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Facial Plast Surg 2025; 41(04): 491-502
DOI: 10.1055/s-0044-1791691
Original Research

Enhanced Understanding of Facial Nerve Anatomy and Arborization in the Indian Population: Implications for Surgical Procedures

Authors

  • Sneha Gulati 

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Satyaswarup Tripathy 

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Tulika Gupta 

    2   Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Sunil Gaba 

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Devi Prasad Mohapatra 

    3   Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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Abstract

The anatomy and arborization patterns of the extraparotid facial nerve show considerable variation among different populations, impacting surgical approaches in plastic, head and neck, and ENT surgeries. This study focuses on the Indian population to provide a detailed understanding of these variations, specifically highlighting the Davis type IV arborization pattern's prevalence and its clinical relevance. We conducted a comprehensive dissection of 16 formalin-preserved Indian cadaveric hemifaces. The study meticulously mapped the facial nerve trunk (FNT), its furcation points, and branches. Key anatomical landmarks for locating these nerve structures were identified, including the tip of the mastoid process, the angle of the mandible, and a novel line between the lateral palpebral fissure and otobasion superioris. The most common arborization pattern observed was Davis type IV (31.3%). The study provided precise measurements for locating the FNT and its branches, using identifiable landmarks. These findings facilitate more accurate surgical planning, crucial for procedures involving nerve repair or grafting. This research offers vital insights into the facial nerve anatomy specific to the Indian population, with significant implications for surgical precision and patient outcomes. By establishing reliable anatomical landmarks and elucidating the predominant arborization pattern, the study enhances the understanding of facial nerve behavior during surgical interventions, particularly in the context of facial paralysis treatment and reconstructive surgeries. Due to the small sample size, however, this study only acts as a pilot for further research.

Keywords

facial nerve anatomy - arborization patterns - Indian population - surgical anatomy - extraparotid facial nerve

Authors' Contributions

S.G. has contributed toward the acquisition of data and has designed and written the manuscript. S.T. has conceived the idea and guided for the write up. T.G. has done critical appraisal of the manuscript. S.G. has edited the paper. D.P.M. gave further insight into clinical applicability and editing of the paper. The final version for publication is approved by all five authors. The requirements for authorship have been met and each author believes that the manuscript represents honest work.


Ethical Approval

Requisite approval taken from institutional ethics committee (No.: INT/IEC/2020/SL1590). Since the management of patients did not involve any experimental treatments or any deviation from standard medical care, an informed consent for participation, photography, and publication from the patient party was deemed sufficient for ethics approval.


Only voluntarily donated cadavers were used in the study, after obtaining written and informed consent from the next of kin at the time of donation, stating that the cadavers can be used for research purposes.


Availability of Data and Materials

The authors confirm that the data supporting the findings of this study are available within the article.




Publication History

Article published online:
15 October 2024

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