Anatomic landmarks for masseteric nerve identification: Anatomic study for a new reference point

ABSTRACT Context: In cases of chronic facial palsy, where direct neurotisation is possible, ipsilateral masseteric nerve is a very suitable motor donor. We have tried to specifically locate the masseteric nerve for this purpose. Aims: Describing an approach of localisation and exposure of both the zygomatic branch of Facial nerve and the nerve to masseter, with respect to a soft tissue reference point over face. Settings and Design: Observational cross sectional study, conducted on 12 fresh cadavers. Subjects and Methods: A curved incision was given, passing about 0.5cms in front of the tragal cartilage. A reference point “R” was pointed out. The zygomatic branch of facial nerve and masseteric nerve were dissected out and their specific locations were recorded from fixed reference points with help of copper wire and slide callipers. Statistical Analysis Used: Central Tendency measurements and Unpaired “t” test. Results: Zygomatic branch of the Facial nerve was located within a small circular area of radius 1 cm, the centre of which lies at a distance of 1.1 cms (±0.4cm) in males and 0.2cm (±0.1cm) in females from the point, ‘R’, in a vertical (coronal) plane. The nerve to masseter was noted to lie within a circular area of 1 cm radius, the centre of which was at a distance of 2.5cms (±0.4cm) and 1.7cms (±0.2cm) from R, in male and female cadavers, respectively. Finally, Masseteric nerve's depth, from the masseteric surface was found to be 1cm (±0.1cm; male) and 0.8cm (±0.1cm; female). Conclusions: This novel approach can reduce the post operative cosmetic morbidity and per-operative complications of facial reanimation surgery.

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Anatomic Considerations for a Posterior Endoscopic Approach to the Cricoarytenoid Joint

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419826140 ◽

2019 ◽

Vol 128 (5) ◽

pp. 420-425

Author(s):

Michael Z. Lerner ◽

Sherry A. Downie ◽

Melin Tan-Geller

Keyword(s):

Horizontal Plane ◽

Vocal Fold ◽

Posterior Approach ◽

Average Distance ◽

Endoscopic Approach ◽

Anatomic Study ◽

Anatomic Landmarks ◽

Cricoarytenoid Joint ◽

Vocal Fold Motion ◽

Adult Cadaver

Objective: This anatomic study considers the feasibility of a posterior endoscopic approach to the cricoarytenoid joint (CAJ) by describing relationships between readily identifiable anatomic landmarks and the posterior CAJ space in cadaver larynges. Study Design: Anatomic study. Methods: Six adult cadaver larynges (2 male, 4 female) were studied. Digital calipers were used for measurements, and Image J software was used for angle calculations. All cricoarytenoid joints were injected with colored gel via a posterior approach using a 27-gauge needle. Results: The average age of the larynges studied was 78.7 ± 10 years. The average posterior CAJ space (pCAJs) length measured 4.95 ± 0.9 mm. The average distance from the superior aspect of the midline cricoid lamina (MCL) to the center of pCAJs and the corniculate cartilage (CC) to the center of the pCAJs were 8.35 ± 1.5 mm and 14.54 ± 1.9 mm, respectively. The average pCAJs angle of declination (AD) from the horizontal plane was 54° ± 6.2°. All 12 cricoarytenoid joints were successfully injected with colored gel via a posterior approach. Conclusions: The posterior CAJ space can be located surgically using readily identifiable anatomic landmarks. An understanding of this posterior CAJ anatomy may allow for more consistent intra-articular injection and support the development of other CAJ procedures for a range of disorders of vocal fold motion or malposition.

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To Evaluate the Feasibility of Neurotisation of Facial Nerve Branches with Ipsilateral Masseteric Nerve: An Anatomic Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2014/7708.4302 ◽

2014 ◽

Author(s):

Sridhar Moturi

Keyword(s):

Facial Nerve ◽

Anatomic Study ◽

Masseteric Nerve

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Endoscopic Endonasal Transclival Approach and Retrosigmoid Approach to the Clival and Petroclival Regions

Operative Neurosurgery ◽

10.1227/01.neu.0000347001.62158.57 ◽

2009 ◽

Vol 65 (suppl_6) ◽

pp. ons42-ons52 ◽

Cited By ~ 8

Author(s):

Matteo de Notaris ◽

Luigi Maria Cavallo ◽

Alberto Prats-Galino ◽

Isabella Esposito ◽

Arnau Benet ◽

...

Keyword(s):

Internal Carotid ◽

Abducens Nerve ◽

Anatomic Study ◽

Lateral Extension ◽

Anatomic Landmarks ◽

Endoscopic Endonasal ◽

Fresh Cadaver ◽

Definition Of ◽

Surgical Corridor ◽

Neurovascular Structures

Abstract Objective: The removal of clival lesions, mainly those located intradurally and with a limited lateral extension, may be challenging because of the lack of a surgical corridor that would allow exposure of the entire lesion surface. In this anatomic study, we explored the clival/petroclival area and the cerebellopontine angle via both the endonasal and retrosigmoid endoscopic routes, aiming to describe the respective degree of exposure and visual limitations. Methods: Twelve fresh cadaver heads were positioned to simulate a semisitting position, thus enabling the use of both endonasal and retrosigmoid routes, which were explored using a 4-mm rigid endoscope as the sole visualizing tool. Results: The comparison of the 2 endoscopic surgical views (endonasal and retrosigmoid) allowed us to define 3 subregions over the clival area (cranial, middle, and caudal levels) when explored via the endonasal route. The definition of these subregions was based on the identification of some anatomic landmarks (the internal carotid artery from the lacerum to the intradural segment, the abducens nerve, and the hypoglossal canal) that limit the bone opening via the endonasal route and the natural well-established corridors via the retrosigmoid route. Conclusion: Different endoscopic surgical corridors can be delineated with the endonasal transclival and retrosigmoid approaches to the clival/petroclival area. Some relevant neurovascular structures may limit the extension of the approach and the view via both routes. The combination of the 2 approaches may improve the visualization in this challenging area.

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Anatomic Landmarks of the Glossopharyngeal Nerve: A Microsurgical Anatomic Study: In Reply

Neurosurgery ◽

10.1227/01.neu.0000129102.82344.80a ◽

2004 ◽

Keyword(s):

Glossopharyngeal Nerve ◽

Anatomic Study ◽

Anatomic Landmarks

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Cognitive Reflection Effects on Time Discounting

Journal of Individual Differences ◽

10.1027/1614-0001/a000254 ◽

2018 ◽

Vol 39 (2) ◽

pp. 99-106 ◽

Cited By ~ 4

Author(s):

Michał Białek ◽

Przemysław Sawicki

Keyword(s):

Individual Differences ◽

Individual Difference ◽

Delay Discounting ◽

Reference Point ◽

Reference Points ◽

Cognitive Reflection Test ◽

Process Information ◽

Time Discounting ◽

Cognitive Reflection ◽

The Way

Abstract. In this work, we investigated individual differences in cognitive reflection effects on delay discounting – a preference for smaller sooner over larger later payoff. People are claimed to prefer more these alternatives they considered first – so-called reference point – over the alternatives they considered later. Cognitive reflection affects the way individuals process information, with less reflective individuals relying predominantly on the first information they consider, thus, being more susceptible to reference points as compared to more reflective individuals. In Experiment 1, we confirmed that individuals who scored high on the Cognitive Reflection Test discount less strongly than less reflective individuals, but we also show that such individuals are less susceptible to imposed reference points. Experiment 2 replicated these findings additionally providing evidence that cognitive reflection predicts discounting strength and (in)dependency to reference points over and above individual difference in numeracy.

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