This material is accepted for publication in Operative Neurosurgery journal.
Please find the paper on the following LINK
Please find the paper on the following LINK
01. Facial nerve with parotid gland preserved
Soft tissue dissection of the superficial anatomical layers of the head and neck. The scalp blood supply as well as innervation is presented. The frontal and temporal branches of the facial nerve are microsurgically dissected and presented.
Annotations Sternocleidomastoid m., Great auricular n., Splenius capitis m., Splenius cervicis m., Levator scapulae m., Splenius medius m., External jugular v., Trapezius m., Posterior auricular v., Occipitalis minor m., Occipital a., Masseter m., Platysma m., Facial v., Auriculotemporal n., Facial n., Frontal branch of the facial n., Zygomatic branch of the facial n., Superficial temporal a., Parietal branch, Frontal branch, Auricularis anterior m., Temporalis m., Auricularis superior m., Orbicularis oculi m., Occipitofrontalis m., Buccal fat pad
Soft tissue dissection of the superficial anatomical layers of the head and neck. The scalp blood supply as well as innervation is presented. The frontal and temporal branches of the facial nerve are microsurgically dissected and presented.
Annotations Sternocleidomastoid m., Great auricular n., Splenius capitis m., Splenius cervicis m., Levator scapulae m., Splenius medius m., External jugular v., Trapezius m., Posterior auricular v., Occipitalis minor m., Occipital a., Masseter m., Platysma m., Facial v., Auriculotemporal n., Facial n., Frontal branch of the facial n., Zygomatic branch of the facial n., Superficial temporal a., Parietal branch, Frontal branch, Auricularis anterior m., Temporalis m., Auricularis superior m., Orbicularis oculi m., Occipitofrontalis m., Buccal fat pad
02. Facial nerve with parotid gland removed
The parotid gladn has been removed exposing the main trunk of the facial nerve at the stylomastoid foramen exit. The buccal and mandibular branche of the VIIth nerve has been microsurgically dissected and presented. A neck dissection exposing the carotid artery, jugular vein and the hypoglossal nerve was done.
Annotations Facial n., Frontal branch, Zygomatic branch, Buccal branch, Mandibular branch, Digastric m., Hypoglossal n., Internal jugular v., Internal carotid a., External carotid a., Common carotid a., External jugular v., Facial v., Submandibular gland., Facial a., Masseter m., Fat pad with branches from the facial n., Risorius m., Zygomaticus major m., Auricularis anterior m., Orbicularis oculi m., Occipitofrontalis m., Superficial temporal a., Auricularis superior m., Parietal branch, Frontal branch, Posterior auricular n., Occipital a., Occipitalis minor n., Great auricular n., Sternocleidomastoid m., Splenius capitis m., Splenius cervicis m., Trapezius m., Levator scapulae m., Scalenus medius m.
The parotid gladn has been removed exposing the main trunk of the facial nerve at the stylomastoid foramen exit. The buccal and mandibular branche of the VIIth nerve has been microsurgically dissected and presented. A neck dissection exposing the carotid artery, jugular vein and the hypoglossal nerve was done.
Annotations Facial n., Frontal branch, Zygomatic branch, Buccal branch, Mandibular branch, Digastric m., Hypoglossal n., Internal jugular v., Internal carotid a., External carotid a., Common carotid a., External jugular v., Facial v., Submandibular gland., Facial a., Masseter m., Fat pad with branches from the facial n., Risorius m., Zygomaticus major m., Auricularis anterior m., Orbicularis oculi m., Occipitofrontalis m., Superficial temporal a., Auricularis superior m., Parietal branch, Frontal branch, Posterior auricular n., Occipital a., Occipitalis minor n., Great auricular n., Sternocleidomastoid m., Splenius capitis m., Splenius cervicis m., Trapezius m., Levator scapulae m., Scalenus medius m.
03. Facial nerve mastoid segment
The facial nerve can be followed from the mastoid segment to extracranial course and its branches.
Annotations Facial n., Frontal branch, Zygomatic branch, Buccal branch, Mandibular branch, Digastric m., Hypoglossal n., Internal jugular v., Internal carotid a., External carotid a., Common carotid a., External jugular v., Facial v., Lingual v., Submandibular gland., Facial a., Masseter m., Fat pad with branches from the facial n., Risorius m., Zygomaticus major m., Auricularis anterior m., Orbicularis oculi m., Occipitofrontalis m., Superficial temporal a., Auricularis superior m., Ophthalmic v., Parietal branch, Frontal branch, Temporalis m., Temporalis m., External jugular v., Posterior auricular v., Transverse sinus, Mastoid sinus, Mastoid emmissary v., Spine of Henle, Root of zygoma, Lateral semicircular canal, Superior semicircular canal, Posterior semicircular canal, Endolymphatic sac, Jugular bulb, Superior petrosal sinus, Temporal dura, Retrosigmoid dura, Incus, Chorda tympani, Occipitalis minor n., Occipital a., Sternocleidomastoid m.
The facial nerve can be followed from the mastoid segment to extracranial course and its branches.
Annotations Facial n., Frontal branch, Zygomatic branch, Buccal branch, Mandibular branch, Digastric m., Hypoglossal n., Internal jugular v., Internal carotid a., External carotid a., Common carotid a., External jugular v., Facial v., Lingual v., Submandibular gland., Facial a., Masseter m., Fat pad with branches from the facial n., Risorius m., Zygomaticus major m., Auricularis anterior m., Orbicularis oculi m., Occipitofrontalis m., Superficial temporal a., Auricularis superior m., Ophthalmic v., Parietal branch, Frontal branch, Temporalis m., Temporalis m., External jugular v., Posterior auricular v., Transverse sinus, Mastoid sinus, Mastoid emmissary v., Spine of Henle, Root of zygoma, Lateral semicircular canal, Superior semicircular canal, Posterior semicircular canal, Endolymphatic sac, Jugular bulb, Superior petrosal sinus, Temporal dura, Retrosigmoid dura, Incus, Chorda tympani, Occipitalis minor n., Occipital a., Sternocleidomastoid m.
04. Facial nerve labyrinthine and tympanic segments
A combined petrosal approach type bone flap was done ezposing the middle fossa. Extradural exposure of the Meckel’s cave and gasserion ganglion was done. The mandibular and maxillary divisions of the trigeminal nerve were exposed. The internal accoustic canal was drilled from middle fossa and the labyrinthine and tympanic segments of the facial nerve, as well as the geniculate ganglion were revealed. Therefore the facial nerve can be followed from the internal accoustic canal to its extracranial branches.
Annotations Facial n., Chorda tympani, Geniculate ganglion, GSPN, Incus, Lateral semicircular canal, Superior semicircular canal, Posterior semicircular canal, Cochlea, Anterior petrosectomy, Mandibular n., Middle meningeal a., Maxillary n., Internal acoustic canal, Posterior fossa dura, Tentorium, Middle fossa dura, Transverse sinus, Sigmoid sinus, Superior petrosal sinus, Petrosigmoid fossa, Endolymphatic sac, Frontal branch, Zygomatic branch, Buccal branch, Mandibular branch, Digastric m., Hypoglossal n., Zygomaticus major m., Orbicularis oculi m., Occipitofrontal m., Superficial temporal a., Posterior auricular v., External jugular v., Great auricular n., Sternocleidomastoid m., Facial v., Facial a., Masseter m., Splenius capitis m., Occipital a., Splenius cervicis m., Levator scapulae m., Trapezius m.
A combined petrosal approach type bone flap was done ezposing the middle fossa. Extradural exposure of the Meckel’s cave and gasserion ganglion was done. The mandibular and maxillary divisions of the trigeminal nerve were exposed. The internal accoustic canal was drilled from middle fossa and the labyrinthine and tympanic segments of the facial nerve, as well as the geniculate ganglion were revealed. Therefore the facial nerve can be followed from the internal accoustic canal to its extracranial branches.
Annotations Facial n., Chorda tympani, Geniculate ganglion, GSPN, Incus, Lateral semicircular canal, Superior semicircular canal, Posterior semicircular canal, Cochlea, Anterior petrosectomy, Mandibular n., Middle meningeal a., Maxillary n., Internal acoustic canal, Posterior fossa dura, Tentorium, Middle fossa dura, Transverse sinus, Sigmoid sinus, Superior petrosal sinus, Petrosigmoid fossa, Endolymphatic sac, Frontal branch, Zygomatic branch, Buccal branch, Mandibular branch, Digastric m., Hypoglossal n., Zygomaticus major m., Orbicularis oculi m., Occipitofrontal m., Superficial temporal a., Posterior auricular v., External jugular v., Great auricular n., Sternocleidomastoid m., Facial v., Facial a., Masseter m., Splenius capitis m., Occipital a., Splenius cervicis m., Levator scapulae m., Trapezius m.
05. Facial nerve and facial colliculus fourth ventricle
Annotations V. of cerebellopontine fissure, Right vertebral a., Left vertebra a., Anterior spinal a., PICA, XII n, Olive, VI n., IX/X/XI nerve group, VII/VIII nerve group, V nerve right, Pons, Basilar a., SCA, III n., PCA P2, Substantia nigra, Nucleus ruber, Aqueduct, Cerebral peduncle, Perforating a., PCA P1, Pcom, IV n., Vein of cerebellomedullary fissure, Superior petrosal v., V nerve left, Medulla oblongata, XII n. fibers left, VI nerve
Annotations V. of cerebellopontine fissure, Right vertebral a., Left vertebra a., Anterior spinal a., PICA, XII n, Olive, VI n., IX/X/XI nerve group, VII/VIII nerve group, V nerve right, Pons, Basilar a., SCA, III n., PCA P2, Substantia nigra, Nucleus ruber, Aqueduct, Cerebral peduncle, Perforating a., PCA P1, Pcom, IV n., Vein of cerebellomedullary fissure, Superior petrosal v., V nerve left, Medulla oblongata, XII n. fibers left, VI nerve
06. Skull base and internal acoustic canal
Annotations Vertebral artery V3 segment, Venous plexus, Left accessory nerve, Right accessory n., Hypoglossal n., Jugular tubercle, VII/VIII nerve complex, IX/X/XI nerve complex, Labyrinthine a., Petrosal v., Suprameatal tubercle, Trigeminal n., Abducens n., Porus trigeminus, Trochlear n., Oculomotor n., IV nerve, V1, V2, V3, Gasserian ganglion, GSPN, Arcuate eminence, Tegmen tympani, Middle meningeal a. and v., Clivus and associated venous plexus, Chiasma opticum, Anterior clinoid process, Internal carotid a., Middle cerebral a., Anterior cerebral a., Periorbita, Sigmoid sinus, Vertebral artery V4 segment, Transverse sinus
Annotations Vertebral artery V3 segment, Venous plexus, Left accessory nerve, Right accessory n., Hypoglossal n., Jugular tubercle, VII/VIII nerve complex, IX/X/XI nerve complex, Labyrinthine a., Petrosal v., Suprameatal tubercle, Trigeminal n., Abducens n., Porus trigeminus, Trochlear n., Oculomotor n., IV nerve, V1, V2, V3, Gasserian ganglion, GSPN, Arcuate eminence, Tegmen tympani, Middle meningeal a. and v., Clivus and associated venous plexus, Chiasma opticum, Anterior clinoid process, Internal carotid a., Middle cerebral a., Anterior cerebral a., Periorbita, Sigmoid sinus, Vertebral artery V4 segment, Transverse sinus