Anastomoses between the cervical branch of the facial nerve and the transverse cervical cutaneous nerve

Abstract

Head and neck surgeons must possess a thorough knowledge of facial nerve anatomy to avoid inducing iatrogenic injury during surgery. Anastomoses of the cervical branch (CB) of the facial nerve and the transverse cervical cutaneous nerve (TCCN) are poorly documented in our field. Knowledge of these anastomoses and their positions allows for (1) preservation of high CBs that contribute to lower lip depressor function, and (2) identification of the facial nerve in retrograde dissections. Our objective was to improve understanding of facial nerve anatomy by describing these anastomoses. The communicating branch between the TCCN and the CB was evaluated in 22 adult neck halves (11 cadavers). The facial nerve was exposed, and the CB was traced anteriorly. The TCCN was identified and traced superiorly to its anastomosis(es) with the CB. The distance from each anastomosis to the selected landmarks was recorded. Between the CB and the TCCN, 33 anastomoses were identified, with at least 1 anastomosis per hemineck and 2 anastomoses in 11 heminecks. Anastomoses were identified along the inferior border of the submandibular gland (SMG; 20 specimens) or posterior to the SMG (12 specimens). Five specimens had both anastomoses near the inferior border of the SMG, and 6 specimens had 1 anastomosis near the inferior border and 1 posterior to the SMG. Communication between the TCCN and the CB is regularly present. Its anatomic locations are either posterior to the SMG, often within the parenchyma of the parotid gland, or near the inferior border of the SMG. Awareness of these anastomoses allows a method for identification and preservation of the CB of the facial nerve as well as a starting point for retrograde facial nerve dissections.