Variation in Branching Pattern of Facial Nerve in the Face

Abstract

The facial nerve enters the parotid gland high up on its posteromedial surface and runs forward and downwards behind the mandibular ramus after exiting the skull at the stylomastoid foramen. It divides into superior (temporofacial) and inferior (cervicofacial) trunks within the parotid substance, resulting in five primary peripheral branches extending out across the face. These branches diverge within the parotid gland and leave by its anteromedial surface, medial to anterior margin, to supply the muscles of facial expression. The face of an 86-year-old embalmed female cadaver was dissected during standard dissection of the head and neck region for medical undergraduates in the Department of Anatomy, Punjab Institute of Medical Sciences, Jalandhar, India. Following the fine dissection, we found a variance in the branching pattern of the facial nerve on the right side of the face, as well as the similar pattern on the left. In parotid surgery, the challenge for head and neck surgeons is to remove the tumour while maintaining the functional and anatomical integrity of all branches of the facial nerve. As a result, surgeons must be aware of the variances in order to do successful surgery.