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Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Once it has exited the facial canal at the stylomastoid foramen, the facial nerve gives off several rami before it divides into its main branches. Near the exit site at the stylomastoid foramen, the facial nerve gives off the posterior auricular nerve, which supplies auricular muscles and the occipitalis, the digastric branch, and the stylohyoid branch. The facial nerve then pierces the parotid gland where it divides into five branches that supply muscles of facial expression and the platysma: temporal, zygomatic, buccal, marginal mandibular, and cervical (Figure 21.11).
Physiology of Hearing
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Soumit Dasgupta, Michael Maslin
The pinna is vestigial in man, with non-functional auricular muscles. In lower groups of mammals, especially predators, these muscles are well developed and can move the pinna to localize and concentrate acoustic energy to the external auditory meatus, hence participating in spatial resolution of sound as well as focusing the energy to a relatively smaller area to be incident on the tympanic membrane.
Case 3.6
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
So how do you perform the procedure?I mark a linear incision just above the post-auricular sulcus, ensuring that:the superior extent stops short of the root of the helix, to prevent visibility of the scar from the front, andthe inferior extent allows access to the concha, or lobule if required.The cartilage is then exposed until the helical rim is reached, ensuring I do not extend the dissection beyond that on to the anterior aspect. I then expose the post-auricular muscles and ligaments as well as the mastoid fascia.I ensure meticulous haemostasis is achieved at this point, as diathermy around the Mustarde sutures placed in the next step may weaken them.I then mark the position of three to four mattress sutures with a Methylene-dipped 25-gauge needle on either side of the anti-helical fold to recreate this. I use clear 4/0 Prolene sutures to place the mattress sutures as per the tattooed marks, ensuring I do not pierce the anterior skin. I then tension the sutures to achieve a smooth line.With regard to the middle third, I divide the post-auricular muscles using bipolar dissection to decrease the risk of subsequent bleeding. I then use one or two 4/0 clear Prolene mattress sutures between the posterior aspect of the concha and the mastoid fascia and periosteum, again ensuring I do not pierce the anterior skin.If the lobule is prominent, I correct this with a fishtail pattern excision.I first extend the inferior skin incision by marking a V extension, with the apex of the V at the most prominent point of the lobule.I then mark a mirror image on the mastoid skin, by pressing the lobule on the skin before the ink dries to form the fishtail pattern that is excised.Subcutaneous haemostasis is then repeated before skin closure.
Baseline, retest, and post-injury profiles of auditory neural function in collegiate football players
Published in International Journal of Audiology, 2021
Grant Rauterkus, Deborah Moncrieff, Gregory Stewart, Erika Skoe
The electrode montage, stimulus, presentation settings, and analysis approach replicated previous work (Kraus et al. 2017, 2016). FFRs were recorded using a vertical electrode montage (Cz: active; A2: reference; Fpz: ground) to a speech stimulus (40 ms, “da”) presented 10.9 times per second at 80 dB SPL to the right ear in alternating polarity through a Mu-metal shielded ER2 insert earphone. The foam insert earphone provided a ∼30 dB attenuation of ambient noise, which is roughly equivalent to a single-walled sound booth. Recordings were bandpass filtered from 100 to 1500 Hz, with a notch filter at 60-Hz to eliminate electrical noise. 6000 artefact-free sweeps were averaged using a 76.8 ms window. The amplitude-based artefact rejection threshold was ± 23 μV; when >10% of sweeps were rejected, the participant was excluded from analyses (n = 2, Figure 1). Presence of a post-auricular muscle artefact was also grounds for exclusion (n = 1).
Posterior auricular muscle patch graft for exposed orbital implant
Published in Orbit, 2019
Catherine Y. Liu, Michael G. Sun, Scott Jones, Pete Setabutr
1% Lidocaine with 1:100,000 parts epinephrine was injected subcutaneously in the post auricular area near the site of incision (Figure 1) and on the helix of the external ear. The post auricular area was then exposed by placement of a 4-0 silk traction suture through the helix and rotated anteriorly to the cheek. An incision was made in the post auricular crease using a #15 blade. Dissection was continued subcutaneously where the posterior auricular muscle and fascia were identified. An appropriately sized patch graft was harvested using a #15 blade and scissors and set aside in sterile saline. Good hemostasis was achieved using electrocautery. The wound was then closed in layers using buried 4-0 vicryl sutures to re-approximate the remaining posterior auricular muscle and interrupted 4-0 vicryl to close the skin and subcutaneous tissue. Bacitracin ointment was applied to the post auricular donor site. Perioperative IV cefazolin was given.
Auditory brainstem responses obtained with randomised stimulation level
Published in International Journal of Audiology, 2023
Marta Martinez, Joaquin T. Valderrama, Isaac M. Alvarez, Angel de la Torre, Jose L. Vargas
Figure 1 shows the individual ABR signals obtained with the conventional and RSL stimulus paradigms at different hearing levels. This figure shows the expected amplitude reduction and latency increase of the components as the stimulus level decreases. The visual inspection of these figures also shows that the waveform morphology obtained with the two stimulus paradigms is very similar, with the only exception of subject 9, where a strong post-auricular-muscle component (PAM) is observed with the conventional procedure which is absent in the RSL procedure. Minor differences can also be observed in subjects 3, 4 and 7 at latencies 10–12 ms at high stimulation levels.