Author(s)

Ashraful Islam^1*, Mashiur Rahman², Tareq Mohammad², Milon Kazi², Nazmul Hossain Choudhury², ASM Lutfur Rahman², Farid Uddin Milki²

¹Head, Otolaryngology—Head & Neck Surgery, Bangladesh Medical College & Hospital, Dhaka, Bangladesh.
²ENT, Bangladesh Medical College & Hospital, Dhaka, Bangladesh.

Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.

Facial Nerve Trunk, Identification, Styloid Process, Parotid Surgery

Islam, A. , Rahman, M. , Mohammad, T. , Kazi, M. , Choudhury, N. , Rahman, A. and Milki, F. (2022) Styloid Process Is the Robust Landmark for Identification of the Facial Nerve during Parotid Surgery. International Journal of Otolaryngology and Head & Neck Surgery, 11, 164-174. doi: 10.4236/ijohns.2022.114018.