TITLE:
Styloid Process Is the Robust Landmark for Identification of the Facial Nerve during Parotid Surgery
AUTHORS:
Ashraful Islam, Mashiur Rahman, Tareq Mohammad, Milon Kazi, Nazmul Hossain Choudhury, ASM Lutfur Rahman, Farid Uddin Milki
KEYWORDS:
Facial Nerve Trunk, Identification, Styloid Process, Parotid Surgery
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.11 No.4,
July
15,
2022
ABSTRACT: 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.