Origin of the Buccal Branch of Facial Nerve and Anastomosis of the Facial Nerve Branches

Background: In parotid surgery, the extratemporal course of the Facial Nerve (FN) is very variable. Familiarity with these variations in the branching patterns is extremely crucial in successful dissection and preservation of the nerve. The present study aimed to describe the origin of the buccal branch of facial nerve and anastomosis of the facial nerve branches. Methodology: A total of 90 facial nerves were dissected, [40 cadavers (bilateral) and 10 patients (unilateral)]. Out of these 50 cases, 41 were males (37 cadavers and 4 patients) and 9 were females (3 cadavers & 6 patients). Forty-six (51%) were left and 44 (49%) were right facial nerves. Photographs of intra-parotid distribution of each facial nerve were taken during dissection. Results: In 78.8% of the cases, the buccal branch originated mainly from the lower division. Anastomotic connections were present between the buccal nerve and lower division in 36.67% of the cases, between the upper and lower divisions in 33.3% of the subjects, between the main trunk & lower division in 7.78% of the cases and between the buccal branch & the upper division in 2.2% of the cases. Conclusion: Majority of the buccal branches originated from the cervicofacial division and most of the anastomotic interconnections were identified between the lower and upper division. Anatomical variations in the origin and anastomosis can shed more light on the different consequences of facial paralysis that may encounter after parotid field surgery.