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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Superficial branches of the buccal branch of the facial nerve innervate the procerus muscles. The buccal branches come off from the facial nerve after it has exited the stylomastoid foramen and spread transversely to supply the muscles around the mouth and in the infraorbital region.
Facial Layers
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Eqram Rahman, Yves Saban, Giovanni Botti, Stan Monstrey, Shirong Li, Ali Pirayesh
The greater auricular nerve is found approximately 5 cm inferior to the external auditory meatus, running deep within the superficial cervical fascia. The mental nerve, a branch of the inferior alveolar nerve, exits the mental foramen where it can be seen and palpated when the oral mucosa is stretched. This nerve provides innervation to the lower lip and the mandible. The buccal mucosa and the skin on the cheek is innervated by the buccal branch of the mandibular nerve, while the anterior two-thirds of the tongue is innervated by the lingual nerve (a branch of the man-dibular division of the trigeminal nerve) [2].
Oral Cavity Tumours Including Lip Reconstruction
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Sensory innervation to the area is via the buccal branch of the mandibular division of the trigeminal nerve. Lymphatic drainage of the site is via the ipsilateral facial and submandibular nodes to the deep cervical chain. The thickness of the cheek, from mucosal lining to external skin, is 1–3 cm.
Fascicular turnover flap in the reconstruction of facial nerve defects: an experimental study in rats
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Miyuki Uehara, Wu Wei Min, Moriaki Satoh, Fumiaki Shimizu
A periauricular incision with a marginal mandibular extension was made on the left face of a rat. The buccal and marginal branches of the facial nerve were exposed. Eight-millimeter gaps were introduced into the marginal branches of the left facial nerve by excision of the nerves. To block the signal to the whisker pad, 8-mm gaps were also introduced into the buccal branch of the left facial nerve by its excision, and the proximal stump of the buccal branch was ligated with 9–0 nylon. The left marginal mandibular branch gap was bridged with a fascicular turnover flap or autograft. The fascicular turnover flap was elevated from the proximal end of the mandibular branch’s gap under a microscope. At the fascicular turn over flap elevation, a horizontal axis half incision of the mandibular branch was made at a point 9 mm from the cut end, and long axis incision was extended distally until a point 1 mm from the distal cut end using 31 G injection needle and microscissors. By this procedure, the half-sized retrograde nerve flap was elevated. This half-sized nerve flap from the original nerve branch was turned 180°, and the cut end of the turnover flap was sutured to the distal stump of the mandibular branch with 9–0 nylon sutures in an end-to-end fashion. Two epineural sutures were used for nerve suture (Figures 1 and 2). The autograft was taken from the buccal branch at a length of 8 mm and inset to the mandibular branch’s gap. For nerve grafting, end-to-end epi-neural sutures were laid down with 9–0 nylon. Suturing was done with two sutures.
Oral mucosa grafting in periorbital reconstruction
Published in Orbit, 2018
The OMG should be dissected off the submucosal fat and minor salivary glands (MSG) covering the inner surface of the buccinator muscle.74,75 Trauma to the buccinator which serves as a muscle of facial expression may lead to wound contracture and restriction of mouth opening.76 Perioral numbness may result from injury to the buccal nerve caused by aggressive posterior dissection during harvesting from the inner cheek. The harvesting surgeon must be constantly aware of the structures within the anatomical buccal space lateral to the buccinator muscle. These include the buccal fat pad; Stensen’s duct of the parotid gland; the facial artery and vein anteriorly; the buccal artery posteriorly; lymphatic vessels; together with buccal branches of the facial and trigeminal nerves. Stensen’s duct arises from the parotid gland, continues forward lateral to the masseter, it then turns medially at the anterior border of the masseter, passes through the buccal fat pad and penetrates the buccinator muscle before terminating at its orifice on the mucosa opposite the maxillary second molar tooth.74,75 Inadvertent trauma to Stensen’s duct may lead to a transient decrease in parotid salivary flow. Damage can be avoided by visually identifying the opening of Stensen’s duct or by squeezing the parotid gland.77,78
The shark flap: a modified internal mammary artery perforator flap for composite defects in head and neck reconstruction
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Anna Scarabosio, Alessandro Tel, Filippo Contessi Negrini, Roberta Albanese, Massimo Robiony, Piercamillo Parodi
A 53-year-old woman presented with recurrent squamous cell carcinoma located in the cheek area, extending in depth until mandibular periosteum, through the parotid gland and masseter. She required a radical resection which included a large skin area (14 × 16 cm) of the cheek, a total parotidectomy and the resection of the zygomatic arch and the coronoid process, down to the level of the temporomandibular joint (TMJ) capsule. Fronto-temporal and buccal branch of the right VII cranial nerve were sacrificed to ensure safe margins. A prophylactic supraomohyoid neck dissection was performed during the same surgery.