Verma Roshan, Reddy Gontu Gopi Satya Sai, Prakash D N S, Sahni Daisy
Dept. of Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Dept of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Surg Oncol. 2022 Sep;13(3):647-651. doi: 10.1007/s13193-022-01535-5. Epub 2022 Apr 27.
The incidence of facial palsy in parotid surgeries is up to 50% transient and 17% complete facial palsy. Locating facial nerve trunk during parotid surgery can be tricky despite using the standard landmarks. During a cadaveric dissection, we came across a simple technique to identify the trunk of facial nerve which we have also tried to use it in clinical setting and found it to be useful. Parotidectomy was done in 12 cadaveric hemi-faces. The distance between the mastoid tip and the tympanic segment of facial nerve was measured. The distance of the facial nerve and mastoid tip and tympanomastoid suture and facial nerve was measured. The trunk of facial nerve was found to cross the tympanomastoid sulcus-mastoid tip at around 8-10 mm from the mastoid tip in 70% of the cases. We extrapolated this information in 5 cases of parotidectomy in operative setting. We were able to identify facial nerve trunk accurately in 4/5 cases. Imaginary line connecting the mastoid tip and tympanomastoid suture can be used to locate the probable position of the facial nerve trunk reliably during parotidectomy.
腮腺手术中面神经麻痹的发生率高达50%为短暂性，17%为完全性面神经麻痹。尽管使用了标准标志，但在腮腺手术中定位面神经主干仍可能很棘手。在尸体解剖过程中，我们发现了一种识别面神经主干的简单技术，我们也尝试在临床环境中使用它，发现它很有用。对12个尸体半侧面部进行了腮腺切除术。测量了乳突尖与面神经鼓室段之间的距离。测量了面神经与乳突尖、鼓乳缝与面神经之间的距离。在70%的病例中，发现面神经主干在距乳突尖约8 - 10毫米处穿过鼓乳沟-乳突尖。我们将这一信息外推到5例手术中的腮腺切除术。我们能够在4/5的病例中准确识别面神经主干。连接乳突尖和鼓乳缝的假想线可用于在腮腺切除术中可靠地定位面神经主干的可能位置。
