The relationship of the parotid duct to the buccal and zygomatic branches of the facial nerve; an anatomical study with parameters of clinical interest

There have been studies concerning the protection of the facial nerve during plastic surgery intended for the parotid gland. The close relationship between the parotid duct and the buccal and zygomatic branches of the facial nerve is studied here. The dissections were performed on 10 fixed cadavers at the Anatomy Dissection Laboratory of Ankara University in 2004. The reference points used for surgery of this region were taken into consideration as the landmarks for morphometric measurements. In 7 of the cases the zygomatic branch was double and in 3 it was single. In 4 of the 7 cases with a double zygomatic branch both superior and inferior branches crossed the parotid duct. In the remaining 3 cases the superior branches of the zygomatic nerve coursed through the zygomatic major and minor muscles. In 9 of all the cases the zygomatic branch of the facial nerve crossed the duct anteriorly and in one it did so posteriorly (case 10). The buccal branch was single in 4 of the cases and double in 6. Among these one of the most precise measurements was the distance between the lateral canthus and the intersection point of the zygomatic branch and the duct with a coefficient of variation of 9.9%. With the use of this reliable measurement the intersection point of the zygomatic branch and the duct may be estimated to be within 5.16 ±1.01 centimetres of the lateral canthus. Facial nerve paralysis is the most important complication of superficial face surgery and the anatomy of this region must thus be taken into detailed consideration by surgeons.