Exposure of the facial nerve in parotid surgery. (Use of the tympanomastoid fissure as a guide)

Tabb, Harold G.; Scalco, Anthony N.; Fraser, Susan

doi:10.1288/00005537-197004000-00004

Cited by 22 publications

(7 citation statements)

References 12 publications

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“…The FN is one of the most critical structures encountered during surgical extirpation of the parotid gland especially since these closely approximate the nerve [139]. Table 7 shows the incidence rates reported in the literature for FN paralysis (transient or permanent).…”

Section: Operative Managementmentioning

confidence: 99%

Current Thinking on Malignant Salivary Gland Neoplasms

Arrangoiz¹

2013

JCTR

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Abstract:Malignant salivary gland neoplasms are rare, representing approximately 3% to 7% of all head and neck cancers. Contrasting from the more common mucosal head and neck cancers, which, in general, are ascribed to excessive tobacco, alcohol use, and more recently to viral infection, specific carcinogenic factors for malignant salivary gland growths have not been as clearly identified. Histologically, they represent a heterogeneous group of tumors. Forty histologic types of epithelial tumors of the salivary glands have been reported; some are exceedingly rare and may be the topic of only a few case reports. Salivary tumors can arise in the major salivary glands or in one of the minor salivary glands (predominantly mucus secreting glands), which are distributed throughout the upper aerodigestive. Most patients who develop malignant salivary gland tumors are in the sixth or seventh decade of life. FNA should be considered as part of the diagnostic evaluation but due to its varying sensitivities and specificities imaging modalities such as ultrasound, CT scans, and MRI should also be used as diagnostic adjuncts. Surgery is the primary modality for management of these tumors, nontraditional surgical approaches and instrumentation, as well as facial nerve monitoring, can be selectively utilized to try and decrease the morbidity associated with these surgical procedures. Adjuvant treatment is primarily achieved with radiation therapy. Chemotherapy continues to have a palliative role in the management of salivary gland tumors; however, research in this field is trying to identify a therapeutic role for chemotherapy in order to improve overall survival.

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Section: Operative Managementmentioning

confidence: 99%

Current Thinking on Malignant Salivary Gland Neoplasms

Arrangoiz¹

2013

JCTR

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“…The tympanomastoid suture is a more xed landmark to identify the facial nerve. In many studies, it is accepted as one of the best landmarks due to its xed position and close relationship with the stylomandibular foramen [7,8]. However, the use of this suture as a landmark has some disadvantages: it requires periosteal elevation, and the dense sternocleidomastoid muscle tendon structure adhering to the mastoid tip covers the tympanomastoid suture [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

A New and Reliable Landmark in Parotid Surgery: Tragomastoid Groove (Akil Groove)

Kınış

Akıl

Yılmaz

et al. 2020

Preprint

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Background: Parotid surgery is a frequently performed surgery in otorhinolaryngology practice with many possible complications. Due to the high ratio of facial paralysis during parotid surgery, we defined a new landmark for identifying and protecting the facial nerve as early as possible during surgery. Materials and Methods: The study was designed as a prospective anatomical method. The important details and relationship of the tragomastoid groove to the facial nerve truncus were examined during surgery on 30 patients. In addition, the demographics of the patients, the type of surgery and the pathological results of surgeries were evaluated.Results: The mean distance of the tragomastoid groove to the facial nerve truncus was 20.53±1.71 mm, the mean deepness of the tragomastoid groove was 1.91+-0.26 mm, and the mean superficial part of the tragomastoid groove was 0.83±0.23 mm. The tragomastoid groove was situated either across from the facial nerve at the place where the facial nerve truncus exits the stylomastoid foramen or just inferior to the truncus in all patients. Conclusion: The tragomastoid groove was defined for the first time in the literature as a reliable landmark for identifying the facial nerve truncus easily during parotid surgery.

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“…8 Although the styloid process has the advantage of being very close to the facial nerve, it has fallen out of favor because the nerve can be superficial to the styloid process, and the styloid process itself can be small or absent in a proportion of cases. 3,4,9 The stylomastoid artery also has been described as a landmark to identify the facial nerve but has not become popular, probably due to the inconsistent presence and anatomical variations reported by some authors themselves. 10 Another landmark that has been described is the transverse process of axis.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have described the TMS as the best landmark to identify the facial nerve trunk because it is easy to find, its position is invariable, and its relation to the nerve reliable because it leads to the stylomastoid foramen. 3,5,9,11 But there are lot of objections; some authors claim that using the TMS as a landmark increases the complexity of the surgical intervention because it requires elevation of the periosteum around the ear canal and dissection inferiorly to reach it. 2,12,13 Studies by Browne and by Pather and Osman concluded that the TMS is obscured by the strong tendon of the sternocleidomastoid muscle inserted into the lateral surface of the mastoid process from its apex to its superior border.…”

Section: Discussionmentioning

confidence: 99%

“…The importance of the facial nerve and controversies about how to identify it are exemplified by the multiple anatomical landmarks described to identify the facial nerve during parotidectomy. [1][2][3][4] These include the tragal pointer, posterior belly of temporal bone resection. This was conveyed and discussed with the other authors and prompted the study, which was designed in three steps: first as a cadaver study, followed by a radiologic study that consisted of two parts, and a prospective clinical study.…”

Section: Introductionmentioning

confidence: 99%

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Easy and Safe Method for Facial Nerve Identification in Parotid Surgery

et al. 2015

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Background A safe and easy anatomical landmark is proposed to identify the facial nerve in parotid surgery. The facial nerve forms the center point between the base of the styloid process and the origin of the posterior belly of the digastric muscle. Objective To evaluate the consistency, accuracy, and safety of the landmark in identifying the facial nerve. Methods The study was designed in three steps: a cadaver study, a radiologic study, and a prospective clinical study. Anatomy was initially studied in two cadavers. Then the images of 200 temporal styloid regions were studied for consistency of the presence of the styloid base. In the second part of the radiologic study, the distance between the styloid base and the origin of the posterior belly of the digastric muscle was studied in 50 parotid regions. The clinical study involved 25 patients who underwent parotidectomy. Results The styloid base was present in all the images studied. The mean distance between the styloid base and the origin of the posterior belly of the digastric was found to be 0.72 cm (range: 0.45-0.99 cm). The facial nerve could be identified consistently and safely in all patients. Conclusion This trident landmark provided safe, accurate, and easy identification of the facial nerve using two fixed bony landmarks.

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Exposure of the facial nerve in parotid surgery. (Use of the tympanomastoid fissure as a guide)

Cited by 22 publications

References 12 publications

Current Thinking on Malignant Salivary Gland Neoplasms

Current Thinking on Malignant Salivary Gland Neoplasms

A New and Reliable Landmark in Parotid Surgery: Tragomastoid Groove (Akil Groove)

Easy and Safe Method for Facial Nerve Identification in Parotid Surgery

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