Methodsĭissections were carried out in 13 fresh white cadavers (26 heminecks). In addition, anatomic variations of the nerve as well as its relation to the external jugular vein (EJV) will be described. The purpose of our report is to describe this distal course of the GAN as it approaches the earlobe and to define consistent boundaries for this danger zone. It is here that it is most likely to be injured.
#SCAPHA AURICULA SKIN#
3, 4, 12– 14 However, during skin flap elevation, the nerve is routinely encountered proximal to McKinney's point and closer to the earlobe. Previous authors have described the location of the great auricular nerve (1) as it emerges from underneath the sternocleidomastoid muscle (SCM) and (2) as it courses along the midbelly of the muscle. Although not as significant as motor nerve injury, iatrogenic injury of the GAN can have long-term sequelae.
Injury to the great auricular nerve (GAN) during facelift surgery can occur while skin flaps are being undermined or at the time of posterior platysmal suspension. Four types of branching patterns were identified.Ĭonclusions: The 30-degree angle described above rapidly and accurately identifies the nerve's location.įacelift, rhytidectomy, great auricular nerve, nerve injury, anatomic landmarks, cadaver, SMAS, anatomy, facelift complication, danger zone
The distance from the EAC to the nerve was 4.9 ± 1.1 cm at the anterior muscle border, 7.3 ± 1.0 cm at the midbelly of the SCM, and 9.8 ± 1.2 cm at the GAN's emergence from under the SCM. Results: In 100% of the dissections, the superior course of the GAN fell within a 30-degree angle constructed using the vertical limb perpendicular to the Frankfurt horizontal and a second limb drawn posteriorly from the midlobule. Branching patterns of the nerve and its relation to the external jugular vein were identified. The distance from the bony external auditory canal (EAC) to the nerve was measured at the anterior muscle border, at the midbelly of the SCM, and as the nerve emerged from under the SCM. Transparent paper overlay tracings were then done to record each nerve's location. A vertical line through the midlobule was drawn perpendicular to the Frankfort's horizontal, acting as a reference to the course of the GAN. Methods: Thirteen fresh cadavers were dissected. The purpose of our study was to identify the superior course of the great auricular nerve as it applies to facelift. Objectives: Previous reports have described the nerve's location at the midbelly of the sternocleidomastoid muscle (SCM) or at its emergence from underneath the SCM. Although rare, injury can result in long-term sequelae.
Many growers divide their plants after flowering, but life on the nursery is too busy, so their plants are usually divided in July to August. Gillian says these picky alpines hate being too wet, but they also don’t like being too dry in summer, because root aphids thrive in dry conditions. Root aphids have recently been a nuisance to growers of auriculas, so I wanted to learn how they manage their plants.
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