Download PDF
CC BY-NC-ND 4.0 · Indian J Plast Surg 2010; 43(01): 060-064
DOI: 10.1055/s-0039-1699405
Original Article
Association of Plastic Surgeons of India

Marginal mandibular branch of the facial nerve: An anatomical study

Arvinder Pal Singh Batra
Department of Anatomy, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
,
Anupama Mahajan
Department of Anatomy, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
,
Karunesh Gupta
1   Chakitsa Hospital, Amritsar, Punjab, India
› Author Affiliations
Further Information

Publication History

Publication Date:
08 January 2020 (online)

Also available at
  PDF Download Permissions and Reprints

ABSTRACT

Smile is one of the most natural and important expressions of human emotion. Man uses his lips mainly to register his emotions. Thus, the slightest asymmetry or weakness around the lips and mouth may transform this pleasant expression into embarrassment and distortion. The circumoral musculature, the major part of which is supplied by the marginal mandibular branch of the facial nerve, is the main factor in this expression. Therefore, an injury to this nerve during a surgical procedure can distort the expression of the smile as well as other facial expressions. This nerve often gets injured by surgeons in operative procedures in the submandibular region, like excision of the submandibular gland due to lack of accurate knowledge of variations in the course, branches and relations. In the present study, 50 facial halves were dissected to study the origin, entire course, termination, branches, muscles supplied by it, its anastomoses with other branches of facial nerve on the same as well as on the opposite side and its relations with the surrounding structures. The marginal mandibular branch of the facial nerve was found superficial to the facial artery and (anterior) facial vein in all the cases (100%). Thus the facial artery can be used as an important landmark in locating the marginal mandibular nerve during surgical procedures. Such a study can help in planning precise and accurate incisions and in preventing the unrecognized severance of this nerve during surgical procedures.

KEY WORDS

Facial nerve - marginal mandibular nerve - smile distortion
 

  • REFERENCES

  • 1 Egasse D. Facial nerve: Particular aspects of the cervicofacial anatomy. Ann Dermatol Venereol 2001; 128:59-62.
  • 2 O'Brien CJ. Facial nerve localization in parotid surgery. ANZ J Surg 2002; 72:370.
  • 3 Toure S, Vacher C, Bertrand JC. Anatomy of the marginal mandibular branch of facial nerve. Rev Stomatol Chir Maxillofac 2004; 105:149-52.
  • 4 Tulley P, Webb A, Chana JS, Tas ST, Hudson D, Grobbelaar AO, et al. Paralysis of the marginal mandibular branch of the facial nerve: Treatment options. Br J Plast Surg 2000; 53:378-85.
  • 5 Wang TM, Lin CL, Kuo KJ, Shih C. Surgical anatomy of the mandibular ramus of the facial nerve in Chinese adults. Acta Anat (Basel) 1991; 142:126-31.
  • 6 Kim DI, Nam SH, Nam YS, Lee KS, Chung RH, Han SH. The marginal mandibular branch of the facial nerve in Koreans. Clin Anat 2009; 22:207-14.
  • 7 Dingman RO, Grabb WC. Surgical anatomy of the mandibular ramus of the facial nerve based on the dissection of 100 facial halves. Plast Reconstr Surg Transplant Bull 1962; 29:266-72.
  • 8 Spaltehoz W. Hand Atlas of Human Anatomy Vol 3. Philadelphia: J. B. Lippincott Company; 1903. p. 701-2.
  • 9 Jackson IT, Sommerlad BC. Recent advances in plast Surg Vol 3. New York: Churchill Livingstone; 1985. p.175.
  • 10 Rodel R, Lang J. Peripheral branches of the facial nerve in the cheek and chin area: Anatomy and clinical consequences. HNO 1996; 44:572-6.
  • 11 Converse JM. Head and Neck Surgery In: Plastic and Reconstructive Surgery Second Edition, Vol 5. Philadelphia, Landon, Toronto: WB Saunders and Company; 1979. p. 112.
  • 12 Charles R, Rodney S. Rob Charles Operative surgery. London: Butterworths; 1983. p. 524-5.
  • 13 Strelzow VV, Strelzow AG. Osteosynthesis of mandibular fractures in the angle region. Arch Otolaryngol 1983; 109:403-6.
  • 14 Barron JN, Saad MN (Eds). Manual of operative Plastict and Reconstructve Surgery Vol 1. Edinburgh, United Kingdom: Churchill Livingstone; 1980. p. 437.
  • 15 Stark RB. Secondary surgery of the lips. Plast Surg of the Head and Neck Vol 2. New York: Churchill Livingstone; 1987. p. 738, 810, 822.
  • 16 Martin H. The operative removal of tumors of the parotid gland. Surgery 1952; 31:670-682.
  • 17 Davis RA, Barry JA, Johan MS, Leroy EK. Surgical anatomy of the facial nerve and parotid gland based upon the study of 350 cervicofacial halves. Surg Gynecol Obstet 1956; 102:385-412.
  • 18 Baker DC, Conley J. Avoiding facial nerve injuries in rytidectomy: Anatomical variations and pitfalls. Plast Reconstr Surg 1979; 64:781-95.