Topographic Relationships Between the Transverse Facial Artery, Branches of the Facial Nerve, and the Parotid Duct in the Lateral Midface in a Korean Population

Background: The aims of the present study were to clarify the topographic relationships between various structures in the lateral midface and to provide important anatomical information pertinent to face lifting or treatment of damage to the midface structure. Methods: Thirty-two fixed cadavers were dissected (23 males and 9 females; mean age, 66.8 years) and 55 sides of midface were used. The transverse facial artery (TFA), zygomatic branch (Zb) and buccal branch (Bb) of the facial nerve, and the parotid duct (PD) were identified. The structures of the lateral midface were measured relative to the zygion and tragion. The vertical average distances from the zygion to each structure increased in the following order: ZB of the facial nerve, TFA, first Bb of the facial nerve, and PD. The horizontal average distance from the tragion to the point of emergence from anterior border of the parotid gland was also measured. Results: The TFA was the closest and the third Bb of the facial nerve was the farthest away. The angles between the horizontal line and ZB of the facial nerve, TFA, PD, and first Bb of the facial nerve were +10.4, -2.3, -18.5, and -27.1 degrees, respectively. Conclusions: These results may be used to establish the precise locations and the courses of the important midface structures, and represent valuable data that may help to prevent complications during surgery for face lifting and reconstruction of the facial nerve and PD.