Posterior auricular artery as a novel anatomic landmark for identification of the facial nerve: A cadaveric study

Background: Despite preservation techniques, performing a parotidectomy carries a transient facial nerve dysfunction rate in up to 65% of cases and a permanent facial nerve weakness rate of 4%-7%. Methods: The lateral aspect of the face and neck was exposed in 5 cadaveric heads (10 sides). The relationship of the posterior auricular artery (PAA) and the facial nerve was studied and recorded and descriptive measurements were taken. Results: In all specimens, the facial nerve trunk crossed the PAA inferior to the stylomastoid foramen and could be identified precisely by tracing the PAA proximally. The distance from the cross point of the PAA and the facial nerve to the external meatal cartilage was 5.2 ± 0.2 mm. Conclusion: The PAA represents a potential new anatomic landmark for facial nerve identification at the main trunk.