RESUMEN
Introduction: There are twelve cranial nerves and seventh one is the Facial cranial nerve, which supplies the muscles of facial expression. It gives of five terminal branches, which form a plexus with in the parotid gland. These branches exhibit variations in their branching pattern. Detection of the main trunk of facial nerve and its branches is important in all surgeries of this area, to avoid any injury that may lead to the loss of function of this nerve. This study has elaborated the branching and communications among the terminal branches of facial nerve in parotid gland
Objectives: To study the anatomical variations in the terminal branching and communicating pattern of the seventh cranial nerve and to observe the division pattern of the facial nerve trunk in parotid area
Study Design: It was carried out at Department of Forensics and Department of Anatomy in King Edward Medical University Lahore
Period: The study commenced in March 2014 after approval of the synopsis by the Advance Studies and Research Board of KEMU and was successfully completed in December 2015
Methodology: Dissection of one hundred hemi-faces in the Departments of Forensic and Anatomy at King Edward Medical University Lahore. Adult cadavers of both sexes were included and with mutilated face were excluded. A Descriptive Cross-sectional type of study. Collected data was analyzed in SPSS 13. Simple frequency/percentages tables and charts were used to presents the outputs. Chi-Square, Student t-test and ANOVA were used
Results: Branching and Communicating Pattern according to occurrence were: Type I, 9%, Type II, 39%, Type III, 20%, Type IV, 25%, Type V, 6%, Type VI, 1%. 95% cases showed bifurcation
Conclusion: Most common branching pattern was Type II [39%], and least common was Type VI [1%]. Surgery of Zygomatic region must be done carefully due to complexity of branching in this area
RESUMEN
Marginal mandibular nerve is one of the five terminal motor branches of facial nerve given in the substance of parotid gland. Injury to this nerve during surgical procedures hampers the actions of muscles of the lip and chin causing functional and aesthetic impairment. This study on number of rami and communication of marginal mandibular nerve will benefit maxillofacial, general, cosmetic /plastic surgeons to safely prevent iatrogenic injury to this important branch of facial nerve. Dissection of one hundred [100] hemi-faces of adult unclaimed cadavers of both genders was done [from September 2009 to March 2010] in Forensic and Anatomy departments of King Edward Medical University, Lahore. Cadavers with any scar or mutilated face/ neck were excluded from this study. In 100 hemi faces, number of rami of marginal mandibular nerve varies from 1-3. Single branch is most common [74%] followed by two [20%] and three rami [6%]. In 36% of cases communication was seen with buccal branch, 1% with cervical branch, with both buccal and cervical branches in 1% of cases. No communication with either buccal or cervical branch of facial nerve was seen in 62% of cases. Frequency of communication increases with number of Rami of marginal mandibular nerve. In our population single marginal mandibular nerve is most common [74%] which does not communicate with other branches of facial nerve frequently [74.3%]. Therefore transection of this nerve during surgical procedures can result in permanent paralysis