POSTERIOR AURICULAR NERVE – A NOVEL LANDMARK FOR IDENTIFICATION OF THE FACIAL NERVE IN SUPERFICIAL PAROTIDECTOMY

Background-Facial nerve identification andpreservation is the most critical step in parotidsurgery. Though there are described landmarks tolocate the facial nerve trunk, they have individualvariations. The posterior auricular nerve (PAN) is abranch of the facial nerve and is always present, itcan be followed to reach the facial nerve trunk.MATERIALS AND METHODSA retrospective cohort study in which analysis ofparotidectomy performed from January 2017 toNovember 2018 at our tertiary referral center wasdone.RESULTSA total of 23 parotidectomies were performed, ofwhich 18 cases were pleomorphic adenoma. In fourcases of pleomorphic adenoma we could clearlyidentify and preserve the PAN. Using PAN as thelandmark the facial nerve trunk was located, all itsperipheral branches were dissected andpreserved. PAN identification narrows down thetarget area of dissection to identify the facial nervetrunk.CONCLUSIONThe posterior auricular branch of the facial nervecan be used as a standard landmark in parotidsurgeries, that almost always leads to the facialnerve trunk.CLINICAL SIGNIFICANCEThough identification of PAN may be difficult in allcases, effort must be made to identify it under magnification. If done meticulously PAN can be anideal landmark to identify facial nerve in parotidsurgery.KEYWORDSParotid surgery, Superficial Parotidectomy,Posterior auricular nerve, Facial nerve.