tragal pointer

Facial nerve paralysis is a daunting potential complication of parotid surgery and is widely reported. Knowledge of the key landmarks of the facial nerve trunk is essential for safe and effective surgical intervention in the region of the parotid gland. In current practice, wide ranges of landmarks are used to identify the facial nerve trunk, however, there is much debate in the literature about the safety and reliability of each of these landmarks. The aim of this study, therefore, was to evaluate the relation of the surrounding anatomical structures and surgical landmarks to the facial nerve trunk...

OBJECTIVE: Establish normative data concerning parotidectomy and facial nerve dissection and determine the relationship between the length of the facial nerve dissected during parotidectomy and subsequent facial nerve paresis. STUDY DESIGN: Prospective mapping of facial nerve during parotidectomy and comparison with postoperative facial nerve function. METHODS: A prospective observational study of 78 patients who underwent 79 parotidectomy procedures...

OBJECTIVES: To determine the accuracy of using surrogate anatomic structures radiologically to predict the relation of parotid lesions to the intraparotid facial nerve. SETTING: Tertiary centre. DESIGN: Retrospective. PATIENTS AND METHODS: All patients with parotid masses over a 5-year period who undertook parotidectomy were considered. A radiologist and an otolaryngologist reviewed the images. Their decision regarding the location of the lesions using four surrogate structures was compared with intraoperative documentation...

"Plastipore" prostheses (TORP, PORP) in the middle ear have established themselves in recent years for the restoration of optimal transformation of air pressure in partial or total loss of the ossicular chain, provided that certain conditions are observed. A good protector between the tympanic membrane or the tympanic membrane graft, and a prosthetic screen is essential. For this we use a transplant composed of perichondrium and cartilage from the tragal cartilage cut in a certain manner, which also functions ideally as a tympanic membrane graft...

A number of different approaches can be used to expose the facial nerve. The route taken will depend on the pathology and the portion of the nerve that requires exposure. When performing a parotidectomy approach to the extratemporal portion of the facial nerve, the tragal pointer is a key landmark, but other landmarks also should be used to identify the facial nerve safely. The lateral semicircular canal, the chorda tympani nerve, the digastric ridge, and the cochleariform process are some of the useful landmarks in the mastoid and middle ear...