the course of buccal branch especially in relation to parotid duct is studied Aim : To describe the origin, course and number of buccal branches of facial nerve and its pattern of relation with the parotid duct. Materials & Methods : The study was done in 100 cadaveric cranial halves including fetuses. The buccal branch was observed for its origin and course. The relationship of buccal branch to the parotid duct was noted and classified accordingly. Results: Buccal branch originated from the lower trunk of facial nerve in 68 % and from the upper trunk in 28% while the two trunks contributed to the origin in 4%. The buccal branch passed inferior to parotid duct in 41% and superior to duct in 25%. In 28%, buccal branch formed a plexus over the duct along with other branches. In 6%, there were two branches, one passed superior and the other passed inferior to the parotid duct. Conclusion: The knowledge regarding the variations of buccal branch of facial nerve can be a surgeon's guide during facial surgeries.

A case of myoepithelioma arising in an accessory parotid gland

The present paper describes the first reported case, to our knowledge, of a myoepithelioma arising in an accessory parotid gland. Because pre-operative fine-needle aspiration cytological findings and operative findings suggested that this tumour was malignant, the decision was made to remove the tumour surgically along with the buccal branches of the facial nerve. The resected nerve was reconstructed by nerve transplantation, using the great auricular nerve. Subsequently the tumour was found to be benign. One year after surgery, the patient had excellent facial nerve function and so far there has been no evidence of recurrence.

Experimental studies on traumatic facial nerve injury

Purpose The purpose of this study was to investigate the outcome of different injuries to the facial nerve.Materials and methods Six patterns of injuries (exposure, compression, crushing, stretching, division and post-division anastomosis) were produced in the buccal branches of the facial nerve in 60 rabbits. Electroneuronography (ENoG) and histology at definite time were used to evaluate the results.Results and conclusions Exposure and compression injuries produced a neuropraxic injury and rapid recovery. Crushing and stretching injuries resulted in axonotmesis and whilst complete recovery can take place it may be very slow. Division and post-division anastomosis fall into neurotmesis injury and do not completely recover within six months; the former recovers slower and later than the latter.