The Anatomic Landmark Approach to Extratemporal Facial Nerve Repair in Facial Trauma.

Area of Science:

• Maxillofacial Surgery
• Facial Nerve Anatomy
• Trauma Reconstruction

Background:

• Extratemporal facial nerve injuries are common in maxillofacial trauma.
• Accurate identification and repair of injured facial nerve branches are crucial for functional recovery.
• Topical anatomic landmarks can aid in locating damaged facial nerve segments.

Purpose of the Study:

• To examine topical anatomic landmarks of the facial nerve.
• To assess the application of these landmarks in extratemporal facial nerve injury cases.
• To correlate facial nerve injury patterns with trauma characteristics and external landmarks.

Main Methods:

• Analysis of 25 maxillofacial trauma patients with facial paralysis undergoing nerve reanimation.
• Recording of trauma characteristics: mechanism, injury length, and location.
• Association analysis between injured nerves, trauma characteristics, and four defined facial nerve areas.

Main Results:

• Buccal branches were most frequently paralyzed (22/25), followed by zygomatic (15/25), frontal (11/25), and marginal (6/25).
• Specific facial nerve areas correlated with paralysis patterns: Area 1 (frontal), Area 2 (zygomatic/buccal), Area 3 (marginal), and Area 4 (main trunk/multiple branches).
• The four identified surface landmarks aided in anticipating traumatized branches and estimating nerve endings for repair.

Conclusions:

• Extratemporal facial paralysis post-trauma is variable and challenging to manage.
• Clinical examination and trauma evaluation are vital for identifying and repairing facial nerves.
• Mapping facial wounds to the four anatomic surface landmarks facilitates anticipation of nerve injury and guides surgical repair.