A new and reliable landmark in parotid surgery: tragomastoid groove (Akil Groove)

F. Akil, V. Kinis, U. Yilmaz, M. Akdag, S.F. Toprak, M. Ayral, H. Durak

Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Dicle University, Diyarbakır, Turkey. vefakinis@hotmail.com

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• Otorhinolaryngology

OBJECTIVE: Parotid surgery is a frequently performed surgery in otorhinolaryngology practice with many possible complications. Due to the high ratio of facial paralysis during parotid surgery, we defined a new landmark for identifying and protecting the facial nerve as early as possible during surgery.

MATERIALS AND METHODS: The study was designed as a prospective anatomical method. The important details and relationship of the tragomastoid groove to the facial nerve truncus were examined during surgery on 30 patients. In addition, the demographics of the patients, the type of surgery and the pathological results of surgeries were evaluated.

RESULTS: The mean distance of the tragomastoid groove to the facial nerve truncus was 20.53±1.71 mm, the mean deepness of the tragomastoid groove was 1.91±0.26 mm, and the mean superficial part of the tragomastoid groove was 0.83±0.23 mm. The tragomastoid groove was situated either across from the facial nerve at the place where the facial nerve truncus exits the stylomastoid foramen or just inferior to the truncus in all patients.

CONCLUSIONS: The tragomastoid groove was defined for the first time in the literature as a reliable landmark for identifying the facial nerve truncus easily during parotid surgery.

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