Surgical Anatomy of Facial Nerve

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    SURGICAL

    ANATOMY OF

    FACIAL NERVE

    Naina

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    Introduction

    VII Cr N ; Mixed N

    Motor , Sensory , parasympathetic fibers

    Motor root special visc. eff. Fibers

    Sensory !arasymp. carried by "NERVUS

    INTERMEDIUS#$N of %risber&'

    NI consists of (eneral visc. )ff.

    Special visc. *ff.

    Somatic *ff.

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    Facial Nerve Nuclei

    + nclei

    -' Motor ncles lo%er

    pons belo% th

    ventricle/' Sperior salivatory

    ncles dorsal to

    motor N

    +' N of tracts solitaris

    medlla oblon&ata

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    Central Connections ofFN

    0orsal part of N 123

    spra nclear inn.

    3o%er part of N C23 inn.

    Imp Clinical varieties of

    VII N lesions

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    Cont

    Fibers corse to%ards

    floor of IV ventricle

    4rap arond VI N ncl.

    Facial collicls

    5etrace alon& pons

    )xits ponto medllary 6n.

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    Course

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    Intra cranial portion

    From brainstem to I*M

    len&th -78-9mm

    FN crosses C! an&le %it :thCN

    NI 0evoid of epinerim

    hin layer of pia mater

    Surg imp :

    -' Iatro&enic trama in C! an&le

    tmor sr&ery

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    Intra Temporal Region

    From I*M to SMF

    3en&th /: to +' Imp landmar> for /nd&en

    83SCC 8!yramidal eminence

    812% short process of

    incs$3' 3SCC$M'

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    Mastoid Segment

    Vertical se&ment

    From /nd&en$!M' to

    SMF$*3' 3on&est $-+mm'

    3andmar> "Diga!tric

    Ri&ge FN leaves FC via

    SMF$b2% mastoid tip

    styloid process'

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    !tra Temporal Region

    From SMF to terminal

    branches

    5ns in sbstance of

    parotid Main trn> divides

    8 pper temperofacial

    8 lo%er cervicofacial "e! an!erinu!

    Sperficial to

    5etromandiblar V

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    Cont

    RM"

    FN

    #M

    SCM$"

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    %ranches

    Intra temporal

    re&ion A

    -' (S!N

    /' N to stapedis

    +' Chorda tympani

    ' Sensory ariclarbranch

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    &S'N

    From ((

    / types of fibers

    !re&an& para symp !tery&opalatine &an&.

    !ost &an& lacrimal (

    Sensory fibers to nasal palatine &lds

    Doins deep petrosal N

    N to ptery&oid canal

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    N to !tape&iu!

    =mm above SMF

    Spply stapedis

    Sen!or% auricular 'r

    Doins ariclar br of

    va&s Spply retro ariclar

    &roove concha

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    Chorda tympani

    mm above SMF

    3at ant to FN

    !ost canalicls

    3at to 3! of incs med tomalles

    *nt canalicls$Canal of h&ier'

    / types of fibers

    !arasympathetic sbmandiblar sbli&al ( fibres

    Special sensory ant /2+rdof

    ton&e

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    Surgical importance:

    -' (S!N 8 landmar> in middle cranial fossa

    approach

    /' C landmar> in post tympanotomy

    +' C lat mar&in of facial recess

    ' C medial limit for facial rid&e redction

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    E(tra temporal region

    -' !ost.ariclar N$occfrontalis mscles of

    pinna'

    /'

    Msclar 1rs$post belly ofdi&astric stylohyoid'

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    Terminal branches

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    %(CC)L

    M)N#I%(L)R

    CR"IC)L

    *+&,M)TIC

    TM',R)L

    Temporal :

    Cross y&omatic arch

    *riclaris ant sp;frontalis;orb ocli

    corr&ator spercilii

    )%gomatic :

    Cross y&omatic bone

    ?rbiclatis ocli

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    Marginal man&i*ular :

    -8/cm belo% inf rams of

    mandible

    Mscles of lo%er lipchin +er,ical :

    !latysma depressor

    an&li oris 'uccal :

    - cm belo% y& arch

    *lon& parotid dct

    %(CC)L

    M)N#I%(L)R

    CR"IC)L

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    'uccal *r !upplie! :

    -' 5isoris$smir>'

    /' 1ccinator$aids che%in&'

    +' 3evator3abiiSperioris

    ' 3evator3abii*laEeNasi $snarl'

    7' 3evator*n&li?ris$soft smile'

    =' Nasalis$Flare Nostrils'

    9' ?rbiclaris?ris$!rse 3ips'

    http://en.wikipedia.org/wiki/Risoriushttp://en.wikipedia.org/wiki/Buccinatorhttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Nasalishttp://en.wikipedia.org/w/index.php?title=Orbicularis_Oris&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Orbicularis_Oris&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Orbicularis_Oris&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Orbicularis_Oris&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Orbicularis_Oris&action=edit&redlink=1http://en.wikipedia.org/wiki/Nasalishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/wiki/Levator_Anguli_Orishttp://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Levator_Labii_Alaque_Nasi&action=edit&redlink=1http://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Levator_Labii_Superiorishttp://en.wikipedia.org/wiki/Buccinatorhttp://en.wikipedia.org/wiki/Risorius

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    %lood Supply

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    Surgical Landmar-s

    )ar sr&eryA

    -' (( lies sperior to "roce!!u! coc#leari$ormi!

    /' /nd&en h&s inf aspect of -S++

    +' FN lies above ./ nic#e

    01 Incu!lies lat to FN

    7' FN rns behind "%rami&

    =' FN lies =8:mm deep to T%mpano Ma!toi& !uture

    21 Diga!tric ri&ge mastoid se&

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    Cont

    !arotid sr&ery

    1 Tragal pointer -cm deepinf

    31 T%mpanoma!toi& !uture

    +' N lies lat to St%loi& proce!!

    ' Sperficial to Retroman&i*ular ,ein

    7' N bisects an&le b2% "o!t*ell% o$ &iga!tric styloid

    process

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    Otology could be a dull way o l!e w!t"out t"e#t" c$an!al N a$$ogantly %we$&!ng t"$oug" t"e

    te'(o$al bone to t"e 'u%cle% o ac!al

    e)($e%%!on

    *+O,N GROVES-


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