Facial nerve branching pattern as seen in parotidectomy in Kashmiri population: our experience

Abstract

<p class="abstract"><strong>Background:</strong> A prospective study to analyze the facial nerve branching pattern as seen in various parotidectomy surgeries in Kashmiri population. Main objective was to find out various branching patterns among peripheral branches of facial nerve in parotid tissue so that new young ENT surgeons could get benefited and it should be easy for them to perform parotid surgeries with less complications and unpredictable outcome.</p><p class="abstract"><strong>Methods:</strong> The prospective study was conducted in 35 patients undergoing superficial parotidectomy in our department of otorhinolaryngology GMC Srinagar over a period of one and half year. Facial nerve branching pattern was classified according to the description given by Davis et al. Branching pattern of main trunk was also observed in all cases. </p><p class="abstract"><strong>Results:</strong> The most common type of branching pattern of facial nerve in our study was type I seen in 12 (34.2%) patients, followed by type III seen in 9 (25.7%), followed by type II in 5 (14.2%), type IV in 4 (11.4%) patients, followed by type V in 3 (8.5%) and VI in 2 (5.7%).</p><p><strong>Conclusions:</strong> Type I branching pattern is the most common branching pattern of the facial nerve (34.2%) followed by type III (25.7%), following the pattern as described by Davis. Main trunk was found single in 32 (91.4%%) patients however in 3 (8.57%) patients trunk was dividing in 2 branches before dividing in peripheral branching pattern as described above. </p>

An Anatomic Study of the Facial Nerve Trunk and Branching Pattern in an African Population

“…5, 7,9,16,22,23 Our study found type I (25%) as the most frequent type documented by other studies done in India and Pakistan. 17,18 In other reports from Thailand and India, types II and V were the highest, respectively. 19,24 Type I, the classical textbook pattern, was found to have been one of the least common patterns, which was not the case in this population.…”

“…Types V and VI were the least according to Davis et al 5 and Bernstein and Nelson, 16 respectively, and Katz and Catalano 9 did not report any type VI and the type V was the least in occurrence in his study population. 5, 9,16 Similarly, studies from India and Pakistan, by Malik et al 17 and Khaliq et al, 18 had higher percentages of types I and III, while types V and VI were rare. 17,18 Rana et al, from Pakistan, observed type IIs and IV to be the most common and type VI was the least 19 (►Table 1).…”

“…5, 9,16 Similarly, studies from India and Pakistan, by Malik et al 17 and Khaliq et al, 18 had higher percentages of types I and III, while types V and VI were rare. 17,18 Rana et al, from Pakistan, observed type IIs and IV to be the most common and type VI was the least 19 (►Table 1). The differences in the frequencies are probably due to population from various racial background which renders comparisons between different studies with populations complex.…”

Terminal Branching Pattern of Facial Nerve Seen in Adult Cadavers: An Anatomical Study

“…12 In the present study Type VI (1%), which shows multiple and complex anastomosis among the branches of the two upper and lower divisions, is the least prevalent type and this is in accordance with the other studies in literature. 12,14,15 Type VI was not even seen in many studies. 13 In another study 16 they observed 21% of Type VI, being the second most prevalent type in this study.…”

“…12,13 Other studies had shown greater incidence of Type I prevalence even up to 35.5% and 40% respectively. 14,15 Type I is clinically significant given that if anterior branch is sacrificed, there can be consequential paralysis of the muscles as there is no anastomosis between the other branches. Most prevalent type in the present study is Type II i: e 39%, in which a Zygomatic loop is formed.…”