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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The zygomatic branch of the facial nerve traverses the body of the zygoma towards the lateral angle of the orbital rim. Along with the temporal branches of the facial nerve, it innervates the orbicularis oculi muscles.
Anatomy of the Forehead and Periocular Region
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Marcelo B. Antunes, Stephen A. Goldstein
The muscle function of the upper third of the face enables a person to emanate the emotions of surprise, pain, fear, anger, concern, or worry, among others. The eyebrow has several paired depressor muscles consisting of the corrugators, depressor supercilii, and the orbicularis oculi muscles. The frontal branch of the facial nerve innervates all these muscles. The procerus muscle, also an eyebrow depressor, lies in the midline between the frontalis muscles. The zygomatic branch of the facial nerve innervates the procerus (Figure 4.1).
Emergencies in dermatosurgery
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
B. R. Harish Prasad, C. Madura, M. R. Kusuma
The nerves at greatest risk for transection, trauma, ligation, or electrical injury during cutaneous surgery are the temporal branch of the facial nerve, the marginal mandibular branch of the facial nerve, and the spinal accessory nerve at Erb point [36]. Transection of the buccal and zygomatic branches rarely leads to a clinically noticeable deficit because of the robust cross innervation and arborization of the distal portions of these nerves [37–39]. Cases of nerve transection during cutaneous surgery have been reported in association with resection of large cutaneous tumors in this “danger zone”
Successful Treatment of Interdigitating Dendritic Cell Sarcoma Presenting as Multiple Parotid Tumors
Published in Acta Oto-Laryngologica Case Reports, 2019
Yasuyuki Kajimoto, Naoki Otsuki, Masanori Teshima, Yukiko Morinaga, Tomoo Itoh, Ken-Ichi Nibu
An 82-year-old woman presented at our hospital with one month-long history of painful masses in her right parotid gland without other symptoms. She had no history of smoking or alcohol consumption. On physical examination, two elastic, hard, and mobile masses in her right parotid gland; one was in the upper pole and the other was in the lower pole of the parotid gland. Facial nerve paralysis was not observed and no remarkable findings were observed in ears, nose, oral cavity, and laryngopharynx. Compute tomography (CT) showed three solid masses in the parotid gland (Figure 1(A,B)). No malignant findings were obtained from fine needle aspiration cytology from the mass of the lower end. Based on these findings, we suspected Warthin’s tumor and decided to follow up with the patient’s wishes carefully. However, the mass in the lower pole of the parotid gland had enlarged over the course of 3 months after her first visit. Magnetic resonance imaging (MRI) showed enlarged masses in the parotid gland and lymphadenopathy in Level IIA (Figure 1(C,D,E,F)). Since the malignant tumor was suspected from the clinical course, we initially planned total parotidectomy with facial nerve preservation and modified radical neck dissection. However, the upper tumor invaded the zygomatic branch (Figure 2(A)) and the lower tumor was very close to the mandibular branch. Intraoperative frozen section of the lymph node of level IIA suggested the non-epithelial malignant tumor. Considering these findings, we decided to enucleate the tumor in the lower end and to resect the tumor in the upper-end part.
Prognosis prediction changes based on the timing of electroneurography after facial paralysis
Published in Acta Oto-Laryngologica, 2022
Ki Jin Kwon, Je Ho Bang, Sang Hoon Kim, Seung Geun Yeo, Jae Yong Byun
In the event of facial nerve palsy, the recovery rate is generally 70–90% [2], however, in this study, the rate was 92.6%, which was slightly different from the previous study. The strength of this study is that prognosis was verified by subdividing the results of each ENOG in 10% increments and the test was conducted by dividing the ENOG of OO and NL muscles based on onset time. In addition, AL was evaluated for each branch using NCS to confirm ENOG test results. In early ENOG administered 4–6 d after onset, <10% of OO affected the prognosis, and in late ENOG performed 13–15 d after onset, only <10% of NL affected the prognosis. The temporal difference between ENOG at the OO and ENOG at the NL is apparently due to the difference in length and diameter of each facial nerve branch. According to Paula et al. (2018), the temporal branch has a diameter of 0.94 (± 0.3282) and a length of 30.1 (± 6.8995), and a zygomatic branch has a diameter of 1.002 (± 0.4598) and a length of 38.03 (± 6.6427) [16]. When nerve branch degeneration occurs, the degeneration of the small-diameter and short-length temporal branch is likely to occur faster than other branches, which affects the OO muscle and the initial ENOG value appears to have statistical significance in the prognosis. In late ENOG, only the NL showed statistical significance. Apparently, the ENOG value of the NL involved in the zygomatic branch was more significant for predicting the prognosis when degeneration occurred in all branches of the facial nerve after sufficient neurodegeneration. In addition, collateral regeneration possibly occurred more rapidly in the case of a relatively short-length and small-diameter temporal branch innervating the OO muscle; in the NCS performed 13–15 d after paralysis occurred, only the zygomatic branch showed statistical significance. So far, if ENOG is less than 10%, it is assumed that it is an indication for surgery, and in most studies, if it is less than 10%, the prognosis is expected to be poor. Although this study was conducted by subdividing each nerve branch and specific time point, it showed statistically significant results when it was less than 10%, showing results consistent with previous studies.