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Surgical Anatomy of the Mandibular Ramus of the Facial Nerve Based on the Dissection of 100 Facial Halves
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
In considering open reduction and internal fixation of the mandibular condyle, injury to the marginal mandibular branch of the facial nerve is a commonly cited complication. A recent meta-analysis reported the transmasseteric antero-parotid approach with retromandibular and preauricular extensions for condylar “neck” fractures was the safest in terms of facial nerve injury.1,2
Anatomy of the Lower Face and Neck
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Evan Ransom, Stephen A. Goldstein
The marginal mandibular branch follows a curvilinear course from the lower division of the facial nerve, dipping below the platysma insertion and the edge of the mandible into the upper neck, superficial to the submandibular gland, before ascending beneath the lower face muscles. Unlike those found in the midface, connections between the marginal branch and other facial nerve branches are found in only about 15% of dissection specimens (15). Section of the marginal branch may be significant to a patient, resulting in significant lower face asymmetry, which is made even more obvious with facial expression. Facial nerve injury has been reported between 0.3% and 2.6% of rhytidectomy procedures, with the temporal and marginal nerves at greatest risk (16).
Surgical Anatomy of the Neck
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Laura Warner, Christopher Jennings, John C. Watkinson
The marginal mandibular branch of the facial nerve is the main branch of the lower division of the facial nerve. It takes a variable course and may have up to four branches in the neck. The nerve passes antero-medially across the upper neck in the plane just deep to the platysma muscle but superficial to the investing layer of deep cervical fascia. It can extend as low as the greater cornu of the hyoid bone, before passing superficial to the facial vessels and across the mandible to provide motor supply to the depressor anguli oris, depressor labii inferioris and mentalis muscles. Its action is to move the corner of the mouth and lower lip, however the nerve supply to the lower lip is multifactorial, with contributions from the cervical branch of the facial nerve and the platysma muscle, meaning that if any one of these mechanisms is interrupted lower facial asymmetry may occur.
Clinical management of squamous cell carcinoma of the tongue: patients not eligible for free flaps, a systematic review of the literature
Published in Expert Review of Anticancer Therapy, 2021
Giuseppe Colella, Raffaele Rauso, Davide De Cicco, Ciro Emiliano Boschetti, Brigida Iorio, Chiara Spuntarelli, Renato Franco, Gianpaolo Tartaro
Another local reconstructive option is represented by the SMIF. It is a robust flap that can be used for a various head and neck defects. It is a versatile tool, ease to be harvested, providing well-vascularized and relatively thin tissue. It also overcomes the need of a second stage surgery for flap division, reducing costs and patient’s discomfort [15,16]. Roshdy et al [14] exalted the functional and esthetic outcomes of SMIF reconstruction for large tongue cancer, especially in elderly patients with serious comorbidities. The presence of lateral neck lymphadenopathy is not considered an absolute contraindication, depending on the need of the level I to be included in the dissection [57]. Moreover, laxity of the submental skin is required to provide adequate width of the flap and primary closure of the donor site [57]. Since the blood supply of this flap is based on branches of the facial artery, which anastomose each other from both sides, previous neck dissection does not contraindicates this reconstructive solution [16]. Although not described in the included studies, some authors reported the injury of the marginal mandibular branch of the facial nerve as a possible complication [57].
Design and application of submental island flap to reconstruct non-circumferential defect after hypopharyngeal carcinoma resection: a prospective study of 27 cases
Published in Acta Oto-Laryngologica, 2020
Wenting Pang, Aobo Zhang, Cheng Lu, Jun Tian, Wan-xin Li, Zhenxiao Wang, Yanbo Dong, Shuoqing Yuan, Zihao Niu, Yiyuan Zhu, M. Shahed Quraishi, Liangfa Liu
Total or partial laryngopharyngectomy was performed according to the extent of tumor invasion. After completion of tumor ablation and neck dissection, flap was harvested from the contralateral side in a subplatysmal fashion. In the midline, surgical incision extended down to the mylohyoid muscle in order to allow dissection of the anterior belly of the digastric muscle and mylohyoid muscle from the mandible and the hyoid bone [17]. The submandibular gland was then identified and dissected superiorly and posteriorly with the gland left in position. The marginal mandibular branch of the facial nerve was also identified and protected. During cervical lymphadenectomy we ensured that the facial vessels and the internal jugular vein were protected and preserved. The harvested flap was then transposed downward to close the hypopharyngeal defects with continuous mattress sutures using 3–0 Vicryl and 3–0 silk thread was interrupted sutured subcutaneously and submucosally for strengthening (Figure 1).
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
Three groups were created for the present study. In Group 1, the nerve gap was not reconstructed; this group was used as a control group (n = 8). In Group 2, the nerve gap of the marginal mandibular branch was reconstructed with an 8-mm autograft. The autograft was harvested from the buccal branch (n = 8). In Group 3, the nerve gap was reconstructed with a fascicular turnover flap, as described previously (n = 8). In each group, the whisker movement was recorded on a weekly basis using a video camera. These video files were then assessed using an image analysis software program (TEMA; PHOTRON, Tokyo, Japan). The functional recovery of the marginal mandibular branch of the facial nerve was assessed based on the recovered range of motion (ROM) (Figure 3). The ROM was defined with the angle made by the lines of a–b and b–c described in Figure 3. Point ‘a’ was defined on the whisker, the point “b” was defined on the root of whisker, the point ‘c’ was defined on its left eye.