During superficial parotidectomy, after raising the skin flap, the surgeon identifies the trunk of the facial nerve at the stylomastoid foramen. Which anatomical landmark is most consistently used to locate the nerve trunk?

• A Posterior belly of digastric muscle origin
• B Tympanomastoid suture line ✓
• C External jugular vein crossing the sternocleidomastoid
• D Greater auricular nerve over the sternocleidomastoid

Explanation

The facial nerve trunk exits the skull base through the stylomastoid foramen, and the tympanomastoid (petrotympanic) suture line leads directly to it, making it the most consistent surgical landmark. The posterior belly of digastric and the tragal pointer serve as supplementary guides, while the greater auricular nerve and external jugular vein lie superficially over the sternocleidomastoid and bear no relation to the nerve trunk at the foramen.

Reference: Diseases of Ear, Nose and Throat (Dhingra), 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.