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Study on Distribution of Terminal Branches of the Facial Nerve in Mimetic Muscles (Orbicularis Oculi Muscle and Orbicularis Oris Muscle)

Mitsukawa, Nobuyuki MD*; Moriyama, Hiroshi DDS; Shiozawa, Kei MD; Satoh, Kaneshige MD*

Annals of Plastic Surgery:
doi: 10.1097/SAP.0b013e318284eca0
Peripheral Nerve Surgery and Research
Abstract

Abstract: There have been many anatomical reports to date regarding the course of the facial nerve to the mimetic muscles. However, reports are relatively scarce on the detailed distribution of the terminal branches of the facial nerve to the mimetic muscles. In this study, we performed detailed examination of the terminal facial nerve branches to the mimetic muscles, particularly the branches terminating in the orbicularis oculi muscle and orbicularis oris muscle. Examination was performed on 25 Japanese adult autopsy cases, involving 25 hemifaces. The mean age was 87.4 years (range, 60–102 years). There were 12 men and 13 women (12 left hemifaces and 13 right hemifaces). In each case, the facial nerve was exposed through a preauricular skin incision. The main trunk of the facial nerve was dissected from the stylomastoid foramen. A microscope was used to dissect the terminal branches to the periphery and observe them. The course and distribution were examined for all terminal branches of the facial nerve. However, focus was placed on the course and distribution of the zygomatic branch, buccal branch, and mandibular branch to the orbicularis oculi muscle and orbicularis oris muscle. The temporal branch was distributed to the orbicularis oculi muscle in all cases and the marginal mandibular branch was distributed to the orbicularis oris muscle in all cases. The zygomatic branch was distributed to the orbicularis oculi muscle in all cases, but it was also distributed to the orbicularis oris muscle in 10 of 25 cases. The buccal branch was not distributed to the orbicularis oris muscle in 3 of 25 cases, and it was distributed to the orbicularis oculi muscle in 8 cases. There was no significant difference in the variations. The orbicularis oculi muscle and orbicularis oris muscle perform particularly important movements among the facial mimetic muscles. According to textbooks, the temporal branch and zygomatic branch innervate the orbicularis oculi muscle, and the buccal branch (or the buccal branch and marginal mandibular branch) innervates the orbicularis oris muscle. In this study, we performed dissection of the terminal facial nerve branches that terminate in the orbicularis oculi muscle and orbicularis oris muscle and performed detailed examination of their courses. The results revealed 5 multiple anomalies not in conventional books, and the movements of the muscles might be compensated.

Author Information

From the *Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, Chiba; Departments of †Anatomy and ‡Plastic and Reconstructive Surgery, Showa University, Faculty of Medicine, Tokyo, Japan.

Received July 29, 2012, and accepted for publication, after revision, December 18, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Nobuyuki Mitsukawa, MD, Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan. E-mail: nmitsu@air.linkclub.or.jp.

© 2014 by Lippincott Williams & Wilkins