Craniofacial Surgery

Biography

Biography: Dr.Gopi Satya Sai Reddy

Abstract

In parotid surgeries most commonly faced complication is iatrogenic facial palsy, To decrease the incidence of this complication many landmarks are being used to identify the facial nerve like Tragal pointer, Tympanomastoid suture line, Posterior belly of Digastric muscle, Digastric ridge, Retrograde tracing from marginal mandibular branch of facial. Even with the use of the above landmarks sometimes identification of facial nerve becomes difficult due to distortion of anatomy by tumor and in revision surgeries. There is an incidence of around 40% of transient and 17% of complete facial palsy is parotid surgeries and the risk increases in malignant and revision cases. In this study we tried to explore the possibility of using the Posterior auricular artery as a new landmark for facial nerve identification in parotid surgeries. Our study was done on 12 cadaveric hemifaces where we identified the posterior auricular artery along with its stylomastoid branch and their relation with facial nerve and other predetermined landmarks was measured followed by a high definition photography. We found a fairly consistent and stable relation of posterior auricular artery to facial nerve and surrounding structures. Our results show an average distance of 6.49mm and a range of 5-7 mm between posterior auricular artery and facial nerve. With our results we propose that post auricular artery can be used as a safe and reliable land mark for facial nerve in parotid surgeries, especially in tumours located high up in parotid gland.