Frontotemporal branch of the facial nerve and fascial layers in the temporal region a cadaveric study to define a safe dissection plane sihag RK, gupta SK, sahni d, aggarwal a neurol india

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ORIGINAL ARTICLE Year : 2020 | Volume : 68 | Issue : 6 | Page : 1313-1320

Frontotemporal Branch of the Facial Nerve and Fascial Layers in the Temporal Region: A Cadaveric Study to Define a Safe Dissection Plane

Rakesh K Sihag1, Sunil K Gupta1, Daisy Sahni2, Ashish Aggarwal1

1 Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

2 Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication 19-Dec-2020

Correspondence Address:

Dr Sunil K Gupta Department of Neurosurgery, PGIMER, Chandigarh 160012 India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.304113

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» Abstract

Background: Anatomy of the temporal region is complex with controversy over

the relationship of fascial planes with the upper division of the facial nerve

Objective: This study aimed to identify the safe surgical landmarks to preserve the

frontotemporal branch of the facial nerve during surgery and define the safest approach for surgical procedures in this region

Material and Methods: The anatomical relationship of the frontal branch of the

facial nerve, superficial temporal artery (STA), fascial planes, and fat pads was determined after dissection on 10 cadaveric heads, that is (20 sides) Dissection was performed layer by layer from skin to bone

Results: The temporoparietal fascia was made up of multiple (3–4) layers above

the zygomatic arch and these layers were integrated with thin fibrous septa The frontotemporal branch of the facial nerve (FTFN) was observed in a deeper part of temporoparietal fascia and superficial fat pad The frontotemporal branch of the facial nerve (FTFN) crossed the zygomatic arch as two branches in 25%, as three branches in 65% and as four branches in 10% of specimens

Conclusions: Interfascial dissection between two layers of deep temporal fascia

through the intermediate fat pad is superior to other approaches because of the lack

of facial nerve branches in this plane The Intermediate fat could be easily separated from deep layer of deep temporal fascia

Keywords: Temporal fascia, facial nerve, dissection plane Key Messages: This article, through cadaver studies, defines the disposition of the

frontotemporal branch of the nerve in relation to the different temporal fascia and the fat pads is necessary to stay in the correct dissection plane

How to cite this article:

Sihag RK, Gupta SK, Sahni D, Aggarwal A Frontotemporal Branch of the Facial Nerve and Fascial Layers in the Temporal Region: A Cadaveric Study to Define a Safe Dissection Plane Neurol India 2020;68:1313-20

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Sihag RK, Gupta SK, Sahni D, Aggarwal A Frontotemporal Branch of the Facial Nerve and Fascial Layers in the Temporal Region: A Cadaveric Study to Define a Safe Dissection Plane Neurol India [serial online] 2020 [cited 2021 May

14];68:1313-20 Available from: https://www.neurologyindia.com/text.asp?

2020/68/6/1313/304113

Knowledge of the anatomical landmarks is an essential prerequisite for any surgical procedure The relationship of the temporal fascial planes with the upper division of the facial nerve remains controversial.[1],[2],[3],[4],[5],[6],[7],[8],[9],[10], [11] , [12] , [13] , [14] , [15] , [16]

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The frontotemporal division of the facial nerve (FTFN) supplies muscles of the forehead and face through temporal and zygomatic branches Small branches of the frontotemporal nerve supply the orbicularis oculi, frontalis, and auricularis muscles The anatomy of FTFN in tissue layers has been debated extensively in the literature Many of these studies lack in exact dimension and measurements from fixed landmarks to identify the nerve intra-operatively.[1],[2],[3],[7],[9],[10],[11], [12] , [13] , [14] , [16] , [17]

FTFN is prone to injury in surgical procedures like pterional, frontotemporal orbitozygomatic (FTOZ) craniotomy either directly or indirectly due to the stretching of a nerve This cadaveric study aimed to identify the safe surgical landmarks to preserve the FTFN during surgery

» Material and Methods

The anatomical relationships of the FTFN, superficial temporal artery (STA), fascial planes, and fat pads were determined on 10 cadaveric heads, that is (20 sides) Layer by layer dissection was done from skin to bone Different names were described in the literature for fascia, fat pads, and nerve; therefore, preferred names are taken to avoid confusion [Table 1]

Table 1: Nomenclature of fascia, fat pads, and nerve in literature

Click here to view

Surgical technique

The skin incision started 3 cm below the base of the zygomatic arch, 1 cm anterior

to the tragus, curving forward toward the frontal region ending in the midline at the hairline [Figure 1] Incision involved skin, subcutaneous tissue superficial to the temporoparietal fascia The temporoparietal fascia was dissected layer by layer inferiorly up to parotidomasseteric fascia and reflected anterolaterally with the scalp flap The STA was identified and separated from the skin by dissection in the subcutaneous plane

Figure 1: Surface marking of the skin Incision Incision started 3 cm below the base of the zygomatic arch and 1 cm anterior to the tragus, curving upward and backward above the pinna and then forward toward the frontal region and ended in the midline at the hairline (left side)

Two standard lines were drawn based on the skeletal landmark, the L1 line connecting the lateral bony canthus (LBC) to the upper level of the tragus,

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corresponding to the upper border of the zygomatic arch (Z) and line L2 perpendicular to L1 at lateral bony canthus [Figure 2]a Distances were measured

at points, where the branches of nerve and vessels crossed L1 and L2 The frontotemporal branch of the facial nerve usually had three rami; the point where anterior rami of a frontotemporal branch of facial nerve crossed L1 is the N1 point, middle rami N2, and posterior rami N3 point If multiple branches were crossing then thickest was selected for an objective If only two branches crossed, then anterior and posterior were considered The point where the uppermost nerve crossed the L2 was designated as F, and distance from lateral bony canthus to where the frontal branch of superficial temporal artery (STA) cross the L2 was A1

[Figure 2]b

Figure 2: (a) Surface marking showing line L1 and L2 and (b) the measuring points on the two standard lines LBC- Lateral bony canthus, L1 line connecting the lateral bony canthus to the upper level of the tragus, L2 line perpendicular

to L1 at lateral bony canthus, N1 point where anterior rami of FTFN crossed L1, middle rami N2 and posterior rami N3 point, F- distance from LBC to where the upper most nerve crossed L2, A1 distance between lateral bony canthus to where the frontal branch of STA crosses the L2 (Left side)

» Observations and Results

Following fascial layers and fat pads were observed: temporoparietal fascia, superficial fat pad, the superficial layer of deep temporal fascia, intermediate fat pad, deep layer of deep temporal fascia, deep fat pad and temporal muscle [Figure 3]

Figure 3: Coronal dissection of temporal fossa showing fascial planes and fat pads S -skin, TPF -Temporoparietal fascia, DTF -Deep temporal fascia, S-DTF- superficial layer of deep temporal fascia, D-DTF-deep layer of deep temporal fascia, SFP- superficial fat pad, IFP-intermediate fat pad, DFP- deep fat pad, STV-superficial temporal vein, STA- STV-superficial temporal artery, FTFN- frontotemporal branch of facial nerve, Z- zygomatic arch, PG- parotid gland, TM- temporal muscle)

The temporoparietal fascia was made up of multiple (3–4) layers above the zygomatic arch and these layers integrated with thin fibrous septa deep to the subcutaneous tissue These layers were well defined just above the middle part of

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the zygomatic archand condensed with each other near the superior temporal line

to become a thin single layer This thin layer merged with deep temporal fascia and was attached to the superior temporal line Anteriorly, this fascia inserted into the lateral orbital rim [Figure 4] The temporoparietal fascia which descended below the zygomatic arch continued as a superficial musculoaponeurotic system (SMAS) and had no attachment to the zygomatic arch The temporoparietal fascial layers above the zygomatic arch were easier to dissect from the superficial layer of the deep temporal fascia because of the fatty layer present between them, mainly

in the middle part

Figure 4: Temporoparietal fascia covering STA, STV and FTFN TPF- Temporoparietal fascial layer, Fr-STA- Frontal branch of STA, STV-Superficial temporal vein (Right side)

The superficial fat pad was present between the temporoparietal fascia and superficial layer of deep temporal fascia The thickness of this fat pad was variable, depending on the habitu of the cadaver Maximum thickness was found

in the middle third The superficial temporal vessels were found in the outer part

of temporoparietal fascia whereas the frontotemporal branch of the facial nerve (FTFN) was observed in the deeper part of temporoparietal fascia and superficial fat pad [Figure 4], [Figure 5], [Figure 6] and [Figure 7]

Figure 5: Dissection of the layers of temporal fascia STL-Superior temporal line, S-DTF-superficial layer of deep temporal fascia, D-DTF-Deep layer of deep temporal fascia, SFP-superficial fat pad, IFP- intermediate fat pad 5a-Right side; 5b-Left side

Figure 6: Intermediate fat pad (a) and deep fat pad (b) D-DTF- deep layer of deep temporal fascia, TM- Temporal muscle, DFP- deep fat pad (Left side)

Figure 7: Frontotemporal branches of facial nerve in planer dissection of temporal region 1, 2,3-branches of FTFN, S-DTF- superficial layer

of DTF, TPF- Temporoparietal fascia, STA-superficial temporal artery, SFP- STA-superficial fat pad 7a-Left, 7b-Right, 7c-Left

There was tight adhesion observed over the zygomatic arch between the temporoparietal fascia and superficial layer of the deep temporal fascia, which covered the zygomatic arch The deep temporal fascia which covers the temporal muscle is attached to the superior temporal line, and inferiorly this fascia splits

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into the superficial and deep layer [Figure 5]a The superficial layers continued inferiorly through the anterior surface of the zygomatic arch to form

parotidomasseteric fascia, and deep layer inferiorly attached to the posterosuperior margin of the zygomatic arch These two facial layers were well separated in the middle third by the fat pad and fused in their anterior and posterior third The superficial and deep layers become thicker as it descends towards the zygomatic arch from the superior temporal line [Figure 5]

In between both layers of deep temporal fascia, the fat pad present termed as an intermediate fat pad [Figure 6]a Multiple fibrous septa extend from superficial layer of the deep temporal fascia to this fat pad and this fat layer was more densely adherent to superficial layer by multiple fibrous septa and was loosely adherent to the deep layer This fat layer was observed near the middle third of the zygomatic arch and disappeared below the arch Sometimes deep fat pad was present below the deep layer of deep temporal fascia [Figure 6]b

Frontotemporal branch of facial nerve

Facial nerve gave frontotemporal branch within the parotid gland, courses within parotid, emerged from the anterosuperior surface and then crossed over zygomatic arch Itusually consisted of more than two branches in each cadaver half [Figure 7] The FTFN crossed the zygomatic arch as a single twig in 0.0% cases, as 2 branches in 25%, as 3 branches in 65% and as 4 branches in 10% of specimens It crossed the zygomatic arch area and curved forward inside the deeper layers of temporoparietal fascia and in the superficial fat pad As it coursed upward, it became superficial and near superior orbital rim, pierced temporoparietal fascia to supply frontalis and orbicularis muscles [Figure 8]a The FTFN usually had 3 branches at the upper border of the zygomatic arch, called the anterior, middle, and posterior rami The distance of the most anterior branch of the FTFN from lateral bony canthus (LBC) to 3.2 cm and posterior was 5.1 cm

Figure 8: (a) Frontotemporal branches of facial nerve on right side pierced temporoparietal fascia and supply frontalis and orbicularis muscles; (b) Superficial temporal artery and its course in temporoparietal fascia

Superficial temporal artery

It traveled in a superficial plane of the temporoparietal fascia The branches of the FTFN were anteroinferior to superficial temporal artery [Figure 4], [Figure 8]a and

[Figure 8]b The average distance of superficial temporal artery bifurcation from the upper border of the zygomatic arch was 24 mm In 90% of cases, the

bifurcation took place above the upper border of the zygomatic arch, and in the rest of 10% cases over the arch

Measurements

The distance from lateral bony canthus (LBC) to the points N1, N2, N3 where the FTFN branches (anterior, middle, posterior) crossed L1 measured and A1, F measured on L2

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(N1 point where anterior rami of FTFN crossed L1, middle rami N2 and posterior rami N3 point, F- distance from LBC to where the uppermost nerve crossed L2, A1 distance between lateral bony canthus to where the frontal branch of STA crosses the L2) [Table 2] and [Table 3]

Table 2: Measurements (in cms) of different crossing points of branches of frontotemporal brances of frontal nerve and of superficial temporal artery

Table 3: Average, standard deviation and range

of both sides (in cm)

The average distance between LBC and N1 was 3.2 (±0.55) cm, between LBC and N2 4.2 (±0.59) cm, between LBC and N3 5.1 (±0.49) cm, between LBC and F, 2.4 (±0.54) cm, and between LBC and A1, 3.4 (±0.42) cm The average width of FTFN across the L1 (upper border of the zygomatic arch) was about 1.9 cm and the distance between each ramus was about 1.2 cm [Table 4] The average distance between a frontal branch of superficial temporal artery (STA) and the FTFN was 1.1 cm (range: 0.5–2.3) No significant difference was observed between the two

sides in the t test.

Table 4: Distance between each ramus on L1 (N1-N2-N3) in cm

» Discussion

Anatomical texts of fascial planes in the temporoparietal region are confusing and controversial because of dense adhesions and there is inconsistent use of

nomenclature of fascial layers

Fascial layers and fat pads

Mitz and Peyronie[18] described that temporoparietal fascia presents as a fibromuscular sheet between the facial muscle and the dermis and forms part of

the superficial muscular aponeurotic system (SMAS) Hing et al.[19] observed that temporoparietal fascia was attached to the zygomatic arch We observed that temporoparietal fascia was made up of multiples layers (3–4) above the zygomatic arch and these layers were integrated by fibrous septa [Figure 4] Our results are

similar that observed by Babakurban et al.[11] and Tellioglu et al.[20]

Campiglio et al.[12] and Beheiry et al.[21] observed that above the level of the zygomatic arch, the temporal muscle fascia separated into two sheets, the superficial sheet abutting the zygoma and continuing as parotidomasseteric fascia and the deep sheet abutting the posterior surface of the arch The above two fascial

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sheets were well separated in the middle third by a fat pad and fused in the anterior and posterior third

Yasargil et al.[22] observed that at the orbital level the deep temporal fascia split into two layers The superficial layer was attached to the lateral border of the zygoma and deep layer to the medial border of the zygomatic arch and both layers were separated by a fat layer

Our observations are consistent with most of the studies[13],[16],[23],[24], inthat the temporoparietal fascia was made up of multiple (3–4) layers above the zygomatic arch which were integrated with thin fibrous septa deep to the subcutaneous tissue These layers were well defined just above the middle part of the zygomatic arch These multiple layers condensed with each other near the superior temporal line and became a thin single layer This thin layer merged with deep temporal fascia and was attached to the superior temporal line Anteriorly, this fascia inserted into the lateral orbital rim

The deep temporal fascia was a thick, dense tough fibrous layer covering the temporal muscle; superiorly it attached to the superior temporal line, anteriorly to the orbital rim as a single layer, and split into two layers 2 cm below the superior temporal line [Figure 5] and [Figure 6] The superficial layer of deep temporal fascia crosses the zygomatic arch and continues as the parotidomasseteric fascia and deep layer inserted to the posterosuperior edge of the zygomatic arch

Frontotemporal branch of the facial nerve

We observed that FTFN was not a single nerve, but multiple branches crossing the zygomatic arch and anastomosing with each other [Figure 7] The finding of the

multiplicity of branches was consistent with the finding of Gosain et al.[15], Sabini

et al.[10] but different from Pitanguy et al.[2] who observed a single branch

The FTFN crossed the zygomatic arch as a single branch in 0.0% cases, as two branches in 25%, as three branches in 65% and as four branches in 10% of specimens This is at variance with the findings of some other studies[11],[25]

[Table 5]

Table 5: Number of Branches of FTFN across the zygomatic arch

In our study, we observed that the frontal branch of superficial temporal artery (STA) was located on average 3.4 cm from lateral bony canthus (LBC) on L2 and distance between artery and nerve was on an average, 1.1 cm The mean distance between lateral bony canthus (LBC) and anterior rami of the frontotemporal branch of the facial nerve (N1) was 3.2 cm, between LBC and middle rami (N2) 4.2 cm, and between LBC and posterior rami (N3) 5.1 cm [Table 3] Our results are consistent with that observed by Ishikawa.[26]

Beheiry[21] reported that frontotemporal branches of the facial nerve are found

within layers of temporoparietal fascia and fat pad Ammirati et al. 16 observed that the terminal branches of the temporal branch penetrated the temporoparietal

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fascia at different levels In our study, we showed that the FTFN traversed in deeper planes of temporoparietal fascia above the zygomatic arch and then pierced the fascia near the superior orbital rim to supply frontalis and orbicularis muscle

Dissection plane for the preservation of frontotemporal branch of the facial nerve (FTFN)

In literature, different approaches have been described for safe surgical dissection

to preserve the FTFN

Ammirati et al.[16] observed that terminal branches of the frontotemporal branch

of facial nerve penetrated the temporoparietal fascia at different levels and due to wrong identification of intermediate fat pad as the superficial fat pad,

frontotemporal branches were injured during interfacial dissection, so he described

submuscular dissection to preserve nerve branches Stuzin et al.9 describes that dissection should start in the superficial fat pad and 2 cm above the zygomatic

arch dissection deepen into an intermediate fat pad to preserve nerve Coscarella et

al. 13 proposed submuscular dissection (deep to the temporal muscle) or subfascial dissection (deep to the deep temporal fascia layer) based on the observation that the frontotemporal branch courses within the superficial fat pad Beheiry and Hamid[21] observed that the frontotemporal branch of facial nerve coursed within layers of temporoparietal fasciaand recommended interfascial dissection

Yasargil[22] described interfascial dissection which comprises splitting of two layers of deep temporal fascia through an intermediate fat pad, thus protecting the FTFN Splitting of two layers directly exposes the zygomatic arch and

subperiosteal dissection can be done In another recent article based on cadaver dissections, authors favored the subfascial method, below both the layers of deep fascia, for preservation of facial nerve.[27] Facial nerve danger zones during various plastic surgery procedures have been the object of study for preservation

of frontal, cervical and marginal branches.[28] A safety zone for incisions used for supraorbital key hole surgery in relation to the frontozygomatic junction has been described.[29]

In our study, we reviewed the results of various approaches that may be used for dissection near the zygomatic arch [Figure 9] In addition, the advantages and disadvantages of these various approached were compared [Table 6]

Figure 9: Various surgical approaches shown in figure [1, 2, 3-interfascial (red color line), 4-subfascial (blue line), 5-sub muscular approach (black line)]

Table 6: Comparison of various dissection approaches in temporal region [Figure 9]

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1 The first approach between temporoparietal fascia and the superficial layer

of deep temporal fascia through superficial fat pad [Figure 9] shown by red line 1]

2 The second approach between two layers of deep temporal fascia through an intermediate fat pad [Figure 9] shown by red line 2]

3 The third approach is the combination of the above two approaches which started between temporoparietal fascia and the superficial layer of deep temporal fascia and near the zygomatic arch (around 2 cm above the arch) deepens into intermediate fat pad [Figure 9] shown by red line 3]

4 The fourth approach below the deep layer of deep temporal fascia and above the temporal muscle [Figure 9] shown by blue line 4]

5 Fifth approach the skin, fascia and temporal muscle raised as a single flap, temporal muscle separated from temporal bone [Figure 9] shown by black line 5]

In the first approach, we observed that temporoparietal fascia and the superficial layer of deep temporoparietal fascia are separated by the superficial fat pad and these two fascial layers are adherent to each other by fibrous septa over and below the zygomatic arch The fat pad disappears below the zygomatic arch so dissection between these two layers increases the risk of injury to the frontotemporal nerve (FTFN)

In the second approach, both the layers of deep temporal fascia are separated by an intermediate fat pad and this fat pad loosely adheres to the deep layer of deep temporal fascia and contains fewer blood vessels, so dissection done in this relatively avascular plane and no risk of injury to FTFN As the superficial layer of deep temporal fascia crosses over the zygomatic arch, so dissection can be

continued in a subperiosteal plane over zygoma

In the third approach, it is sometimes difficult to differentiate between superficial fat pads and deep fat pad, so the chance of injury to the facial nerve is more compared to the second approach

In the fourth approach, the deep layer of deep temporal fascia is densely adherent

to the temporal muscle and contains multiple small blood vessels, so dissection in this plane can lead to more blood loss, but risk of injury to facial nerve branches is minimal

The fifth approach combines skin, fascia, and muscle flap, which minimizes the risk of injury to nerve, but due to the large bulk of temporal muscle there is decreased visualization along with the sphenoid ridge and due to excessive retraction, an increased chance of post-operative atrophy of temporal muscle

» Conclusions

The temporoparietal fascia was made up of multiple layers (3–4) above the zygomatic arch, the superficial temporal artery, and vein traversed in superficial layers and frontotemporal branches of the facial nerve in deeper layers of temporoparietal fascia The frontotemporal branch of the facial nerve usually contained three rami over the upper border of the zygomatic arch and its distance from LBC was nearly constant, and the branches of FTFN were found inferior to

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Tài liệu tham khảo	Loại	Chi tiết
1. Furnas DW. Landmarks for the trunk and the temporofacial division of the facial nerve. Br J Surg 1965;52:694-6	Khác
2. Pitanguy I, Ramos AS. The frontal branch of the facial nerve: The importance of its variations in face lifting. Plast Reconstr Surg 1966;38:352-6	Khác
3. Gosain AK. Surgical anatomy of the facial nerve. Clin Plast Surg 1995;22:241-51	Khác
4. Chen TH, Chen CH, Shyu JF, Wu CW, Lui WY, Liu JC. Distribution of the superficial temporal artery in the Chinese adult. Plast Reconstr Surg 1999;104:1276-9	Khác
5. Marano SR, Fischer DW, Gaines C, Sonntag VK. Anatomical study of the superficial temporal artery. Neurosurgery 1985;16:786-90	Khác
6. Mwachaka P, Sinkeet S, Ogeng'o J. Superficial temporal artery among Kenyans: Pattern of branching and its relation to pericranial structures. Folia Morphol 2010;69:51-53	Khác
7. Pinar YA, Govsa F. Anatomy of the superficial temporal artery and its branches: Its importance for surgery. Surg Radiol Anat 2006;28:248-53	Khác
8. Abul-Hassan HS, von Drasek Ascher G, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 1986;77:17-28	Khác
9. Stuzin JM, Wagstrom L, Kawamoto HK, Wolfe SA. Anatomy of the frontal branch of the facial nerve: The significance of the temporal fat pad. Plast Reconstr Surg 1989;83:265-71	Khác
10. Sabini P, Wayne I, Quatela VC. Anatomical guides to precisely localize the frontal branch of the facial nerve. Arch Facial Plast Surg 2003;5:150-2	Khác
11. Babakurban ST, Cakmak O, Kendir S, Elhan A, Quatela VC. Temporal branch of the facial nerve and its relationship to fascial layers. Arch Facial Plast Surg	Khác