A "Window" to Protect the Facial Nerve: A Descriptive Cadaveric Study.

Area of Science:

• Anatomy
• Surgical Procedures

Background:

• Skeletal surgery success relies on adequate surgical access and exposure.
• The retromandibular approach provides access to the ramus condyle region.
• Variations in facial nerve branching impact surgical window accessibility.

Purpose of the Study:

• To investigate the retromandibular approach for skeletal surgery.
• To assess the safety window and accessibility related to facial nerve branching patterns.
• To evaluate the retromandibular vein as a landmark.

Main Methods:

• Dissection of thirty cadaveric facial halves using a retromandibular incision.
• Objective grading of visibility and accessibility.
• Measurement of safety window and furcation distance.
• Documentation of retromandibular vein appearance.

Main Results:

• Eighteen halves showed maximum accessibility; others had limited accessibility.
• Safety window ranged from 1.9 to 3.5 cm.
• Facial nerve encountered in 24 halves; retromandibular vein in 23 halves.

Conclusions:

• The retromandibular approach is versatile for the condyle and subcondylar area, offering good visibility and accessibility.
• Facial nerve branching patterns define the surgical safety window, which is adequate in most cases.
• The retromandibular vein serves as a reliable landmark for the facial nerve's proximity.