The relationship of the buccal branch of the facial nerve to the parotid duct

Purpose: This cadaver dissection studied the relationship of the buccal branch of the facial nerve to the parotid duct and its relevance to surgical procedures in this area. Materials and Methods: Ten cadaveric heads (twenty sides) were dissected. The superficial tissues were removed, and the buccal branch of the facial nerve and the parotid duct were identified. The vertical and horizontal relationships were recorded and analyzed. Results: Eighty- five percent of the cadavers had a single buccal branch of the facial nerve, whereas 15% had two branches. In 75% of cases, the nerve was inferior to the duct as it emerged from the parotid gland, whereas in 25% of cases the nerve crossed the duct, usually from superior to inferior. Conclusion: The buccal branch of the facial nerve has a close relationship with the parotid gland for over 2.5 cm after it emerges from the parotid gland; it normally lies inferior to the duct. This relationship is of importance in performing parotid gland surgery, parotid duct surgery, and some facial cosmetic surgery.