The FASEB Journal
The facial nerve demonstrates wide anatomical variation and significant clinical relevance. Branching patterns of the facial nerve have been extensively studied, but communicating branches have comparatively received far less attention. Communicating branches of the facial nerve are hypothesized as an important means of motor recovery to facial nerve injury, and therefore must be carefully considered by physicians working in the region of innervation. Indeed, damage to branches of the nerve is associated with significant ramifications to patients, and facial nerve injury is the most common complication of facial surgery. Knowledge of communicating branches may contribute to preservation of facial nerve function, and therefore are important to describe and document. This study aims to clarify the frequency and branching patterns of communicating branches of the facial nerve. Cadaver specimens from the Gift Body Program at Kansas City University College of Osteopathic Medicine revealed the anatomy. Cadaveric dissections were performed bilaterally to identify and document communicating branches across the facial nerve extending from the temporal to cervical branches. Frequency and location of communicating branches were assessed among 15 body donors bilaterally, yielding 30 facial nerves for analysis. Due to the variability of facial nerve branches observed bilaterally on specimens, this study utilized right and left facial nerves of each donor as individual specimens. We document and describe the presence of communicating branches across the temporal, zygomatic, buccal, marginal mandibular, and cervical branches. This characterization has more accurately established the generalizable area(s) in which communicating branches are located. A higher frequency of communicating branches between the marginal mandibular and cervical branches was observed than has been previously reported. The locations of these branches are described in relation to nearby landmarks for use in clinical and surgical settings. Branch variations were carefully outlined and overlaid to demonstrate areas of density to support surgical and procedural awareness.
Freed B, Steele R, Coker C, Marolt C, Dennis JF. Overlooked and Underestimated: New Insight on Communicating Branches of The Facial Nerve. The FASEB Journal. 2020; 34(S1). doi: 10.1096/fasebj.2020.34.s1.06325.