title: Tympanomastoid suture and digastric muscle in cadaver and live parotidectomy.
abstract: OBJECTIVE
  To prove that the tympanomastoid suture (TMS) is a significantly closer and less variable anatomic landmark to the facial nerve than the posterior-superior margin of the posterior belly of the digastric muscle (PBD) in parotid surgery.
  
  
  METHODS
  A prospective study of 14 cadaver specimens and 22 live patients comparing the closest measured distances between the TMS and PBD to the facial nerve.
  
  
  RESULTS
  The mean closest distances from the TMS and PBD to the facial nerve were 1.8 (range 0-4) mm and 12.4 (range 7-17) mm, respectively (P < .05) for cadavers. The mean closest distances in live patients from the TMS and PBD to the facial nerve were 2.0 (range 0-4) mm and 10.7 (range 5-14) mm, respectively (P < .05).
  
  
  CONCLUSIONS
  Facial nerve identification and preservation is the key to successful parotid surgery. The TMS is a significantly closer and less variable anatomic landmark compared with the PBD both in cadaver dissection and in live patients.
authors.affiliation: Christiana Care Health Systems, Wilmington, Delaware 19806, USA. RobertLWitt@aol.com
authors.forename: Robert L
authors.initials: RL
authors.lastname: Witt
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Weinstein
authors.forename: Lidia K
authors.initials: LK
authors.lastname: Rejto
mesh_terms: D002102:Cadaver; D002508:Cephalometry; D004424:Ear Canal / Q000294:innervation*; D005154:Facial Nerve / Q000033:anatomy & histology*; D006801:Humans; D008416:Mastoid / Q000294:innervation*; D009334:Neck Muscles / Q000294:innervation*; D010306:Parotid Gland / Q000601:surgery*; D011446:Prospective Studies