[Prevention of the zygomatic branch of the facial nerve in rhytidectomy: an anatomical study].

OBJECTIVE: To investigate the anatomical distribution of the zygomatic branch of the facial nerve and discuss its clinical significance in the rhytidectomy. METHODS: The distribution of the zygomatic branch of the facial nerve was observed on 30 halves of the fifteen candaveric specimens (10 antiseptic cadaveric specimens and 5 fresh cadavers). RESULTS: The zygomatic branch made its way through the upper or the anterior border of the parotid gland, giving rise to 2 or 3 rami, which could be divided into the superior and the inferior rami. The superior rami, which were thin and superficial, crossed the zygomatic arch at its inner one-third or ran along the inferior margin of the zygomatic arch, and then entered beneath the zygomatic ligaments. The inferior rami were comparatively thick and deep, lying 1.0+/-0.3 cm inferior to the superior rami. The inferior and superior rami joined each other on the surface and deep side of the zygomatic major muscle. CONCLUSION: In the prevention of the zygomatic branch damage in rhytidectomy, the areas where caution should taken were the anterior border of the zygomatic major muscle in sub-SMAS dissection and the zygomatic arch in the subperiosteal dissection. The sharp dissection and excess tension should be avoided to reduce the nerve injury.