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SUMMARY: To clarify the path of the temporal branch of facial nerve (TB) crossing the zygomatic arch (ZA). Eighteen fresh adult heads specimens were carefully dissected in the zygomatic region, with the location of TB as well as its number documented. The hierarchical relationship between the temporal branch and the soft tissue in this region was observed on 64 P45 plastinated slices. 1. TB crosses the ZA as type I (21.8 %), type II (50.0 %,), and type III (28.1 %) twigs. 2. At the level of the superior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 36.36±6.56 mm, for the posterior trunk is 25.59±5.29 mm. At the level of the inferior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 25.77±6.19 mm, for the posterior trunk is 19.16±4.71 mm. 3. The average length of ZA is 62.06±5.36 mm. TB crosses the inferior edge of the ZA at an average of 14.67±6.45 mm. TB crosses the superior edge of the ZA at an average of 9.08±4.54 mm. 4. At the level of the ZA, TB passes on the surface of the pericranium while below the SMAS. The TB obliquely crosses the middle 1/3 part of the superior margin of the ZA and the junction of the middle 1/3 part and the posterior 1/3 part of the inferior margin of the ZA below the SMAS while beyond the periosteum. It is suggested that this area should be avoided in clinical operation to avoid the injury of TB.

El objetivo de estudio fue esclarecer el trayecto del ramo temporal del nervio facial (RT) que cruza el arco cigomático (AC). Se disecaron la región cigomática de 18 especímenes de cabezas sin fijar de individuos adultas y se documentó la ubicación del RT y su número de ramos. La relación jerárquica entre el ramo temporal y el tejido blando en esta región se observó en 64 cortes plastinados o P45. 1º El RT cruza el AC como tipo I (21,8 %), tipo II (50,0 %) y tipo III (28,1 %). 2º A nivel del margen superior del AC, la distancia promedio entre el tronco anterior de RT y la parte anterior de la aurícula fue de 36,36±6,56 mm, para el tronco posterior fue de 25,59±5,29 mm. A nivel del margen inferior del AC, la distancia promedio entre el tronco anterior del RT y la parte anterior de la aurícula era de 25,77±6,19 mm, para el tronco posterior era de 19,16±4,71 mm. 3º La longitud media de RT fue de 62,06±5,36 mm. EL RT cruzaba el margen inferior del AC a una distancia media de 14,67±6,45 mm. El RT cruzaba el margen superior del AC a una distancia media de 9,08±4,54 mm. 4º Anivel del AC, el RT pasaba por la superficie del pericráneo mientras se encuentra por debajo del SMAS. El RT cruza oblicuamente el tercio medio del margen superior del AC y la unión del tercio medio y el tercio posterior del margen inferior del AC por debajo del SMAS, más allá del periostio. Se sugiere que esta área debe evitarse en la operación clínica para evitar la lesión de la RT.

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PURPOSE: To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. METHODS: Ten male Wistar rats (12-15 weeks old), without veterinary diseases, weighing 220-280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. RESULTS: The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. CONCLUSIONS: The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.

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Purpose: To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. Methods: Ten male Wistar rats (12­15 weeks old), without veterinary diseases, weighing 220­280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. Results: The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. Conclusions: The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.

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The disposition and topography of the facial nerve are arguably of critical importance for professionals who work directly with oral health. This paper reports a case of anatomical variation in which the dorsal buccal branch of the facial nerve perforated the parotid lymph node parenchyma in two hemiheads of Ovis aries. The infratemporal and facial regions of 30 hemiheads were dissected in a practical class following the methodology indicated in the literature. As expected, after emerging from the stylomastoid foramen, the facial nerve subdivided into the dorsal and ventral buccal branches in all animals. However, in 6.66% of the hemiheads, the dorsal branch perforated longitudinally the parotid lymph node parenchyma. We concluded that even with a low rate of occurrence, anatomical variations of the dorsal buccal branch of the facial nerve may be present in sheep. This knowledge is of essential importance because subsequent traumatic and/or inflammatory changes can cause neural compression and compromise the innervation of the face, leading to semiological and diagnostic confusion.

O nervo facial é, indiscutivelmente, um dos mais importantes para aqueles profissionais que trabalham diretamente com a saúde oral. Sabendo que a disposição e topografia do nervo facial são de importância crítica para a prática médica, objetivou-se relatar um caso de variação anatômica em que o ramo bucal dorsal do nervo facial perfurou o parênquima do linfonodo parotídeo em duas hemicabeças de Ovis aries. As regiões infratemporal e facial de 30 hemicabeças foram dissecadas e conforme esperado, após emergir pelo forame estilomastóideo o nervo facial subdividiu-se nos ramos bucal dorsal e bucal ventral em todos os animais, entretanto, em 6,66% das hemicabeças este primeiro ramo perfurou longitudinalmente o parênquima do linfonodo parotídeo. Concluiu-se que, ainda que com uma taxa de ocorrência baixa, variações anatômicas do ramo bucal dorsal do nervo facial podem estar presentes nos ovinos. Este conhecimento é de essencial importância uma vez que em casos como este as alterações traumáticas e/ou inflamatórias podem causar a compressão neural e comprometimento da inervação da face, possibilitando uma confusão semiológica e diagnóstica.

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The disposition and topography of the facial nerve are arguably of critical importance for professionals who work directly with oral health. This paper reports a case of anatomical variation in which the dorsal buccal branch of the facial nerve perforated the parotid lymph node parenchyma in two hemiheads of Ovis aries. The infratemporal and facial regions of 30 hemiheads were dissected in a practical class following the methodology indicated in the literature. As expected, after emerging from the stylomastoid foramen, the facial nerve subdivided into the dorsal and ventral buccal branches in all animals. However, in 6.66% of the hemiheads, the dorsal branch perforated longitudinally the parotid lymph node parenchyma. We concluded that even with a low rate of occurrence, anatomical variations of the dorsal buccal branch of the facial nerve may be present in sheep. This knowledge is of essential importance because subsequent traumatic and/or inflammatory changes can cause neural compression and compromise the innervation of the face, leading to semiological and diagnostic confusion.(AU)

O nervo facial é, indiscutivelmente, um dos mais importantes para aqueles profissionais que trabalham diretamente com a saúde oral. Sabendo que a disposição e topografia do nervo facial são de importância crítica para a prática médica, objetivou-se relatar um caso de variação anatômica em que o ramo bucal dorsal do nervo facial perfurou o parênquima do linfonodo parotídeo em duas hemicabeças de Ovis aries. As regiões infratemporal e facial de 30 hemicabeças foram dissecadas e conforme esperado, após emergir pelo forame estilomastóideo o nervo facial subdividiu-se nos ramos bucal dorsal e bucal ventral em todos os animais, entretanto, em 6,66% das hemicabeças este primeiro ramo perfurou longitudinalmente o parênquima do linfonodo parotídeo. Concluiu-se que, ainda que com uma taxa de ocorrência baixa, variações anatômicas do ramo bucal dorsal do nervo facial podem estar presentes nos ovinos. Este conhecimento é de essencial importância uma vez que em casos como este as alterações traumáticas e/ou inflamatórias podem causar a compressão neural e comprometimento da inervação da face, possibilitando uma confusão semiológica e diagnóstica.(AU)

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Maned Wolf (Chrysocyon brachyurus) is considered one of the largest and most beautiful canids in South America, inhabits the Cerrado biome, and presents nocturnal habits, especially during the twilight period. It is in danger of extinction, mainly due to anthropic activity in its habitat. What certainly raises the importance of studying and better understanding its biology. The mammalian Facial Nerve is the seventh cranial pair and controls the functions of facial expression muscles and others. Once the anatomical descriptions of this canid are scarce, this paper aimed to describe the anatomy of Facial n. in Maned Wolf and correlate it with that of domestic canids, a phylogenetically close species whose anatomy is well known. For this research, four adult specimens were used, whose carcasses were collected along highways in southeastern Goiás State - Brazil (SISBIO 37072-2), or donated by the Wildlife Screening Center (CETAS) in Catalão - Goiás State. The specimens were fixed in a 10% aqueous formalin solution and stored in the same solution. Dissection was performed by macroscopic anatomical methods. The research was carried out with a favorable opinion of the Animal Use Ethics Committee (CEUA) of the Federal University of Uberlândia (UFU) (under n° 067/12). Anatomical preparations of post-mortem Maned Wolf did not reveal the presence of Caudal Auricular, Internal Auricular, nor Stylohyoid n.. Small ramifications of Facial n. can be considered as collateral branches. The Facial n. emerged as a single trunk, Facial n. Trunk, which branches into Auriculopalpebral, Dorsal Buccal, and Ventral Buccal n.(AU)

O Lobo-Guará (Chrysocyon brachyurus) é considerado um dos maiores e mais belos canídeos da América do Sul, habita o cerrado e apresenta hábitos notívagos, com preferência crepuscular. Motivado, principalmente, pela atividade antrópica em seu habitat, encontra-se em risco de extinção, o que, certamente, eleva a importância de se estudar e compreender melhor a sua Biologia. Nesse contexto, sabe-se que o Nervo Facial de mamíferos é o sétimo par craniano e se envolve com o comando da função dos músculos da expressão facial e outros, porém como as descrições anatômicas desse canídeo são escassas, o objetivo desta pesquisa foi descrever e correlacionar a Anatomia do N. Facial de Lobo-Guará com canídeos domésticos, espécie esta filogeneticamente próxima. Para o desenvolvimento deste trabalho foram utilizados quatro exemplares de Lobo-Guará adultos, cujas carcaças foram recolhidas às margens de rodovias do sudeste goiano (SISBIO 37072-2) ou doadas pelo CETAS-Catalão. Os espécimes foram fixados em solução aquosa de formol a 10% e conservados em igual solução. A dissecação foi realizada sob a luz de técnicas usuais em Anatomia Macroscópica. Ressalta-se que a pesquisa foi desenvolvida com o parecer favorável do CEUA/UFU nº 067/12. As preparações anatômicas envolvendo o Lobo-Guará não revelaram a presença dos nervos: Auricular caudal, Auricular interno e Estilohioideo, apenas pequenos ramos, considerados como ramos colaterais. O n. Facial emergia como um tronco único, o Tronco do N. Facial, o qual se dividia em n. Auriculopalpebral, Bucal dorsal e Bucal ventral.(AU)

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Introdução: A cirurgia de Bichectomia está sendo muito procurada por pessoas que visam diminuir o volume facial. O corpo adiposo da bochecha, ou bola de Bichat, possui uma complexa relação anatômica com estruturas faciais. Uma das complicações que o procedimento pode causar é a paralisia facial temporária ou permanente, em decorrência de injúrias causadas aos ramos terminais do nervo facial, devido à proximidade dessas duas estruturas anatômicas. Metodologia: O objetivo do presente artigo é enfatizar a relação anatômica da bola de Bichat com alguns ramos terminais do nervo facial através da dissecação de cadáveres. Foram feitas dissecações em três hemifaces de cadáveres humanos para a exposição do corpo adiposo da bochecha e dos ramos extracranianos do nervo facial. Resultados: A anatomia dos ramos terminais zigomáticos e bucais do nervo facial se mostrou variável em cada hemiface dissecada, mas sempre intimamente relacionados a bola de Bichat. Conclusões: O profissional que realiza a Bichectomia deve ter pleno conhecimento não só da técnica cirúrgica, mas também da variabilidade anatômica da região... (AU)

Introduction: The Buccal Fat Extraction surgery has been sought by people who aim to reduce facial volume. The Buccal fat pad has a complex anatomical correlation among the facial structures. The facial nerve paralysis is one of Bichat's fat extraction complications which might be temporary or permanent, due to the proximity of those anatomical structures. Methodology: The present article aims to emphasize the anatomical correlation between the Buccal fat pad and a few terminal branches of the facial nerve through the human cadaveric dissection. The dissection was performed on three human cadaveric hemifacial to expose the buccal fat pad body and the facial nerve extracranial branches. Results: The zygomatic and buccal terminal branches anatomy of the facial nerve has shown variables in each dissected hemifacial part. However, it has always presented closely related to Bichat's fat pad. Conclusions: The professional that performs the Buccal Fat Removal surgery must have to have the full knowledge not only about the surgical technique but the anatomical variability of the region, as well... (AU)

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Maned Wolf (Chrysocyon brachyurus) is considered one of the largest and most beautiful canids in South America, inhabits the Cerrado biome, and presents nocturnal habits, especially during the twilight period. It is in danger of extinction, mainly due to anthropic activity in its habitat. What certainly raises the importance of studying and better understanding its biology. The mammalian Facial Nerve is the seventh cranial pair and controls the functions of facial expression muscles and others. Once the anatomical descriptions of this canid are scarce, this paper aimed to describe the anatomy of Facial n. in Maned Wolf and correlate it with that of domestic canids, a phylogenetically close species whose anatomy is well known. For this research, four adult specimens were used, whose carcasses were collected along highways in southeastern Goiás State - Brazil (SISBIO 37072-2), or donated by the Wildlife Screening Center (CETAS) in Catalão - Goiás State. The specimens were fixed in a 10% aqueous formalin solution and stored in the same solution. Dissection was performed by macroscopic anatomical methods. The research was carried out with a favorable opinion of the Animal Use Ethics Committee (CEUA) of the Federal University of Uberlândia (UFU) (under n° 067/12). Anatomical preparations of post-mortem Maned Wolf did not reveal the presence of Caudal Auricular, Internal Auricular, nor Stylohyoid n.. Small ramifications of Facial n. can be considered as collateral branches. The Facial n. emerged as a single trunk, Facial n. Trunk, which branches into Auriculopalpebral, Dorsal Buccal, and Ventral Buccal n.

O Lobo-Guará (Chrysocyon brachyurus) é considerado um dos maiores e mais belos canídeos da América do Sul, habita o cerrado e apresenta hábitos notívagos, com preferência crepuscular. Motivado, principalmente, pela atividade antrópica em seu habitat, encontra-se em risco de extinção, o que, certamente, eleva a importância de se estudar e compreender melhor a sua Biologia. Nesse contexto, sabe-se que o Nervo Facial de mamíferos é o sétimo par craniano e se envolve com o comando da função dos músculos da expressão facial e outros, porém como as descrições anatômicas desse canídeo são escassas, o objetivo desta pesquisa foi descrever e correlacionar a Anatomia do N. Facial de Lobo-Guará com canídeos domésticos, espécie esta filogeneticamente próxima. Para o desenvolvimento deste trabalho foram utilizados quatro exemplares de Lobo-Guará adultos, cujas carcaças foram recolhidas às margens de rodovias do sudeste goiano (SISBIO 37072-2) ou doadas pelo CETAS-Catalão. Os espécimes foram fixados em solução aquosa de formol a 10% e conservados em igual solução. A dissecação foi realizada sob a luz de técnicas usuais em Anatomia Macroscópica. Ressalta-se que a pesquisa foi desenvolvida com o parecer favorável do CEUA/UFU nº 067/12. As preparações anatômicas envolvendo o Lobo-Guará não revelaram a presença dos nervos: Auricular caudal, Auricular interno e Estilohioideo, apenas pequenos ramos, considerados como ramos colaterais. O n. Facial emergia como um tronco único, o Tronco do N. Facial, o qual se dividia em n. Auriculopalpebral, Bucal dorsal e Bucal ventral.

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Abstract Introduction Posterior tympanotomy through facial recess (FR) is the conventional and most preferred approach to facilitate cochlear implantation, especially when the electrode is inserted through the round window. The complications of the FR approach can be minimized by proper understanding of the anatomy of the FR. Objective The present study was undertaken to assess the various parameters of FR and round window visibility, which may be of relevance for cochlear implant surgery. Methods Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of FR and posterior tympanum. Photographs were taken with an 18megapixels digital camera, which were then imported to a computer to determine various parameters. Results The mean distance from the take-off point/crotch of the chorda tympani nerve (CTN) to the stylomastoid foramen was 4.08 ± 0.8 mm(range of 2.06 - 5.5mm). The variations in the course of the CTN included origin at the level of the lateral semicircular canal. Themean chorda-facial angle in our study was 26.91° ± 1.19°, with a range of 25° to 28.69°. The mean FR length ranged between 9.4 mm and 18.56 mm (mean of 12.41 ± 2.91mm) and varied with the origin of the CTN and pneumatization of temporal bone. The average maximum width of the FR was 2.93 ± 0.4 mm (range 2.24-3.45 mm) and the mean width of the FR at the level of the round window was 2.65 ± 0.41 mm. Conclusion The FR approach provides good access to the round windowmembrane in all cases. In some cases, table adjustment is required.

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Abstract Introduction: Various aspects of the round window anatomy and anatomy of posterior tympanum have relevant implications for designing cochlear implant electrodes and visualizing the round window through facial recess. Preoperative information about possible anatomical variations of the round window and its relationships to the adjacent neurovascular structures can help reduce complications in cochlear implant surgery. Objective: The present study was undertaken to assess the common variations in round window anatomy and the relationships to structures of the tympanum that may be relevant for cochlear implant surgery. Methods: Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of round window and its relation to facial nerve, carotid canal, jugular fossa and other structures of posterior tympanum. The dissected bones were photographed by a digital camera of 18 megapixels, which were then imported to a computer to determine various parameters using ScopyDoc 8.0.0.22 version software, after proper calibration and at 1× magnification. Results: When the round window niche is placed posteriorly and inferiorly, the distance between round window and vertical facial nerve decreases, whereas that with horizontal facial nerve increases. In such cases, the distance between oval window and round window also increases. Maximum height of the round window in our study ranged from 0.51-1.27 mm (mean of 0.69 ± 0.25 mm). Maximum width of round window ranged from 0.51 to 2.04 mm (mean of 1.16 ± 0.47 mm). Average minimum distance between round window and carotid canal was 3.71 ± 0.88 mm (range of 2.79-5.34 mm) and that between round window and jugular fossa was 2.47 ± 0.9 mm (range of 1.24-4.3 mm). Conclusion: The distances from the round window to the oval window and facial nerve are important parameters in identifying a difficult round window niche. Modification of the electrode may be a better option than drilling off the round window margins for insertion of cochlear implant electrodes.

Resumo Introdução: Vários aspectos da anatomia da janela redonda e da anatomia da caixa timpânica posterior são relevantes, devido a suas implicações no desenho dos eletrodos para o implante coclear e na visibilidade da janela redonda através do recesso facial. Informações prévias sobre possíveis variações anatômicas da janela redonda e suas relações com as estruturas neurovasculares adjacentes podem ajudar a reduzir as complicações dessa cirurgia. Objetivo: O presente estudo foi realizado para avaliar as diversas variações da anatomia da janela redonda e sua relação com as estruturas adjacentes, o que pode ser relevante para a cirurgia de implante coclear. Método: Trinta e cinco ossos temporais normais de cadáveres humanos frescos foram dissecados para avaliação da anatomia da janela redonda e sua relação com o nervo facial, canal carotídeo, fossa jugular e outras estruturas da caixa timpânica posterior. Os ossos dissecados foram fotografados com uma câmera digital de 18 megapixels e as imagens importadas para um computador para determinar diversos parâmetros, utilizando-se o software ScopyDoc versão 8.0.0.22, após a calibração adequada e com ampliação de 1×. Resultados: Quando o nicho da janela redonda se encontra posicionado posteriormente e inferiormente, a distância entre a janela redonda e o nervo facial vertical diminui, enquanto aquela com o nervo facial horizontal aumenta. Em tais casos, a distância entre a janela oval e a janela redonda também aumenta. A altura máxima da janela redonda em nosso estudo variou de 0,51 a 1,27 mm (média de 0,69 ± 0,25 mm). A largura máxima da janela redonda variou de 0,51 a 2,04 mm (média de 1,16 a 0,47 mm). A distância mínima média entre a janela redonda e o canal carotídeo foi de 3,71 ± 0,88 mm (variação de 2,79 a 5,34 mm) e entre a janela redonda e a fossa jugular, em nosso estudo, foi de 2,47 ± 0,9 mm (variação de 1,24 ± 4,3 mm). Conclusão: A distância da janela redonda a partir da janela oval e do nervo facial são parâmetros importantes para a identificação do difícil nicho da janela redonda. A modificação do desenho do eletrodo pode ser uma opção melhor do que o broqueamento das margens da janela redonda para a inserção dos eletrodos no implante coclear.

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BACKGROUND: When it comes to autogenous nerve grafting, the sural and great auricular nerve (GAN) are the 2 nerves predominately used for trigeminal and facial nerve repair. Arising from the second and third cervical ventral rami, the GAN emerges from the posterior border of the sternocleidomastoid coursing superiorly and anteriorly toward the ear. METHODS: Eleven sides from 5 Caucasian and 1 Asian cadaveric heads (all fresh-frozen) were used. One man and 5 women were used with an age at death ranging from 57 to 91 years, with a mean of 80.3 years. Measurements were made from the inferior border of the ear to the GAN, the GAN to the external jugular vein, and the inferior border of the mastoid process to the GAN; the proximal, medial, and distal diameters of the GAN and the length of the GAN that was obtained from this exposure were also measured. RESULTS: The mean distance from the inferior border of the mastoid process to the GAN, inferior border of the ear to the GAN, and GAN to the external jugular vein was 27.71, 31.03, and 13.28 mm, respectively. The mean length of the GAN was 74.86 mm. The mean diameter of its distal, middle, and proximal portions was 1.51, 1.38, and 1.58 mm, respectively. CONCLUSIONS: The GAN is an excellent option for use in nerve grafting for repair of, for example, facial dysfunction. In this study, we review our measurements, techniques for identification, and dissecting techniques for the GAN. The proximity to the operative area and minimal complications associated with GAN grafting might contribute to improved patient satisfaction and better outcomes regarding functional restoration.

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INTRODUCTION: Various aspects of the round window anatomy and anatomy of posterior tympanum have relevant implications for designing cochlear implant electrodes and visualizing the round window through facial recess. Preoperative information about possible anatomical variations of the round window and its relationships to the adjacent neurovascular structures can help reduce complications in cochlear implant surgery. OBJECTIVE: The present study was undertaken to assess the common variations in round window anatomy and the relationships to structures of the tympanum that may be relevant for cochlear implant surgery. METHODS: Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of round window and its relation to facial nerve, carotid canal, jugular fossa and other structures of posterior tympanum. The dissected bones were photographed by a digital camera of 18 megapixels, which were then imported to a computer to determine various parameters using ScopyDoc 8.0.0.22 version software, after proper calibration and at 1× magnification. RESULTS: When the round window niche is placed posteriorly and inferiorly, the distance between round window and vertical facial nerve decreases, whereas that with horizontal facial nerve increases. In such cases, the distance between oval window and round window also increases. Maximum height of the round window in our study ranged from 0.51-1.27mm (mean of 0.69±0.25mm). Maximum width of round window ranged from 0.51 to 2.04mm (mean of 1.16±0.47mm). Average minimum distance between round window and carotid canal was 3.71±0.88mm (range of 2.79-5.34mm) and that between round window and jugular fossa was 2.47±0.9mm (range of 1.24-4.3mm). CONCLUSION: The distances from the round window to the oval window and facial nerve are important parameters in identifying a difficult round window niche. Modification of the electrode may be a better option than drilling off the round window margins for insertion of cochlear implant electrodes.

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Apresenta dados da Hanseníase no Brasil no Mundo. Apresenta avaliação das Lesões dos nervos periféricos, na região nasal, olhos, Nervo Facial, Nervo Trigêmeo, Teste de Acuidade Visual, Nervo Auricular, Nervo Ulnar, Nervo Mediano, Nervo Radial e Radial Cutâneo, Técnica do Estesiômetro, Nervo Fibular Profundo e Superficial, Nervo Tibial Posterior, Estesiometria nos pés.

It presents data on Hansen's disease in Brazil worldwide. Presents evaluation of peripheral nerve injuries, in the nasal region, eyes, facial nerve, trigeminal nerve, visual acuity test, auricular nerve, ulnar nerve, median nerve, radial and radial cutaneous nerve, esthesiometer technique, deep and superficial fibular nerve, Posterior Tibial Nerve, Stoichiometry in the feet.

Presenta datos sobre la enfermedad de Hansen en Brasil en todo el mundo. Presenta evaluación de lesiones de nervios periféricos, en la región nasal, ojos, nervio facial, nervio trigémino, prueba de agudeza visual, nervio auricular, nervio cubital, nervio mediano, nervio cutáneo radial y radial, técnica de estesiómetro, nervio peroneo profundo y superficial, Nervio Tibial Posterior, Estequiometria en los pies.

Il présente des données sur la maladie de Hansen au Brésil dans le monde entier. Présente l'évaluation des lésions nerveuses périphériques, dans la région nasale, les yeux, le nerf facial, le nerf trijumeau, le test d'acuité visuelle, le nerf auriculaire, le nerf ulnaire, le nerf médian, le nerf cutané radial et radial, la technique de l'esthésiomètre, le nerf fibulaire profond et superficiel, Nerf tibial postérieur, stoechiométrie dans les pieds.

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BACKGROUND: The pterional approach (PA), together with its variants, is still one of the most common methods used by surgeons to reach the anterior and middle cranial base. A highly important technical detail during a PA is the preservation of the frontotemporal branch of the facial nerve, which can be achieved through an interfascial dissection. OBJECTIVE: To describe the anatomy of the interfascial vein (IFV), highlighting its recognition as a significant anatomic reference to perform an interfascial dissection (IFD). METHODS: Eight adult cadaveric heads, fixed with formaldehyde and injected with colored silicone, were studied. In 6 heads, an IFD was performed, simulating a PA. In the 2 remaining heads, the IFV was dissected. In addition, an IFD was performed in 10 patients, studying the IFV anatomy. RESULTS: In the 6 cadaveric heads in which the PA with an IFD was performed, and in the 10 patients who underwent a PA with an IFD, the IFV was found. If the interfascial space is divided into thirds, in all cases, the IFV was located within the middle third of the interfascial fat pad. On the 2 cadaveric heads in which the IFV was anatomically dissected, the IFV was also located within the middle third of the interfascial space. CONCLUSION: Recognizing the IFV in the interfascial space is of great help as an anatomic landmark to confirm that one is actually between both layers of the superficial temporal fascia.

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El adenoma pleomorfo es el tumor benigno más frecuente de las glándulas salivales, con mayor predilección por la glándula parótida. Se presenta un caso clínico de paciente femenino de 53 años de edad, con aumento de volumen en región parotídea y geniana derecha de15 × 12 centímetros, de ocho años de evolución, la tomografía simple de la región presenta tumoración parotídea bien delimitada, la cual afecta lóbulo superficial y profundo de la glándula parótida derecha, la biopsia incisional confi rmó el diagnóstico histopatológico de adenoma pleomorfo por lo cual se realiza parotidectomía total sin preservación del nervio facial.

Pleomorphic adenoma is the most common benign tumor of the salivaryglands, with greater predilection for the parotid gland. We presentthe case of a 53-year-old female patient with a 15 x 12 cm increasein volume in the parotid and right genial region with eight years ofevolution. A simple CT scan of the region revealed a well-defi ned parotidtumor aff ecting the superfi cial and deep lobe of the right parotidgland. An incisional biopsy confi rmed the histopathological diagnosisof pleomorphic adenoma, for which reason a total parotidectomy wasperformed without preservation of the facial nerve.

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The adherence of the overlying tissues to the underlying structures in the face is maintained by the retaining ligaments. True retaining ligaments named orbital, zygomatic and mandibular ligaments are a series of fibrous bands that run from periosteum to the dermis. The tethering effect of true retaining ligaments must be released for achieving a satisfactory movement of facial skin and Superficial Muscular Aponeurotic System (SMAS) during facial rejuvenation procedures. The aim of this study was to define the location of the true retaining ligaments of the face and to discuss their usability as surgical landmarks. The study was made on ten hemi-faces of formaline-fixed cadavers. Dissections resembling face-lift procedures were applied and ligaments were determined. The distances of the ligaments to lateral canthus, tragus and commissure and to the lines from tragus to lateral canthus and commissure were measured. Correlations were investigated statistically. The distances of the zygomatic and mandibular ligaments from the tragus were 66.50±10.78 mm and 114.80±9.76 mm respectively. The distances of the zygomatic ligament from the commissure and the commissure tragus line were 56.30±8.94 mm and 28.40±5.19 mm respectively. The distances of zygomatic and mandibular ligaments from the tragus were strongly correlated with a ratio of 3/5 and there was a strong correlation between the distances of the zygomatic ligament from the commissure and commissure- tragus line with a ratio of 2. The results of this study elucidated the possibility of the use of the true retaining ligaments as surgical landmarks for facial surgery.

La adherencia de los tejidos que recubren a las estructuras subyacentes en la cara se mantiene por los ligamentos de retención. Los ligamentos de retención verdaderos llamados ligamentos orbitales, cigomático y mandibular son una serie de bandas fibrosas que se extienden desde el periostio a la dermis. El efecto de la inmovilización de los verdaderos ligamentos de retención debe ser liberado para lograr un movimiento satisfactorio de la piel del rostro y del SMAS durante los procedimientos de estiramiento facial. El objetivo fue definir la ubicación de los verdaderos ligamentos de retención de la cara para discutir su utilidad como puntos de referencia quirúrgicos. El estudio se realizó sobre diez hemi-caras de cadáveres, fijadas con formalina. Las disecciones se asemejaron a los procedimientos de estiramiento facial, se aplicaron y determinaron los ligamentos. Se midieron las distancias de los ligamentos al canto lateral, trago, comisura y a las líneas de trago a canto lateral y comisura. Las correlaciones fueron analizadas estadísticamente. Las distancias de los ligamentos cigomático y mandibular desde el trago fueron 66,50±10,78 mm y 114,80±9,76 mm, respectivamente. Las distancias del ligamento cigomático a la comisura y la línea de comisura al trago fueron 56,30±8,94 mm y 28,40±5,19 mm, respectivamente. Las distancias de los ligamentos cigomático y mandibular desde el trago estaban correlacionadas de forma importante con una relación de 3/5 y había una fuerte correlación entre las distancias del ligamento cigomático desde la línea de comisura y el trago - con una relación de 2. Los resultados de este estudio han dilucidado la posibilidad de la utilización de los verdaderos ligamentos de retención como puntos de referencia quirúrgicos para la cirugía facial.

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BACKGROUND: Many studies have been dedicated toward bettering the understanding of the anatomy of this branch and the relative danger zone. However, most of these articles have focused on identifying the location of this branch based on its trajectory and associations with deep structures, causing some difficulties for aesthetic surgeons to identify its location during facial aesthetic surgery. Here, we present the concept of the marginal nerve triangle; its contents, relations and clinical applications in cosmetic surgery are discussed. METHODS: This is an anatomical study performed using 64 hemifaces from 32 Peruvian fresh cadavers (25 men and 7 women). They were dissected manually and observed macroscopically by the authors. The marginal nerve and the related structures were dissected from its origin to the terminal branches and associated with the described triangular area. RESULTS: The marginal branch of the facial nerve was found to lie in the described triangle in all cases. This is a triangular area formed by the intersection of three points located at the lateral commissure of the mouth, the mastoid apophysis and a point located over the anterior border of the extracellular matrix (ECM) muscle with a line which intersects the lateral commissure of the mouth and the mandibular groove. CONCLUSIONS: The trajectory of the marginal and cervical branches of the facial nerve can be reliably and easily found at the described triangle following the reference points. This study will help guide surgeons to these branches of the facial nerve as it applies to aesthetic surgery.

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HYPOTHESIS: The physical relationship between anatomical landmarks such as the tympanic portion of the facial nerve and the orientation of the middle turn of the cochlea are sufficiently constant to provide guidance to surgeons performing cochlear implantation in the ossified cochlea. BACKGROUND: Placing an implant in an ossified cochlea is technically difficult. The surgeon needs to drill two tunnels through the promontory bone to insert electrode arrays in the region of the basal and middle turns of the cochlea. However, few studies describe the orientation of these tunnels or how to use anatomical landmarks to guide the surgeon during their creation. This problem is particularly true for the superior (middle turn) tunnel. DESIGN: Twenty human temporal bones from adult cadavers were analyzed. They were dissected with exposure of all middle ear structures, followed by the removal of the tympanic ring, tympanic membrane, malleus, and incus. We measured the angle between the tympanic segment of the fallopian canal and a line passing through the lower portion of the middle turn of the cochlea. RESULTS: The measured angles varied from 123 and 152 degrees with an average of 133.85 degrees and the standard deviation of ± 6.83 degrees. CONCLUSION: The tunnel for the middle turn should be created with an inclination of about 134 degrees in relation to the tympanic segment of the facial nerve.

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PURPOSE: Initial study of the pig`s temporal bone anatomy in order to enable a new experimental model in ear surgery. METHODS: Dissection of five temporal bones of Sus scrofa pigs obtained from UNIFESP - Surgical Skills Laboratory, removed with hole saw to avoid any injury and stored in formaldehyde 10% for better conservation. The microdissection in all five temporal bone had the following steps: inspection of the outer part, external canal and tympanic membrane microscopy, mastoidectomy, removal of external ear canal and tympanic membrane, inspection of ossicular chain and middle ear. RESULTS: Anatomically it is located at the same position than in humans. Some landmarks usually found in humans are missing. The tympanic membrane of the pig showed to be very similar to the human, separating the external and the middle ear. The middle ear`s appearance is very similar than in humans. The ossicular chain is almost exactly the same, as well as the facial nerve, showing the same relationship with the lateral semicircular canal. CONCLUSION: The temporal bone of the pigs can be used as an alternative for training in ear surgery, especially due the facility to find it and its similarity with temporal bone of the humans.

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