Buccal Branch Of Facial Nerve Research Articles

Neurolymphomatosis in Non-Hodgkin's Lymphoma

non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of hematopoietic puffins, with diphun B-velicocyclotinous lymphoma accounting for 25% of all NHLs and having the greatest midline to axis growth (Leeuwenуе et al., 2014). Of all NHLs, the central and peripheral nervous systems are most often affected in diphytic B-lycocytic lymphoma (Padala, & Kallam, 2022. Liu, & Barta, 2019). In NHL, infiltration of cranial and peripheral nerves can be detected - neurolymphomatosis (NL) emerges. NL is a very rare condition and occurs in about 0.2% of patients with NHL (Baehring, Damek, Martin, Betensky & Hochberg, 2003). These infiltrations can manifest with detection of mononeuropathy, multiple neuropathy, symmetric neuropathy or plexopathy (Grisold W., Grisold A., Marosi, Meng, & Briani, 2015). The aim of the work was to study the features of the clinical course, diagnosis and treatment of neurolymphomatosis in the form of lesions of the trigeminal, facial cranial nerve and the left ulnar nerve in diffuse B-bollichelial non-Hodgkin lymphoma based on a clinical case. We present a review of a clinical case of peripheral nervous system involvement in a patient born in 1977 with diffuse B-cell non-Hodgkin's lymphoma. The diagnosis was established on the basis of clinical manifestations of lesions of the branches of the trigeminal and left facial nerves, the left ulnar nerve, magnetic resonance imaging of the head and brain, electroneuromyography, and immunohistochemical examination of the infiltrate biopsy from the affected buccal branch of the left facial nerve. In March 2022, the patient developed moderate peripheral paresis of the mimic muscles on the left side, burning pain with impaired tactile and pain sensitivity of the dorsum, wing of the nose, and left instep. A week later there was a decrease in the strength, tactile and pain sensitivity, and patience of the fourth and fifth fingers of the left hand. Within a month, the burning pain had spread to the left cheek, periorbital, and chin areas of the face. In 2021, the patient was diagnosed with B-bollichelial non-Hodgkin's lymphoma with involvement of the right axillary, supraclavicular lymph nodes, left breast, followed by chemotherapy and clinical remission. Magnetic resonance imaging of the head revealed a perineural lesion of the third branch of the right trigeminal nerve, the second branch of the left trigeminal nerve, and the cheek branch of the left facial nerve. Electroneuromyography revealed an axonal lesion of the left ulnar nerve. The results of examination of the infiltrate biopsy from the affected buccal branch of the facial nerve specimens confirmed non-Hodgkin's diffuse B-cell lymphoma, GCB-phenotype and nerve damage due to NHL. Treatment of multiple neuropathy with glucocorticosteroids, nonsteroidal anti-inflammatory drugs, acelicholinesterase inhibitors, and specific chemotherapy resulted in limited therapeutic effect. Prescribing pregabalin resulted in decreased reduction of neuropathic facial pain. Thus, neurolymphomatosis is a rather rare manifestation of non-Hodgkin's lymphomas, the use of magnetic resonance imaging of the head and brain as well as immunohistochemical examination of the affected nerve infiltrate biopsy is important to confirm the diagnosis.
 In the Ukrainian scientific medical literature, there are few descriptions of cases of neurolymphomatosis in NHL, although they occur in patients, and it is necessary to describe in more detail the peculiarities of the collicular course of the diagenesis and treatment in these cases.

P-61069874-222 - Antero-Parotid trans-massetric approach for reduction of mandibular subcondylar fractures; clinical tricks.

Sub-condylar fractures of mandible are a common occurrence in the trauma of the maxillofacial region both in children and adults. These fractures are treated by open reduction and internal fixation or by closed reduction according to the patient's age, his general condition and the facilities available in a particular healthcare setting. Use of the antero-parotid trans-massetric approach for treating mandibular subcondylar fractures has the least postoperative complications among other approaches for treating mandibular subcondylar fractures. Data was collected over seven years with a total of 245 fractures operated on 205 patients. Only minor complications were noticed during the 10 day post operative period, with mild temporary weakness of the buccal branches of facial nerve in 3.4% of cases while post operative unusual edema and trismus in 8.7% which resolved during the first ten days. No parotid leak/sialocele was found in any of these cases. Our aim is to give some clinical tricks after seven years experience in using this approach to treat subcondylar fractures and to achieve the best results with the least complications. The tricks include: the type of fractures which can be treated with this approach, to identify the access site, to deal with facial nerve branches in surgical site, the needfor perfect retraction and how to aid in reduction of fractures. We recommend this approach as it is rapid,easy, safe and effective for treating low subcondylar fractures.We suggest consideration of those clinical tricks to achieve the least complications and minimize surgical time.

Intra Parotid Facial Nerve Neurofibroma: A Rare Case Report.

Primary solitary neurofibromas of facial nerve in the parotid are rare. We present a case of solitary neurofibroma of facial nerve within parotid gland in a 38year old gentleman who presented with left sided painful preauricular swelling of 3months duration with normal facial nerve function.Computed tomography (CT) revealed a well marginated solid mass within superficial lobe of left parotid gland showing mild enhancement. The mass could not be delineated from peripheral buccal branch of facial nerve during surgery and histopathology revealed a neurofibroma.

Antero-parotid Trans-massetric Approach For Reduction Of Mandibular Subcondylar Fractures; Clinical Tricks

Introduction: Mandibular fractures in the subcondylar area are frequent in the trauma of the maxillofacial area. This injury is frequent almost at the same rate in adults and children. These fractures are treated by open reduction along with internal fixation or closed reduction. The patient’s age, general health condition, and healthcare setting must be taken into account when deciding on the surgical option. Most of the approaches for open reduction and internal fixation of subcondylar fractures carry the risks of injury to the facial nerve branches and developing sialocele. Although the antero-parotid trans-masseteric approach which was introduced by Wilson in 2005and has the least post-operative complications among other approaches, it is still not widely used by maxillofacial surgeons. The article will give some clinical tricks after ten years of clinical experience, in using this approach for treating about 245 mandibular condylar fractures, on 205 patients. Methodology: This is a retrospective cohort study to evaluate the results of adult population group comprising 205 patients. There were totally 245 fractures of which 205 patients’ surgery was done. Data were gathered from January 2010 to December 2020. Only minimal complications were observed within the first ten days after surgery, including slight transient weakening of the facial nerve, particularly buccal branches, in 3.4 percent of cases and unusual edema and trismus in 8.7% of cases, both of which recovered within the first ten days. In none of these cases, a parotid leak/sialocele was discovered. Discussion: Although the antero-parotid trans-masseteric approach is not widely used between oral and maxillofacial surgeons worldwide, it has the least post-operative complicationscompared to the other approaches for treating mandibular condylar fractures. Data collected from January 2010 till December 2020 with a total of 245 fractures operated on 205 patients. Only minor complications were noticed during the 10 days post operative period with mild temporary weakness of the buccal branches of facial nerve in 3.4% of cases and post operative unusual edema and trismus in 8.7% which resolved during the first ten days post operatively.No parotid leak/sialocele was found in any of these cases. Our aim is to give some clinical tricks after ten years experience in using this approach to treat condylar fractures, to simplifying the technique and to achieve the best results with the least complications. The tricks include the type of fractures that can be treated with this approach, to identify the surgical site, to retract the parotid gland along with its attached fascia posteriorly to open through the masseter muscle, to identify facial nerve branches in surgical site, the needs for perfect retraction and the use of optimum muscle relaxant to aid during reduction ofdisplaced and dislocated subcondylar fractures of mandible. Results And Conclusion: Only minor complications were noticed during the 10 days post operatively with mild temporary weakness of the buccal branches of facial nerve in 3.4% of cases and unusual moderate to severe post-operative facial edema and trismus in 8.7 % which resolved during the first ten days post operatively. No parotid leak/sialocele was found in any of these cases. We recommend this approach as it is rapid, easy, safe, and effective for treating low subcondylar fractures. We suggest considering perioperatively these clinical tricks can achieve the best outcome with least complications and minimize operating time.

Reinnervation of facial muscles using ipsilateral masticatory branch of trigeminal nerve and cross-facial autotransplantation with contralateral buccal branch of facial nerve using sural nerve (step-by-step modeling of technique on cadaveric material)

Reinnervation of facial muscles using ipsilateral masticatory branch of trigeminal nerve and cross-facial autotransplantation with contralateral buccal branch of facial nerve using sural nerve (step-by-step modeling of technique on cadaveric material)

Pattern of The Buccal Branch of Facial Nerve Among A Sample of Sudanese Subjects: A Multicenters Study

Among different races, the intra parotideal course of the facial nerve is very variable. Familiarity with the buccal branch pattern types have a paramount importance for meticulous manipulation and avoidance of nerve injury. This study aimed to describe the pattern of the buccal branch of facial nerve among a sample of Sudanese subjects.

Origin of the Buccal Branch of Facial Nerve and Anastomosis of the Facial Nerve Branches

Origin of the Buccal Branch of Facial Nerve and Anastomosis of the Facial Nerve Branches

The nerve supply of zygomaticus major: Variability and distinguishing zygomatic from buccal facial nerve branches

The zygomaticus major (ZM) is important for the human smile. There are conflicting data about whether the zygomatic or buccal branches of the facial nerve are responsible for its motor innervation. The literature provides no precise distinction of the transition zone between these two branch systems. In this study, a definition to distinguish the facial nerve branches at the level of the body of the zygoma is proposed. In the light of this definition, we conducted an anatomical study to determine how the source of innervation of the ZM was distributed. A total of 96 fresh-frozen cadaveric facial halves were dissected under loupe magnification. A hemiparotidectomy was followed by antegrade microsurgical dissection. Any branch topographically lying superficial to the zygoma or touching it was classed as zygomatic, and any neighboring inferior branch was considered buccal. The arborization of the facial nerve was diffuse in all cases. In 64 out of 96 specimens (67%, 95% CI: 56% to 76%), zygomatic branches innervated the ZM. Buccal branches innervated ZM in the other 32 facial halves (33%, 95% CI: 24% to 44%). There were no differences in respect of sex or facial side. All facial halves displayed additional branches, which crossed the muscle on its inner surface without supplying it. In 31 specimens, a nerve branch ran superficial to ZM in its cranial third. According to our classification, the zygomaticus major is innervated by zygomatic branches in 67% of cases and by buccal branches in 33%. Clin. Anat. 31:560-565, 2018. © 2018 Wiley Periodicals, Inc.

Effect of cervical sympathetic ganglionectomy on facial nerve reconstruction using polyglycolic acid-collagen tubes

A polyglycolic acid-collagen (PGA-c) tube was used as an artificial nerve guide during facial nerve reconstruction performed in a canine model of stellate ganglion block (SGB). The model was generated using a cervical sympathetic ganglionectomy. We evaluated the effects of blood flow on nerve regeneration.First, we resected the left cervical sympathetic ganglion in beagles (n=6). We assessed buccal mucosal blood flow and nasal skin temperatures once per week for 12weeks and Horner’s sign 2, 4, and 6months after resection. We compared these values to those measured prior to resection. Blood flow was increased for 6–11weeks, but sympathetic control remained blocked after 6months.Second, we divided beagles into 3 groups: resection models (negative control), from which 7mm of the left facial nerve buccal branch was resected (n=5); reconstruction models, which underwent nerve reconstruction using PGA-c tubes (n=6); and SGB+reconstruction models, which underwent a left cervical sympathetic ganglionectomy immediately after reconstruction (n=6). The right side of the face served as control (n=17). Nerve regeneration was significantly greater in the SGB+reconstruction model dogs than in the reconstruction model dogs, as measured by both electrophysiological and morphological analyses at postoperative week 12. In particular, motor nerve conduction velocity was increased approximately 2-fold (p=0.018). We were able to generate an SGB model with long-term increased blood flow facilitated by the promotion of facial nerve regeneration by PGA-c tubes.

Facial-nerve regeneration ability of a hybrid artificial nerve conduit containing uncultured adipose-derived stromal vascular fraction: An experimental study.

This study investigated the potential of uncultured-stromal-vascular-fraction (SVF) cells in promoting facial nerve regeneration in a rat model. A 7-mm nerve defect was created in the buccal branch of facial nerve in five groups of Lewis rats (total n = 30, n = 6 per group). A silicone tube, infused with syngeneic uncultured-SVF was implanted into the facial nerve defect. Groups 1-3 received 1 × 103 , 1 × 105 , and 1 × 107 cells, and regenerated nerves were examined at 13 weeks after the surgery. The findings were compared to the autograft and collagen-alone groups with facial palsy score (FPS), the number of myelinated fibers, fiber diameter, axon diameter, myelin thickness, and g ratio. There was no significant difference in FPS between the autograft and 1 × 105 -cell groups at 13 weeks after surgery, and FPS values of these two groups were significantly higher than those of the other three groups (P < 0.01). Axon diameter significantly increased in the 1 × 105 -cell group compared with the 1 × 103 - (P < 0.05) and 1 × 107 -cell groups (P < 0.01). Myelin thickness was found to be the highest in the autograft group, followed by the 1 × 105 -, 1 × 103 -, 1 × 107 -cell, and negative control groups, and there were significant differences among all groups (P < 0.01). The infusion of uncultured-SVF into the artificial nerve conduit promoted optimal nerve regeneration that was significantly better than nerve conduit alone. © 2016 Wiley Periodicals, Inc. Microsurgery 37:808-818, 2017.

The injury of marginal mandibular branch unexpectedly promotes the repair of buccal branch of facial nerve in a rat model

Conclusions: The results indicate that the injury of the marginal mandibular branch improved the recovery of the buccal branch in a rat model.Objective: The aim of this study was to investigate whether the injury or intactness of the marginal mandibular branch affects the regeneration of the facial nerve buccal branch in a rat model.Methods: This experiment was conducted on 30 adult rats, which were randomly and equally divided into two groups. The buccal branch of the facial nerve was transected and reconstructed, with the marginal mandibular branch damaged (group A) or intact (group B). The vibrissae movement of rats was assessed since the 4th week after operation. At the 8th and 12th week, compound muscle action potentials (CMAPs) and morphological changes of injured buccal branches were evaluated.Results: After the operation, vibrissae movement of rats was eliminated in group A, but it was similar to the health side in group B. CMAPs were recorded from regenerated buccal branches in group A since the 8th week, but no CMAPs could be recorded in group B at each time point. Additionally, the diameter of nerve fibers, the thickness of myelin sheath, and the density of regenerated fibers in group A were significantly larger than those in group B (p < 0.05).

Progressive cranial nerve involvement and grading of facial paralysis in gelsolin amyloidosis

Hereditary gelsolin amyloidosis (GA) is a rare condition caused by the gelsolin gene mutation. The diagnostic triad includes corneal lattice dystrophy (type 2), progressive bilateral facial paralysis, and cutis laxa. Detailed information on facial paralysis in GA and the extent of cranial nerve injury is lacking. 29 GA patients undergoing facial corrective surgery were interviewed, examined, and studied electroneurophysiologically. All showed dysfunction of facial (VII) and trigeminal (V) nerves, two-thirds of oculomotor (III) and hypoglossal (XII) nerves, and half of vestibulocochlear (acoustic) (VIII) nerve. Clinical involvement of frontal, zygomatic, and buccal facial nerve branches was seen in 97%, 83%, and 52% of patients, respectively. Electromyography showed marked motor unit potential loss in facial musculature. Cranial nerve involvement in GA is more widespread than previously described, and correlates with age, severity of facial paralysis, and electromyographic findings. We describe a grading method for bilateral facial paralysis in GA, which is essential for evaluation of disease progression and the need for treatment.

A cadaveric study on the buccal branch of facial nerve - origin and its relation pattern to the parotid duct

Abstract Background : The knowledge of anatomy of facial nerve and its terminal branches is important for the successful outcome in facial surgeries. The buccal branch of facial nerve due to its characteristic variations in origin and diverse relationship with the parotid duct can be easily injured during parotid duct surgery, parotidectomy or face lift operations. An operating surgeon would find it helpful if the course of buccal branch especially in relation to parotid duct is studied Aim : To describe the origin, course and number of buccal branches of facial nerve and its pattern of relation with the parotid duct. Materials &amp; Methods : The study was done in 100 cadaveric cranial halves including fetuses. The buccal branch was observed for its origin and course. The relationship of buccal branch to the parotid duct was noted and classified accordingly. Results: Buccal branch originated from the lower trunk of facial nerve in 68 % and from the upper trunk in 28% while the two trunks contributed to the origin in 4%. The buccal branch passed inferior to parotid duct in 41% and superior to duct in 25%. In 28%, buccal branch formed a plexus over the duct along with other branches. In 6%, there were two branches, one passed superior and the other passed inferior to the parotid duct. Conclusion: The knowledge regarding the variations of buccal branch of facial nerve can be a surgeon's guide during facial surgeries.

A cadaveric study on the buccal branch of facial nerve - origin and its relation pattern to the parotid duct

A cadaveric study on the buccal branch of facial nerve - origin and its relation pattern to the parotid duct

Transoral Buccinator-Pexy (TBP)

We describe a novel surgical technique to enhance the aesthetics of the midface by creating malar dimples. Dimples are the natural cheek indentations that become more apparent with facial animation. The aim of this study is to present our technique to create the appearance of these natural indentations using a simple transoral approach and to assess its safety. The transoral buccinator-pexy is done 1.5 to 2 cm superior to a point bisecting an angle formed by the projection of the lateral commissure and the lateral canthus. Local anesthetic is injected and an 18-gauge needle is introduced perpendicular through the skin marking and brought out through the buccal mucosa. A 4-mm punch biopsy or a small incision is made in the buccal mucosa. A small amount of buccal mucosa is then excised. 4-0 Nonabsorbable suture is threaded through the needle to the desired dimple location on the skin. The suture is then rethreaded from extraoral to intraoral, taking a portion of the dermis and buccinator muscle creating the desired dimple. The procedure was done successfully without complication in our series of patients. The mean follow-up was 18 months. Cadaveric dissection demonstrated key anatomical landmarks and we created a "zone of safety." Transoral buccinator-pexy deepened the submalar soft tissue. The indentations were made slightly pronounced, making the dimples visible without animation. After several weeks, the dimples were only present with animation. Cadaveric dissection was done to illustrate the relationship of the parotid duct and buccal branches of facial nerve to the area in which it is safe to perform TBP. The position of the dimple can be adjusted based on the patient's desires; however, identifying the papilla of Stensen duct is paramount. Transoral buccinator-pexy is a safe and effective in-office procedure that can be done to produce aesthetically pleasing dimples. The technique is simple and the results are consistent.

Manual stimulation of the whisker pad after hypoglossal–facial anastomosis (HFA) using a Y-tube conduit does not improve recovery of whisking function

Facial nerve injury is a common clinical trauma involving long-term functional deficits with facial asymmetry leading to associated psychological issues and social hardship. We have recently shown that repair by hypoglossal-facial or facial-facial nerve surgical end-to-end anastomosis and suture [hypoglossal-facial anastomosis (HFA) or facial-facial anastomosis (FFA)] results in collateral axonal branching, polyinnervation of neuromuscular junctions (NMJs) and poor function. We have also shown that another HFA repair procedure using an isogenic Y-tube (HFA + Y-tube) and involving a 10-mm gap reduces collateral axonal branching, but fails to reduce polyinnervation. Furthermore, we have previously demonstrated that manual stimulation (MS) of facial muscles after FFA or HFA reduces polyinnervation of NMJs and improves functional recovery. Here, we examined whether HFA + Y-tube and MS of the vibrissal muscles reduce polyinnervation and restore function. Isogenic Y-tubes were created using abdominal aortas. The proximal hypoglossal nerve was inserted into the long arm and sutured to its wall. The distal zygomatic and buccal facial nerve branches were inserted into the two short arms and likewise sutured to their walls. Manual stimulation involved gentle stroking of the vibrissal muscles by hand mimicking normal whisker movement. We evaluated vibrissal motor performance using video-based motion analysis, degree of collateral axonal branching using double retrograde labeling and the quality of NMJ reinnervation in target musculature using immunohistochemistry. MS after HFA + Y-tube reduced neither collateral branching, nor NMJ polyinnervation. Accordingly, it did not improve recovery of function. We conclude that application of MS after hypoglossal-facial nerve repair using an isogenic Y-tube is contraindicated: it does not lead to functional recovery but, rather, worsens it.

Vascularized versus Nonvascularized Island Median Nerve Grafts in the Facial Nerve Regeneration and Functional Recovery of Rats for Facial Nerve Reconstruction Study

Histological and physiological basis of the therapeutic efficacy of the vascularized autologous nerve graft in facial nerve regeneration remains poorly understood because of no established rat model. The left median nerve and median artery/vein of Lewis rats were collectively ligated, and harvested as a vascularized island median nerve, which was transplanted to a 7-mm gap in the left buccal branch of facial nerve. Nerve regeneration was investigated. The numbers of myelinated fibers, axon diameter, and myelin thickness were significantly higher in the vascularized nerve graft group than in the nonvascularized nerve graft group. Compound muscle action potential measurement showed that the parameters of vascularized group were similar to those in the intact control group. A vascularized median nerve graft resulted in better facial nerve regeneration outcomes.

Analysis of Anatomical Relationship between Stensen's Duct and Buccal Branch of Facial Nerve

www.e-acfs.org pISSN 2287-1152 eISSN 2287-5603 102 Copyright © 2013 The Korean Cleft Palate-Craniofacial Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence: Hwan Jun Choi Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 330-721, Korea Tel: +82-41-570-2195 / Fax: +82-41-573-3723 / E-mail: medi619@hanmail.net Received August 21, 2013 / Revised September 27, 2013 / Accepted October 7, 2013 이하선관과 안면신경의 협근지 사이의 해부학적 관계 분석

Level I Sparing Radical Neck Dissections for Cutaneous Melanoma in the Lymphoscintigram Era

Excision of regional lymph nodes (LNs) in the neck as part of the management for tumors of the head and neck dates back to the 19th century. Crile originally reported the technique of performing a radical neck block dissection in 1905, with notable modifications to the extensive dissection reported throughout the 20th century by Suarez, Ballantyne, Ariyan, and Shah among others. These modifications have aimed to reduce the morbidity encountered by performing the radical neck dissection while balancing the need to remove diseased structures in the head and neck. In this report, we evaluate the outcomes of performing a functional radical neck dissection while sparing the level I LNs as indicated by lymphoscintigraphy. The charts of patients from the Yale Melanoma Unit who underwent resection of their head and neck melanoma from January 2000 to December 2006 were reviewed. The location of the primary melanoma and clinical course was noted. Those patients who underwent neck dissections were documented and the extent of the dissections from the operative reports was noted. Demographic and outcome data were recorded, including clinical course of melanoma presentation, local recurrence, and postoperative management. Student t test and χ tests were used to determine statistical significance between groups. P values less than 0.05 were considered statistically significant. A total of 41 patients who were documented to have had a head and neck primary melanoma underwent a functional radical neck dissection. Level I dissections were deemed necessary in 39% of these cases, whereas 61% of patients received functional radical neck dissections with sparing of level I LNs. Specific recurrence of melanoma in the submandibular basin was equivocal for LN sparing dissections (n=1) as compared to excision of level I LNs (n=1) (4% vs 6.25%, P=0.488). Follow-up metastatic rates between the 2 groups were also comparable (44% vs 56%, P=0.328). Overall metastatic rate in follow-up for all patients undergoing LN dissection was 48.8%. There was no statistically significant difference between the average age of patients at diagnosis, Breslow depth, Clark level, and staging between patients who underwent functional radical neck dissections with either excision or sparing of level I LNs. Clinical and pathological presentation between patients who needed level I sparing dissections and those who did not, failed to demonstrate a statistically significant difference allowing for an adequate comparison. Our results indicate that if lymphoscintigraphy does not show drainage to level I LNs, the functional radical neck dissection can be tailored to spare level I LNs without affecting local recurrence. When not indicated by lymphoscintigram, sparing of level I nodes can be performed safely without changing clinical outcomes, while saving operating room time and minimizing potential damage to the buccal branch of facial nerve and the submandiblular gland.

Intraparotid facial nerve schwannoma involving the deep lobe: A case report

Schwannomas are nerve sheath tumors, and 20–40% of all schwannomas are seen in the head and neck regions. Intraparotid facial nerve shwannoma involving the deep lobe of parotid are uncommon. The preoperative diagnosis of intraparotid facial nerve lesion is difficult when the facial nerve is normal. We present here a case of intaparotid schwannoma arising from the lower buccal branch of facial nerve and mainly involving the deep lobe of the parotid gland.