Safe Zone for Dissection in Frontotemporal Region to Avoid Injury to the Temporal Branch of Facial Nerve

Abstract

The objective of this study is to provide a reliable roadmap for temporal branch of the facial nerve, in order to minimize, the risk of injury to the nerve during surgical dissections. A literature search was conducted on temporal branch of facial nerve. The date search range was 1950 to 2017. Databases searched included Medline, Web of science, Biosis, SciELO, Data Citation, and Zoologic Records. Data were collected on, author specialty, date of publication, and the relationship of the temporal branch of facial nerve to various landmarks in the frontotemporal region reported in human anatomic studies. Among the 48 studies reviewed, a total of 3477 anatomic dissections were performed in the craniofacial region. Temporal branch of facial nerve was located between 2.5 and 3 cm from lateral orbital rim. In relation to the zygomatic arch, it was found anywhere from the midpoint of the arch to 1 finger breath posterior to the arch. For the plane, it was most commonly described as being under the superficial temporal fascia (STF) or within the loose areolar tissue. Most anatomic dissections found 2 to 4 twigs of the temporal branch of facial nerve. In relation to the lateral canthus, it was found to be 2.85 þ/-0.69 cm superior and 2.54 þ/-0.43 cm lateral to the lateral canthus.Our study suggests consolidated data on surgical landmarks in order to ensure safe dissection in temporal region and prevent injury to the temporal branch of facial nerve.

Anatomical relationship between the inferior temporal septum and the temporal branch of the facial nerve for clinical applications

“…17 In the temporal region, the fascia layer that the TBFN lies on has been controversial, 2,6,12,[16][17][18] compared with the intuitive results from previous studies about the course of the TBFN. [19][20][21][22] Using layer-by-layer dissection, Agarwal et al described a fascial transition zone in the frontotemporal region that the TBFN crossed from the subsuperficial temporal fascia to run within the superficial temporal fascia. 6 The present study histologically confirmed that the TBFN fibers were consistently identified in the subsuperficial temporal fascia, which differs dramatically on the two sides of the ITS.…”

Primary Neurorraphy of the Frontotemporal Branch of the Facial Nerve in Pediatric Patients

“…The frontotemporal branch of the facial nerve (referred to for the remainder of this article as the frontotemporal nerve), which innervates the frontalis, corrugator supercilii, and procerus muscles, is 1 of the 5 motor branches of the facial nerve. There are many studies on its facial course and danger zones for injury 6–10 . The primary aim of these studies was to describe how to avoid frontotemporal nerve injury during various surgical procedures; however, in cases of trauma injury may be inevitable.…”

“…There are many studies on its facial course and danger zones for injury. [6][7][8][9][10] The primary aim of these studies was to describe how to avoid frontotemporal nerve injury during various surgical procedures; however, in cases of trauma injury may be inevitable. In the case of injury, the first-line treatment is tension-free primary neurorrhaphy.…”