Skin incision:
A curved skin incision (left side, marked with green) is made just in front of the tragus extending in caudal direction behind the mandibular angle and curving anteriorly to the neck below the mandible. In cranial direction the skin incision is slightly curved ending below the superior temporal line.
A curved skin incision (left side, marked with green) is made just in front of the tragus extending in caudal direction behind the mandibular angle and curving anteriorly to the neck below the mandible. In cranial direction the skin incision is slightly curved ending below the superior temporal line.
1. SMAS exposure
A curved skin incision (left side, marked with green) is made just in front of the tragus extending in caudal direction behind the mandibular angle and curving anteriorly to the neck below the mandible. In cranial direction the skin incision is slightly curved ending below the superior temporal line. The skin is elevated from the Superficial Musculoaponeurotic System (SMAS) of the face. The parotid gland is identified, and the superficial temporal artery is presented.
A curved skin incision (left side, marked with green) is made just in front of the tragus extending in caudal direction behind the mandibular angle and curving anteriorly to the neck below the mandible. In cranial direction the skin incision is slightly curved ending below the superior temporal line. The skin is elevated from the Superficial Musculoaponeurotic System (SMAS) of the face. The parotid gland is identified, and the superficial temporal artery is presented.
2. Zygomatic branch of the facial nerve identified
The parotid glad in dissected and the zygomatic branch of the facial nerve is identified with the help of electrostimulation. The zygomatic branch is followed to the root of the facial nerve at the stylomastoid foramen.
The parotid glad in dissected and the zygomatic branch of the facial nerve is identified with the help of electrostimulation. The zygomatic branch is followed to the root of the facial nerve at the stylomastoid foramen.
3. Massteric nerve identified
The masseteric branch of the trigeminal nerve is identified between the fibers of the masseter muscle, below the zygomatic arch.
The masseteric branch of the trigeminal nerve is identified between the fibers of the masseter muscle, below the zygomatic arch.
4. Masseteric to facial nerve anasotomosis
The zygomatic branch of the facial nerve is transected and reflected anteriorly. The Masseteric nerve is mobilized and transected. A masseteric to facial nerve anastomosis is done under microscopic magnification with two 9.0 nylon sutures.
The zygomatic branch of the facial nerve is transected and reflected anteriorly. The Masseteric nerve is mobilized and transected. A masseteric to facial nerve anastomosis is done under microscopic magnification with two 9.0 nylon sutures.