Background:
For close proximity of the buccal branch (of facial nerve) to
Stensen’s duct, knowledge of surgical anatomy would be very important in
surgical exploration of this area, including parotidectomy, retrograde
dissection of the parotid and surgical repair of the Stensen’s duct, etc.
The aim of this study is to attempt to depict the distribution of
buccal branch on Taiwanese adult cadavers.
Method:
Thirty-five cadaveric hemi-faces were included in our research.
Facial defect owing to tumor and trauma were excluded. Buccal branch of facial
nerve was defined according to the textbook of Gray’s anatomy 40th edition. The observation of the
relationship between buccal branch and Stensen’s duct was mainly focused on the
intersection along the Stensen’s duct and the emergence from the anterior
border of parotid gland. Intraobervational and interobservational errors were
found both negligible
Result:
The number of intersection ranged from 1-5, and 2 intersections
showed the highest proportion, 37%. The distance between the intersection and
emergence of Stensen’s duct ranged from 2.56 to 58.95mm. At the anterior border
of parotid gland, we found the number of buccal branch ranged from 1-3 superior
to the emergence of Stensen’s duct, and 0-2 inferior to duct. In 12(34%) cases,
single buccal branch was superior to duct, and the mean distance between the
emergence was 15.31±5.25mm, and 21(60%) cases showed two buccal branch
superiorly, the mean distance were 8.18±5.96mm and 17.90±5.77mm. In 24(69%)
cases, single buccal branch was inferior to duct, the mean distance was
10.44±5.64mm. There were 6(17%) cases absent of buccal branch inferior to the
emergence of Stensen’s duct. We could not find direct anastomosis or
communicating fibers between upper and lower buccal branch in 11(31%) of cases.
Conclusion:
We depicted the emergence of Stensen’s duct to analyze the
distribution of buccal branch, and we found that there is a larger variation in
distribution among our Taiwanese cadaver than that of previous studies in other
countries. Surgeons shall be advised to take the utmost caution when dissecting
either Buccal branch or Stenson’s
duct.
Keywords: emergence of Stenson's duct; Stenson's duct, facial nerve;
buccal branch; intersection,
