AI Summary & Key Takeaways
AI InsightConclusion: A surgical approach involving a skin-platysma-deep fascia flap incision placed 4 cm below the mandibular edge ensures safe exposure of the SMG while preserving both the marginal mandibular and cervical branches of the facial nerve.
📌 3 Key Takeaways
Abstract
Aims: This study aimed to describe the topographic anatomy of the marginal mandibular nerve (MMN) and cervical branch of facial nerve (CBFN) and propose a surgical technique to reduce the risk of MMN-CBFN injuries during submandibular gland (SMG) resection. Methods: 12 hemifaces from 7 low-formalin-fixed, red-blue-latex-injected cadaveric heads were dissected under 2.5×magnification using a surgical microscope. After elevation of skin-SMAS-platysma flap, a meticulous dissection was performed to expose the MMN, CBFN, facial vessels, hypoglossal nerve, masseter muscle, and SMG. All structures were mapped using relevant surgical landmarks. Results: The MMN was predominantly located (91.6%) in the 10 mm area both superior and inferior to the mandibular edge. The MMN crossed the mandibular edge 4.2±0.8 cm anterior to the mandibular angle (at the masseter’s anterior border) alongside the facial artery. The most inferior branch of the CBFN was located 3.7±0.6 cm below the mandibular edge. The MMN-CBFN consistently coursed between the layers of the investing fascia deep to the platysma. Conclusion: A surgical approach involving a skin-platysma-deep fascia flap incision placed 4 cm below the mandibular edge ensures safe exposure of the SMG while preserving both the marginal mandibular and cervical branches of the facial nerve.