OBJECTIVES/HYPOTHESIS: To prove that the tympanomastoid suture (TMS) is a significantly closer and less variable anatomic landmark to the facial nerve than the posterior-superior margin of the posterior belly of the digastric muscle (PBD) in parotid surgery. MATERIALS AND METHODS: A prospective study of 14 cadaver specimens and 22 live patients comparing the closest measured distances between the TMS and PBD to the facial nerve. RESULTS: The mean closest distances from the TMS and PBD to the facial nerve were 1.8 (range 0-4) mm and 12.4 (range 7-17) mm, respectively (P < .05) for cadavers. The mean closest distances in live patients from the TMS and PBD to the facial nerve were 2.0 (range 0-4) mm and 10.7 (range 5-14) mm, respectively (P < .05). CONCLUSIONS: Facial nerve identification and preservation is the key to successful parotid surgery. The TMS is a significantly closer and less variable anatomic landmark compared with the PBD both in cadaver dissection and in live patients.
OBJECTIVES/HYPOTHESIS: To prove that the tympanomastoid suture (TMS) is a significantly closer and less variable anatomic landmark to the facial nerve than the posterior-superior margin of the posterior belly of the digastric muscle (PBD) in parotid surgery. MATERIALS AND METHODS: A prospective study of 14 cadaver specimens and 22 live patients comparing the closest measured distances between the TMS and PBD to the facial nerve. RESULTS: The mean closest distances from the TMS and PBD to the facial nerve were 1.8 (range 0-4) mm and 12.4 (range 7-17) mm, respectively (P < .05) for cadavers. The mean closest distances in live patients from the TMS and PBD to the facial nerve were 2.0 (range 0-4) mm and 10.7 (range 5-14) mm, respectively (P < .05). CONCLUSIONS: Facial nerve identification and preservation is the key to successful parotid surgery. The TMS is a significantly closer and less variable anatomic landmark compared with the PBD both in cadaver dissection and in live patients.