A 45-year-old woman is scheduled for parotid gland surgery to remove a benign tumor. The surgeon is planning the approach to identify and preserve the facial nerve during the procedure.
Which of the following is the most reliable way of identifying the facial nerve in parotid surgeries?
A. By removing the styloid process
B. By tracing it from the mastoid cavity
C. By using the tragal pointer
D. Searching at the tympanomastoid sulcus
Answer:
The Correct Answer is: C. By using the tragal pointer
Explanation:
By using the tragal pointer (C):
– The tragal pointer is a reliable anatomical landmark used to identify the facial nerve during parotid surgery. It is the cartilaginous projection at the anterior edge of the external auditory canal (the tragus).
– The facial nerve trunk is typically located approximately 1 cm deep and inferior to the tragal pointer. This method provides a consistent reference point for surgeons to locate and preserve the facial nerve during parotidectomy.
Explanation of Incorrect Options:
By removing the styloid process (A):
– Removing the styloid process is not a standard or necessary step in identifying the facial nerve during parotid surgery. This approach could be invasive and complicate the procedure.
By tracing it from the mastoid cavity (B):
– Tracing the facial nerve from the mastoid cavity is not a practical approach in parotid surgery. The nerve can be more effectively and safely identified using external landmarks like the tragal pointer or the tympanomastoid suture.
Searching at the tympanomastoid sulcus (D):
– The tympanomastoid sulcus (also known as the tympanomastoid suture) is another anatomical landmark where the facial nerve can be identified. However, it is less commonly used compared to the tragal pointer.
In conclusion, the most reliable way of identifying the facial nerve in parotid surgeries is by using the tragal pointer, making option C the correct answer.