title: Surgical anatomy of the preauricular anteroparotid approach for mandibular condyle surgery.
abstract: OBJECTIVE
  The different surgical approaches used to treat mandibular condyle fractures are carried out in the periparotid skin area and can lead to facial nerve injury. We conducted a preauricular and anteroparotid surgical approach. Our main aim was to show the anatomical relationship between this approach site and the facial nerve branches, and to define cutaneous landmarks to locate the extraparotid facial nerve branches.
  
  
  METHODS
  A 2-step dissection of 13 fresh human cadaver semi-heads was performed: a preauricular approach followed by a superficial parotidectomy to visualize the facial nerve. Its course and ramifications were studied and compared to cutaneous landmarks. The proximity of the facial nerve branches with the surgical approach site was observed.
  
  
  RESULTS
  The approach allowed systematically visualising the zygomatic and/or buccal branches. No facial nerve branches were sectioned. In three cases (23 %), a nerve branch was visualized during the approach. The buccal and zygomatic branches were ramified in 77 % of cases.
  
  
  CONCLUSIONS
  During our preauricular anteroparotid approach, the buccal and zygomatic branches were visualized but none was sectioned. Most often the approach was carried out between these two branches (46 % of cases). Cutaneous landmarks used were reliable to define a safe and nerve-free area for dissection. The buccal and zygomatic branches are very interesting because their high number of ramifications and anastomoses could serve as nerve relays in case of surgical lesion.
authors.affiliation: Medico-Surgical Anatomy Unit, Bordeaux Ségalen University, 33076, Bordeaux Cedex, France, mathieu.laurentjoye@yahoo.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Laurentjoye
authors.forename: Alice
authors.initials: A
authors.lastname: Veyret
authors.forename: Bruno
authors.initials: B
authors.lastname: Ella
authors.forename: André Pierre
authors.initials: AP
authors.lastname: Uzel
authors.forename: Claire
authors.initials: C
authors.lastname: Majoufre-Lefebvre
authors.forename: Philippe
authors.initials: P
authors.lastname: Caix
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Ricard
mesh_terms: D000368:Aged; D002102:Cadaver; D005154:Facial Nerve / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000033:anatomy & histology* / Q000601:surgery*