An Anatomicosurgical Study of the Temporal Branch of the Facial Nerve

Ammirati, Mario; Spallone, A; Ma, Jiechao; Cheatham, Mel; Becker, Donald P.

doi:10.1097/00006123-199312000-00012

Cited by 22 publications

(45 citation statements)

References 23 publications

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“…The frontal branch of the facial nerve that supplies the frontal muscle lies in the subgaleal fat pad. 3 To minimize the risk of injury to this nerve, extensive exposure of the subgaleal fat pad should be avoided. The temporal fascia is incised sharply along the inferior margin of the incision.…”

Section: Scalp Flap Elevation and Preservation Of The Frontalmentioning

confidence: 99%

Orbitozygomatic craniotomy

Zabramski¹,

Kırış²,

Sankhla³

et al. 1998

Journal of Neurosurgery

223

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The orbitozygomatic approach provides wide, multidirectional access to the anterior and middle cranial fossae, as well as to the upper third of the posterior fossa and clivus. The authors describe technical details of the surgical approach as it has evolved over 3.5 years of experience in 83 consecutive cases. This modified technique eliminates the need for bone reconstruction of the orbital walls to prevent enophthalmos and minimizes the risk of injury to the frontal branch of the facial nerve. At a follow-up evaluation after a period averaging 14 months, all patients were pleased with the cosmetic results of this approach.

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Section: Scalp Flap Elevation and Preservation Of The Frontalmentioning

confidence: 99%

Orbitozygomatic craniotomy

Zabramski¹,

Kırış²,

Sankhla³

et al. 1998

Journal of Neurosurgery

223

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show abstract

“…One of the possible complications during the soft-tissue dissection is injury to the frontal branch of the facial nerve. [34][35][36][37][38][39][40] However, according to the literature, there is a safe zone for the facial nerve in the area that is 2.5 cm posterior to the lateral canthus of the eye. 36,37,41 Therefore, if the dissection does not pass this limit, the danger posed by possible damage to the frontal branch of the facial nerve is kept to a minimum.…”

Section: Stepwise Dissectionmentioning

confidence: 99%

Pure Endoscopic Lateral Orbitotomy Approach to the Cavernous Sinus, Posterior, and Infratemporal Fossae: Anatomic Study

et al. 2018

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Objective The aim of this anatomic study is to describe a fully endoscopic lateral orbitotomy extradural approach to the cavernous sinus, posterior, and infratemporal fossae. Material and Methods Three prefixed latex-injected head specimens (six orbital exposures) were used in the study. Before and after dissection, a computed tomography scan was performed on each cadaver head and a neuronavigation system was used to guide the approach. The extent of bone removal and the area of exposure of the targeted corridor were evaluated with the aid of OsiriX software (Pixmeo, Bernex, Switzerland). Results The lateral orbital approach offers four main endoscopic extradural routes: the anteromedial, posteromedial, posterior, and inferior. The anteromedial route allows a direct route to the optic canal by removal of the anterior clinoid process, whereas the posteromedial route allows for exposure of the lateral wall of the cavernous sinus. The posterior route is targeted to Meckel's cave and provides access to the posterior cranial fossa by exposure and drilling of the petrous apex, whereas the inferior route gives access to the pterygopalatine and infratemporal fossae by drilling the floor of the middle cranial fossa and the bone between the second and third branches of the trigeminal nerve. Conclusion The lateral orbitotomy endoscopic approach provides direct access to the cavernous sinus, posterior, and infratemporal fossae. Advantages of the approach include a favorable angle of attack, minimal brain retraction, and the possibility of dissection within the two dural layers of the cavernous sinus without entering its neurovascular compartment.

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“…Few key steps have been advocated to expand the virtual cone of exposure, among them is the mobilization of the temporalis muscle. [3][4][5][6] Particular attention has been given to the frontal branch of the facial nerve (FBFN) (also known as the temporal branch or the frontotemporal branch of the facial nerve), as it is the most vulnerable neural structure to be injured during exposure with anterolateral craniotomies. The unpleasant cosmetic outcome caused by frontalis muscle palsy provoked craniofacial surgeons to thoroughly study the unique anatomy of the FBFN and develop safer dissection techniques to preserve the anatomical and functional integrity of the nerve.…”

Section: Introductionmentioning

confidence: 99%

“…Proposed interfascial and subfascial dissection of the deep temporal fascia has reduced the incidence of frontalis muscle palsy; however, injury to the frontal branch still occurs. 5,[7][8][9][10] The anatomical variations in the course of the FBFN above the zygoma both in direction and fascial depth steered the development of other novel approaches. 5,11 In this article, we propose a combined subgaleal/myocutaneous (CSGMC) technique that preserves the integrity of temporal fascial planes with the ultimate goal of minimizing muscle atrophy.…”

Section: Introductionmentioning

confidence: 99%

Combined Subgaleal/Myocutaneous Technique for Temporalis Muscle Dissection

et al. 2012

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Background The frontal branch of the facial nerve (FBFN) is the most susceptible neural structure to injury during frontotemporal craniotomies. The balance between adequate temporalis muscle mobilization and frontal branch protection with minimal anatomical alteration is the philosophy behind our approach to temporalis muscle dissection. Objective To describe a combined subgaleal/myocutaneous technique for dissection and mobilization of the temporalis muscle in anterolateral cranial approaches. Methods Interdisciplinary literature review of the anatomical course of the FBFN was performed. Retrospective analysis of anterolateral craniotomies performed at our institution in which the combined subgaleal/myocutaneous (CSGMC) technique was performed. Results A total of 71 cases of anterolateral craniotomies (excluding full variant orbitozygomatic) were performed with the successful application of a CSGMC technique (36 pterional, 31 orbitopterional, and 4 fronto-orbital). Partial frontalis weakness was transient in one case. Conclusion The CSGMC technique provides sufficient protection for the FBFN and allows for adequate mobilization for a variety of skull base exposures while minimally violating myofascial anatomy. This is the first reported technique that allows both adequate temporalis muscle mobilization with performance of the one-piece orbitofrontal and orbitopterional approaches, without disruption of the superficial/deep temporalis fascia and fat-pad complex.

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An Anatomicosurgical Study of the Temporal Branch of the Facial Nerve

Cited by 22 publications

References 23 publications

Orbitozygomatic craniotomy

Orbitozygomatic craniotomy

Pure Endoscopic Lateral Orbitotomy Approach to the Cavernous Sinus, Posterior, and Infratemporal Fossae: Anatomic Study

Combined Subgaleal/Myocutaneous Technique for Temporalis Muscle Dissection

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