AVOIDING INJURY TO THE ZYGOMATIC AND TEMPORAL BRANCHES OF THE FACIAL NERVE. ANATOMICAL LANDMARKS FOR SAFE SURGERY

Authors: Victor-Vlad COSTAN, Mihai-Liviu CIOFU, Andrei NICOLAU, Daniela ŞULEA, Eugenia POPESCU

Abstract:

The integrity of the temporal and zygomatic branches of the facial nerve is essential for the functionality of the periorbital area, since they supply motor fibers to the periocular muscles, particularly the orbicularis oculi. The branches are vulnerable to injury due to post-traumatic lacerations in the temporo-zygomatic region, but also during surgery, for the removal of malignant or benign tumors of the area, reconstructive procedures, plastic surgery interventions, temporomandibular joint surgery, as well as surgery for cranio-facial anomalies or surgical treatment of zygomatic bone fractures. Numerous authors have attempted at defining the areas of safety or increased risk of facial nerve injury, but there are inconsistencies in the existing literature, due to differences in the terminology of the anatomic layers, in the level of dissection and variability of the structures used as landmarks. The purpose of this paper is to gather and structure the relevant existing information regarding the anatomical landmarks that allow avoidance of injury to the temporal and zygomatic branches of the facial nerve, and to corelate the findings with applications during specific high-risk surgical procedures.

Keywords:
  • anatomic landmark
  • dissection
  • facial nerve
  • injury
  • orbicularis oculi.
  • temporal
  • zygomatic