Relationship between buccal branches of the facial nerve, parotid duct, buccal fat pad and Zuker’s point

Abstract

Objectives: The aim of this study was to determine the relationship of the buccal branches of the facial nerve with the parotid duct, the buccal fat pad and the Zuker’s point, and reveal the incidence of the neural communications of buccal branch with the zygomatic and marginal mandibular branches of the facial nerve. Methods: Fifteen formalin-fixed cadaveric heads (8 females and 7 males) with a mean age of 73.93±14.42 years were dissected bilaterally to reveal the buccal, zygomatic and marginal mandibular branches of the facial nerve, the parotid duct and the buccal fat pad. Positional relationships of these structures and the anatomical features of buccal and zygomatic branches were evaluated. Results: The mean number of buccal and zygomatic branches was 2.40±0.62 and 1.90±0.60 respectively. Buccal branches crossed the parotid duct in 67%, formed a plexus along the parotid duct in 27% and coursed superior or inferior to the parotid duct without crossing in 6% of the dissected specimens. The mean number of intersection points of buccal branches on parotid duct was 4.03±1.03. Parotid duct crossed along the superior border of buccal fat pad in 66%, deep to buccal fat pad in 27% and between the superior and inferior lobes of buccal fat pad in 7%. Buccal branches crossed superficial to buccal fat pad in 80% and some branches passed superficial and through the buccal fat pad in 20%. Conclusion: It is essential to know the positional interrelations of the buccal branches of the facial nerve with the parotid duct and buccal fat pad for clinical implications. The relation of Zuker’s point with zygomatic and buccal branches and with parotid duct should not be overlooked.