Zoulamoglou Menelaos, Zarokosta Maria, Kaklamanos Ioannis, Piperos Τheodoros, Flessas Ioannis, Kakaviatos Dimosthenis, Kalles Vasileios, Bonatsos Vasileios, Sgantzos Markos, Mariolis-Sapsakos Theodoros
University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece.
University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece; Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece.
Int J Surg Case Rep. 2017;41:124-127. doi: 10.1016/j.ijscr.2017.10.006. Epub 2017 Oct 10.
Identification and preservation of the facial nerve (FN) is a major challenge when performing parotidectomy. Anatomic variations of the relation between the FN and the retromandibular vein (RMV) pose a high risk of nerve injury and bleeding during the operation.
An unusual anatomic variation of the relation between the FN and the RMV was unexpectedly detected during superficial parotidectomy. The operation was uneventful. A meticulous review of the recent literature was conducted as well.
Variations of the relation between the FN and the RMV are mainly identified during the operation, since when performing parotidectomy, surgeons typically detect all the FN branches by locating the RMV. Such kind of variations, are not as rare as considered and their presence complicates parotid surgery and increases the potentiality of nerve injury and hemorrhage.
Surgeons' deep knowledge and perpetual awareness concerning the probable anatomic variations of the relation between the FN and the RMV combined with detailed exposure of the operative field and of the relationship between these adjacent anatomical structures lead to safe parotid surgery.
在进行腮腺切除术时，识别和保留面神经（FN）是一项重大挑战。面神经与下颌后静脉（RMV）之间关系的解剖变异在手术期间造成神经损伤和出血的高风险。
在浅叶腮腺切除术中意外发现了面神经与下颌后静脉之间关系的一种不寻常解剖变异。手术过程顺利。同时对近期文献进行了细致回顾。
面神经与下颌后静脉之间关系的变异主要在手术中被识别，因为在进行腮腺切除术时，外科医生通常通过定位下颌后静脉来检测所有面神经分支。这类变异并不像认为的那样罕见，它们的存在使腮腺手术复杂化，并增加了神经损伤和出血的可能性。
外科医生对面神经与下颌后静脉之间关系可能存在的解剖变异有深入了解并始终保持警惕，再加上对手术区域以及这些相邻解剖结构之间关系的详细显露，可实现安全的腮腺手术。
