Related Experiment Video
Updated: Aug 18, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Tympanomastoid suture and digastric muscle in cadaver and live parotidectomy
Robert L Witt1, Gregory S Weinstein, Lidia K Rejto
1Christiana Care Health Systems, Wilmington, Delaware 19806, USA. RobertLWitt@aol.com
Objectives/Hypothesis:
To prove that the tympanomastoid suture (TMS) is a significantly closer and less variable anatomic landmark to the facial nerve than the posterior-superior margin of the posterior belly of the digastric muscle (PBD) in parotid surgery.
Materials And Methods:
A prospective study of 14 cadaver specimens and 22 live patients comparing the closest measured distances between the TMS and PBD to the facial nerve.
Results:
The mean closest distances from the TMS and PBD to the facial nerve were 1.8 (range 0-4) mm and 12.4 (range 7-17) mm, respectively (P < .05) for cadavers. The mean closest distances in live patients from the TMS and PBD to the facial nerve were 2.0 (range 0-4) mm and 10.7 (range 5-14) mm, respectively (P < .05).
Conclusions:
Facial nerve identification and preservation is the key to successful parotid surgery. The TMS is a significantly closer and less variable anatomic landmark compared with the PBD both in cadaver dissection and in live patients.
