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Extratemporal facial nerve branching patterns: systematic review of 1497 cases

Published online by Cambridge University Press:  26 August 2022

A Poutoglidis ,
G K Paraskevas ,
N Lazaridis ,
C Georgalas ,
K Vlachtsis ,
K Markou ,
S Gougousis ,
G Fyrmpas ,
S Keramari  and
A Tsentemeidou
...Show all authors
A Poutoglidis
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
G K Paraskevas
Affiliation:
Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Medical School, Greece
N Lazaridis
Affiliation:
Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Medical School, Greece
C Georgalas
Affiliation:
Endoscopic Skull Base Centre Athens, Hygeia Hospital, Greece Department of Otorhinolaryngology – Head and Neck Surgery, University of Nicosia, Cyprus
K Vlachtsis
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
K Markou
Affiliation:
Second Academic Department of Otorhinolaryngology – Head and Neck Surgery, Papageorgiou Hospital, Greece
S Gougousis
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
G Fyrmpas
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
S Keramari
Affiliation:
Second Department of Paediatrics, School of Medicine, AHEPA University Hospital, Greece
A Tsentemeidou
Affiliation:
First Department of Dermatology and Venereology, School of Medicine, Greece
X Vardaxi
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
K Garefis
Affiliation:
Second Academic Department of Otorhinolaryngology – Head and Neck Surgery, Papageorgiou Hospital, Greece
F Poutoglidou
Affiliation:
Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Greece
N Tsetsos*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
*
Author for correspondence: Dr N Tsetsos, Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Exochi, Thessaloniki57010, Greece E-mail: tsetsosnikos@yahoo.gr
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Abstract

Objective

The aim of this systematic review was to analyse the complex anatomy of the extratemporal portion of the facial nerve with an accurate description of the branching patterns based on the Davis classification.

Method

Medline, ScienceDirect and the Cochrane Library databases as well as other sources were searched by two independent reviewers.

Results

Analysis of 21 studies with a total of 1497 cases showed that type III is the most common branching pattern accounting for 26.8 per cent of cases. The type I pattern, previously considered as the normal anatomy in most textbooks, was the fourth most common branching pattern at 16.3 per cent. The majority of specimens (96.4 per cent) were found to have a bifurcated main trunk, and only 3.2 per cent were found with a trifurcated main trunk.

Conclusion

Surgeons should be aware of anatomical variations in the course of the facial nerve. An early identification of the branching pattern during surgery reduces the risk for iatrogenic facial nerve injury.

Keywords

Facial NerveAnatomyClassificationCadaverParotid Gland
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 12 , December 2022 , pp. 1170 - 1176
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr N Tsetsos takes responsibility for the integrity of the content of the paper

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