IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK
Hatata, Y., Ibrahim, M., Fawzy, R., Elgohary, H. (2019). IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK. EKB Journal Management System, 2(1), 17-26. doi: 10.21608/fumj.2019.55042
Yasser Hatata; Mohamed Ibrahim; Reda Fawzy; Hazem Elgohary. "IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK". EKB Journal Management System, 2, 1, 2019, 17-26. doi: 10.21608/fumj.2019.55042
Hatata, Y., Ibrahim, M., Fawzy, R., Elgohary, H. (2019). 'IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK', EKB Journal Management System, 2(1), pp. 17-26. doi: 10.21608/fumj.2019.55042
Hatata, Y., Ibrahim, M., Fawzy, R., Elgohary, H. IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK. EKB Journal Management System, 2019; 2(1): 17-26. doi: 10.21608/fumj.2019.55042

IDENTIFICATION OF THE FACIAL NERVE TRUNK DURING SUPERFICIAL PAROTIDECTOMY BY TRIDENT LANDMARK

Fayoum University Medical Journal
Article 3, Volume 2, Issue 1, March 2019, Page 17-26  XML PDF (814.03 K)
DOI: 10.21608/fumj.2019.55042
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Authors
Yasser Hatata1; Mohamed Ibrahim1; Reda Fawzy2; Hazem Elgohary email 3
1Faculty of Medicine, Fayoum University.
2Faculty of Medicine, Kafr El-Sheikh University.
3Faculty of Medicine, Alexandria University.
Abstract
Background: The facial nerve is one of the most important structures encountered during surgical removal of
parotid gland tumours especially since these closely approximate the nerve. The importance of the facial nerve and
controversies about how to identify it are exemplified by the multiple anatomical landmarks described to identify the facial nerve during parotidectomy. The trident landmark is one of these anatomical landmarks (The facial nerve forms the center point between the base of the styloid process and the origin of the posterior belly of the digastric muscle).
Aim of the study: To evaluate the accuracy of the trident landmark as a proposed anatomical landmark for easy,
accurate and safe identification of the facial nerve trunk during superficial parotidectomy.
Patients and methods: This clinical prospective study was conducted between January 2018 and September 2018 at Al Fayoum University Hospital (FUH), Fayoum University, Egypt and Kafr El-Sheikh university hospital (KUH), Kafr El-Sheikh University, Egypt. It included 25 patients; 14 (56%) males and 11(44%) females with a mean age of 42.68 ±17.53 years. All patients had benign tumors of the superficial lobe of the parotid gland and were subjected to superficial parotidectomy. Outcome was evaluated regarding clinical success of facial nerve identification by trident landmark and early post operative complications.
Results: All 25 patients were subjected to superficial parotidectomy. Facial nerve trunk was successfully identified in all the patients with no intra-operative complications. Operative time ranged from 70 to 135 minutes with a mean time 106.80 ±16.13 minutes. Facial nerve deficit of the marginal mandibular nerve (MMN) was noted in 1 patient (4 %), Surgical site infection (SSI) was noticed in 1 patient (4%), Skin flap necrosis in the retroauricular area was also viewed in 1 patient (4%) and no hematoma was noticed in all the patients.
Conclusion: Ttident landmark described here facilitates the identification of facial nerve trunk during superficial parotidectomy with relative ease, safety and accuracy. This can be a very useful method to minimize
the facial nerve injury during parotid surgery.
 
Keywords
Facial nerve trunk; superficial parotidectomy; styloid process; mastoid process; digastric muscle
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