Evaluation of the Intraparotid Branching Patterns of the Facial Nerve During Parotidectomy: A Clinical Study Based on the Davis and Alomar Classifications
YÇ Kumbul, F Yeşilkuş, YE Ekinci, H Yasan, M Tüz, E Okur, ME SivriceBackground:
The branching patterns of the facial nerve (FN) vary among individuals, which may affect the risk of surgical complications.
Aim:
The aim of this study is to examine the relationship between FN branching patterns and clinical variables including facial paralysis in patients undergoing parotidectomy in our clinic and to reveal the region-specific anatomical distribution of the FN.
Methods:
Data from 39 patients who underwent parotidectomy were analyzed. In all cases, the main trunk of the FN was located at the exit of the stylomastoid foramen and dissected. Intraoperative nerve monitoring was used in all cases. The branching patterns of the FN were categorized according to the Davis and Alomar classifications. The relationship between these two classifications and the variables was statistically analyzed.
Results:
Of patients, 53.8% were female and 46.1% were male, with an average age of 47.59 ± 16.12 years. The mean length of the main trunk of the FN was 15.44 ± 3.51 mm. The interbranch anastomosis rate was 74.36%. In the Alomar classification, the most frequent subtype was IB2 (51.28%), while in the Davis classification, Type I (25.64%) and Type III (25.64%) were the most frequent. The rate of facial paralysis (FP) in the early postoperative period was determined to be 33.3%. A significant association was found between malignant tumors and the development of FP (
Conclusion:
Understanding the branching patterns of the FN and regional anatomical variations is critical for improving surgical success during parotidectomy. Among clinical variables, malignant histopathology is the strongest predictor of FP.