title: Fronto-temporal branch of facial nerve within the interfascial fat pad: is the interfascial dissection really safe?
abstract: BACKGROUND
  The study was conducted to clarify the presence or absence of fronto-temporal branches (FTB) of the facial nerve within the interfascial (between the superficial and deep leaflet of the temporalis fascia) fat pad.
  
  
  METHODS
  Eight formalin-fixed cadaveric heads (16 sides) were used in the study. The course of the facial nerve and the FTB was dissected in its individual tissue planes and followed from the stylomastoid foramen to the frontal region.
  
  
  RESULTS
  In the fronto-temporal region, above the zygomatic arch, FTB gives several small twigs running anteriorly in the fat pad above the superficial temporalis fascia and a branch within the temporo-parietal fascia (TPF) to the muscles of the forehead. There were no twigs of the FTB within the interfascial fat pad.
  
  
  CONCLUSIONS
  No branches of the FTB are found in the interfascial (between the superficial and deep leaflet of the temporalis fascia) fat pad. The interfascial dissection can be safely performed without risk of injury to the FTB and potential subsequent frontalis palsy.
authors.affiliation: Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. spiriev@gmail.com.
authors.forename: Toma
authors.initials: T
authors.lastname: Spiriev
authors.affiliation: Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
authors.forename: Florian Heinrich
authors.initials: FH
authors.lastname: Ebner
authors.affiliation: Institute of Clinical Anatomy and Cell Analysis, Eberhard-Karls-University, Elfriede-Aulhorn-Str.8, 72076, Tübingen, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hirt
authors.affiliation: Institute of Clinical Anatomy and Cell Analysis, Eberhard-Karls-University, Elfriede-Aulhorn-Str.8, 72076, Tübingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Shiozawa
authors.affiliation: Institute of Clinical Anatomy and Cell Analysis, Eberhard-Karls-University, Elfriede-Aulhorn-Str.8, 72076, Tübingen, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Gleiser
authors.affiliation: Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
authors.forename: Marcos
authors.initials: M
authors.lastname: Tatagiba
authors.affiliation: Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.|Institute of Clinical Anatomy and Cell Analysis, Eberhard-Karls-University, Elfriede-Aulhorn-Str.8, 72076, Tübingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Herlan
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects*; D005145:Face / Q000033:anatomy & histology / Q000601:surgery; D005152:Facial Muscles / Q000294:innervation / Q000601:surgery; D005154:Facial Nerve / Q000033:anatomy & histology / Q000601:surgery*; D005205:Fascia / Q000033:anatomy & histology; D000071938:Fasciotomy; D006801:Humans; D013703:Temporal Muscle / Q000294:innervation / Q000601:surgery
keywords: Facial nerve; Frontalis palsy; Fronto-temporal branch; Interfascial dissection; Skull base surgery; Subfascial dissection