The clinical significance of the various anastomotic branches of the facial nerve. Report of 100 patients.

During parotid dissection, we have found significant variations in the facial nerve branchings that have not been previously reported. One hundred patients, 48 males and 52 females, had their facial nerve photographed and/or diagrammed during parotid surgery. Ninety-nine patients had facial nerve configurations that could be divided into five main types. One nerve could not be classified into any of these types because of a bizarre configuration. Twenty-four percent of patients had a straight branching pattern (type I); 14% of patients had a loop involving the zygomatic division (type II); 44% of patients had a loop involving the buccal division (type III); 14% of patients had a complex pattern with multiple interconnections (type IV); and 3% of patients had two main trunks, one major and one minor (type V). Familiarity with these common variations in facial nerve anatomy is an absolute necessity for the operating surgeon.