During a superficial parotidectomy, the surgeon identifies the main trunk of the facial nerve. What is the most reliable surgical landmark for locating the main trunk of the facial nerve?

• A Retromandibular vein — the nerve lies deep to it
• B Posterior belly of digastric — the nerve lies superficial to it where it crosses
• C External jugular vein — the nerve lies medial to it
• D Tragal pointer (tympanomastoid suture/cartilaginous tragal pointer) — the nerve lies 1 cm deep and inferior to its tip ✓

Explanation

The most reliable and commonly used surgical landmark for the main trunk of the facial nerve is the tragal pointer (the apex of the tragal cartilage). The main trunk of the facial nerve lies approximately 1 cm deep and slightly inferior to the tragal pointer, just superficial to the styloid process and posterior belly of digastric. Additional landmarks include: the tympanomastoid suture (nerve lies 6–8 mm below its inferior end) and the posterior belly of digastric (nerve crosses superficially at its superior border). However, the tragal pointer is the primary intraoperative landmark taught in surgical anatomy.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.