The Pattern of Facial Nerve Branching: A Cadaveric and Clinical Study

Abstract

Background: Thorough understanding of the branches of the facial nerve is critical during parotidectomy. Many variations of the branching patterns have been observed among different populations. The objective of this study was to determine the different branching patterns in a Sudanese population. Materials and Methods: A total of 90 facial nerves were dissected. There were 40 cadavers (bilateral) and 10 patients (unilateral) who underwent parotidectomy. Only specimens with benign parotid pathology with intact facial nerve were included. Out of the 90 facial nerves examined, 41 were males and 9 females. Forty-six specimens (51%) were left; and 44 (49%) were right facial nerves. Facial nerve branching patterns were classified into 5 types as described by Katz and Kopuz. Results: The most common branching pattern was type III found in 42 cases (46.6%). The second most common was type I which was seen in 18 cases (20%). This is the most common type reported in the literature. Types II, IV, and V were found to be 8.8%, 12.2%, and 11% respectively. Conclusion: Facial nerve branching patterns are very variable and can be very complex. Significant differences exist between races. Surgeons who perform parotidectomy should be very familiar with these differences to avoid surgical misadventures.