Agarwal Ashish Chandra, Srivastava Anitya, Gupta Tejaswi, Agarwal Ashish Chandra
Department of ENT. Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010 India.
Department Of Otorhinolaryngology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010 India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1806-1812. doi: 10.1007/s12070-023-03750-0. Epub 2023 Apr 8.
Facial nerve is responsible for the facial expressions and its preservation during parotidectomy is an important aspect for the operating surgeon. The nerve has a long course and the terminal part traverses through the parotid gland. The branching pattern of the nerve within the gland is highly complex and variable, making parotidectomy a challenging surgery. A cross-sectional record based study was conducted in a tertiary care hospital of a medical college in north India between November 2020 and December 2021 with an aim to describe the branching pattern of the facial nerve within the parotid gland. Patients of all age groups and both genders who underwent superficial parotidectomy for benign parotid gland tumors were taken into consideration. The branching pattern of the nerve was observed and recorded. Twenty patients were included in the study. In seventy percent cases the nerve divided into two main branches whereas in the rest, three branches emerged. In sixty five percent cases, the upper division (temporofacial) further divided into two branches whereas in rest it divided into three. The lower division (cervicofacial) divided into two subdivisions in majority of the cases. Multiple communications were found in the branches given off from the upper division and buccal branch had the most variable origin. A knowledge of branching pattern and the communications between the branches of facial nerve helps in avoiding an iatrogenic injury during parotidectomy and preserving the nerve function.
面神经负责面部表情，在腮腺切除术中保留面神经是外科医生的一个重要方面。面神经行程较长，其终末部分穿过腮腺。面神经在腮腺内的分支模式高度复杂且多变，这使得腮腺切除术成为一项具有挑战性的手术。2020年11月至2021年12月期间，在印度北部一所医学院的三级护理医院进行了一项基于横断面记录的研究，旨在描述面神经在腮腺内的分支模式。纳入了所有年龄组和性别的因腮腺良性肿瘤接受浅叶腮腺切除术的患者。观察并记录面神经的分支模式。该研究纳入了20例患者。在70%的病例中，面神经分为两个主要分支，其余病例中则出现三个分支。在65%的病例中，上支（颞面支）进一步分为两个分支，其余病例中则分为三个分支。下支（颈面支）在大多数病例中分为两个亚分支。在上支发出的分支中发现了多个交通支，颊支的起源变化最大。了解面神经的分支模式及其分支之间的交通支有助于在腮腺切除术中避免医源性损伤并保留神经功能。
