Evaluation of the course of the marginal mandibular branch of the facial nerve: a fresh cadaveric study

Sindel, Alper; Özalp, Öznur; Yıldırımyan, Nelli; Oğuz, Nurettin; Sindel, Muzaffer; llankovan, V.

doi:10.1016/j.bjoms.2020.08.020

Cited by 5 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, various reports form cadaveric studies suggest that the MMB may be located as high as 6.9 mm and 6.5 mm above, and as low as 4 mm and 3 mm below the mandibular base on right and left sides respectively. (10) The mean total length of the nerve until the muscular termination point was calculated 33.57 (S.D 3.41) mm on the right and 33.51 (S.D 4.88) mm on the left side.…”

Section: Discussionmentioning

confidence: 99%

A Modified Submandibular Approach - Assessment of Outcome

Ghanem

Farag

Mosleh

2021

Egyptian Dental Journal

View full text Add to dashboard Cite

The submandibular approach has been an integral tool in facial surgery since 1934. The technique is indicated in different clinical scenarios. This approach is governed by two key determinants; namely the skin tension lines and the course of the marginal mandibular branch.Aim of study: this study suggests that moving the incision further into the neck while respecting the course of the facial nerve would help achieving both optimal esthetic outcome as well as less nerve injuries.Materials and methods: eight patients requiring facial surgery, where the submandibular approach was indicated, were recruited and the modified submandibular incision was applied. The function of the facial nerve was followed up for six months using the Houseman-Brackman test. The esthetic result was assessed by two panels; consultant maxillofacial surgeons, and lay persons mainly concerned with the esthetics. The panel reviewed the cases through a power point presentation. A questionnaire customized to each panel's expertise was then provided.Results: Surgeons grading intra-class correlation coefficient (ICC) showed that there was an excellent agreement in questions 1, 4, 5 and 7 (ICC=0.672, ICC=0.647, ICC=0.753 and ICC=0.679 respectively). The 5 different maxillofacial surgeons had excellent agreement on that the incision utilized accurately facilitated accessibility, good healing and pleasant esthetic outcome. Regarding lay persons grading, intra-class correlation coefficient (ICC) showed that there was an almost perfect inter-observer agreement on the success of the technique esthetically (ICC=0.826 and 0.838 respectively).Conclusion: the modified submandibular approach provided better aesthetic results and lower risk of facial nerve injury.

show abstract

Section: Discussionmentioning

confidence: 99%

A Modified Submandibular Approach - Assessment of Outcome

Ghanem

Farag

Mosleh

2021

Egyptian Dental Journal

View full text Add to dashboard Cite

show abstract

“… 8 Masseter: ant border FA crosses mandible 1cm ant to border On periosteum at antegonial notch; palpable Pulsation Best identified whilst clenching 9. “Naked areas” of Facial artery Exposed FA; no overlying muscles 2 areas lateral to oral commissure Between risorius and Zyg Maj Sup-lat angle mouth at origin of sup labial artery from FA 10 Gonial angle Safe injection area on bone Major neck vessels run post and inferior; avoid facial nerve 94 Piriform fossa Safer injection area on bone or superficial. Avoid the middle lamella Stay on bone Note: Data from Kumar et al 93 Abbreviations: TC, temporal crest; TA, temporal artery; STA, superficial temporal artery; br, branch; FA, facial artery; NTPE, non-thrombotic pulmonary embolism; SO, supraorbital; IO, infraorbital; MTV, middle temporal vein; IO, infraorbital; SO, supraorbital; ST, supratrochlear; SOR, supraorbital rim; LCJ, lid-cheek junction.…”

Section: Introductionmentioning

confidence: 99%

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Heydenrych

Boulle

Kapoor³

et al. 2021

CCID

View full text Add to dashboard Cite

Dermal filler treatments require constant reassessment for improving and safeguarding the rapidly evolving aesthetic field. Suboptimal injection technique, patient selection and product knowledge have touted a concerning increase in filler complications, with new challenges such as the COVID-19 pandemic leading to new paradigms in the understanding, prevention, diagnosis and treatment of complications. The updated 10-point plan has been developed to curtail complications through consideration of causative factors, categorized as patient, product, and procedure-related. Patient-related factors include a preprocedural consultation with careful elucidation of skin conditions (acne, rosacea, dermatitis), systemic disease (allergies, autoimmune disease, underlying bacterial and viral disease (herpes simplex virus, COVID-19 infection), medications (antineoplastic drugs, recreational drugs) and previous cosmetic procedures (including fillers and energy-based devices). Patient assessment should include standardized photography and also evaluate the role of social media, ethnicity, gender, generational, and LGBTQ+ needs. Specified informed consent for both adverse events and their treatment is essential due to the increase in vascular complications, including the risk of blindness. Product-related factors include the powerful advantage of reversibility when using hyaluronic acid (HA) products. Product characteristics such as molecular weight and filler degradation should be understood. Product layering over late or minimally degradable fillers is still inadvisable due to the initial filler being teased into reactivity. Procedural factors such as consistent photographic documentation, procedural planning, aseptic non-touch technique (ANTT), knowledge of topographical anatomy and angiosomes, and technical dexterity including pinch anatomy and needle skills are of pivotal importance. The final section is dedicated to algorithms and checklists for managing and treating complications such as allergic hypersensitivity reactions, vascular events, infection, edema and late-onset adverse events (LOAEs). The updated 10-point plan is a methodical strategy aimed at further minimising the risk of dermal filler complications.

show abstract

“…Furthermore, it was aimed to implement the POSAS v2.0 into providing a clinimetric analysis for linear scars of the neck. (15). Hence the recommended incision position is 2-cm from the mandibular lower margin (5).…”

Section: Discussionmentioning

confidence: 99%

Transcervical Submandibular Approach: A Patient and Observer Scar Objective Score appraisal

ElAshwah

Fahmy

Dessoky

et al. 2022

Alexandria Dental Journal

View full text Add to dashboard Cite

OBJECTIVE:The purpose of this study was to assess the functional and aesthetical performance of transcervical submandibular incision for various procedures in the submandibular area. MATERIALS AND METHODS:The study is a prospective case series for the introduction of the patient and observer scar assessment scale in the postoperative assessment of linear surgical scars in the neck region. Primary outcome variable was the functional and aesthetical outcome performance of transcervical submandibular incision. Statistical significance was set at the 5% level. RESULTS: Twenty-one patients with various procedures in the submandibular area were enrolled in this study. Only three patients reported a transient mild dysfunction in the first week, which dissipated in the subsequent follow up period. The patient side of the scar assessment scale ranged from 7 to 19, with a mean record of 10.2 ± 3.45 and a total satisfaction rate of 85.7% was reported by the patients. The observer side of the scar assessment scale ranged from 19 to 25, with a mean record of 21.9 ± 1.42. Furthermore, an extreme degree of reliability was reported when evaluating the outcomes of both different observers (P<0.001). CONCLUSION:The transcervical approach granted the patients a safer approach, regarding the safety of the marginal mandibular nerve, and a more aesthetically pleasing outcome with superb patient satisfaction. Furthermore, the utilization of the Patient and Observer Scar Assessment Scale in linear facial scars assessment offers a reliable and consistent tool with easy to implement tool.

show abstract

Evaluation of the course of the marginal mandibular branch of the facial nerve: a fresh cadaveric study

Cited by 5 publications

References 24 publications

A Modified Submandibular Approach - Assessment of Outcome

A Modified Submandibular Approach - Assessment of Outcome

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Transcervical Submandibular Approach: A Patient and Observer Scar Objective Score appraisal

Contact Info

Product

Resources

About