Aesthet Surg J. 2022 Feb 11:sjac029. doi: 10.1093/asj/sjac029. PMID: 35148367
Abstract
Background: Major branching patterns of the facial nerve have been extensively studied, as damage to branches of the nerve is associated with complications ranging from weakness to paralysis. However, communicating branches of the facial nerve have received far less attention, despite being hypothesized as a means of motor recovery following facial nerve injury. Objectives: The aim of this study was to characterize the frequency of communicating branches (CommB) of the facial nerve to provide clarity on their anatomy and clinical correlations. Methods: Bilateral facial dissections were completed on cadaveric donors (n=20) to characterize the frequency and location of CommB across terminal branches of the facial nerve. Statistical analyses were used to analyze differences between the location of communications by side, and whether the CommB were more likely to occur on the left or right side (p<0.05). Results: Communicating branches were identified among all terminal branches of the facial nerve, and their frequencies reported. The highest frequencies of CommB were identified between the buccal-to-marginal mandibular and zygomatic-to-buccal branches, at 67.5% (27 comm/40 hemifaces). The second highest frequency of CommB was identified between the temporal-to- zygomatic branches in 62.5% (25/40) of donors. The marginal mandibular-to-cervical branches had CommB at a frequency of 55% (22/40). There was no significant difference in the location or sidedness of CommB. Conclusions: Our characterization more accurately defines generalizable areas in which CommB are located. These locations of branches, described in relation to nearby landmarks, is fundamental for clinical and surgical settings to improve procedural awareness.