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Masseteric nerve position on the “temporomandibular joint–chin tip” artificial axis: an anatomical study

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
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Abstract

Purpose

The use of the masseteric nerve develops in the surgery of facial paralysis rehabilitation. The objective of this study was to determine the topography of the masseteric nerve and to deduce and predict a precise and reproducible anatomical cluster to facilitate its clinical identification during V–VII neurotization surgery.

Method

For the purpose of this work, a cadaveric study was performed on 31 hemi-faces. All dissections were performed bilaterally and comparatively, following steps aiming at simulating, as close as possible, the clinical conditions of a facial palsy rehabilitation by V–VII anastomosis.

Result

For the identification of the masseteric nerve, bony reference points were used, i.e., the temporomandibular joint (TMJ) and the chin point (CT). A virtual axis was drawn between the TMJ and the CT, and the distance [TMJ–MN] determining the smallest length h was then plotted against the distance [TMJ–CT] determining the largest length H, thus allowing the calculation of an h/H proportion ratio (PR) indicating the proximal part of the masseteric nerve from the TMJ. The average length h between the TMJ and the NM was 3.5 cm (± 0.1 cm) from the TMJ, i.e., an average ratio h/H [TMJ–MN]/[TMJ–CT] of 28.1% 4.0 and a median ratio of 28.6% of the distance [TMJ–CT].

Conclusion

Our study opens new perspectives for facilitating its identification and use, offering practitioners a tool to make V–VII the neurotization procedure less complex, with the eventual prospect of a minimally invasive procedure combining imaging, surgery, and augmented reality.

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Acknowledgements

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude. We would like to thank the Anatomy Laboratory of Amiens and all those people who contributed to the realization of this anatomical work. We also want to thank Mr MARMET Romain (medical student at the University of Picardie Jules Verne) for having granted us his work of production of Figure 1.

Funding

The authors declare that they have no conflict of interest and did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Laboratory of Anatomy and Morphogenesis, University of Picardie Jules Verne, Chemin du Thil, 80025, Amiens, France

    Alan Caillouey

  2. Department of Maxillofacial Surgery, University Hospital of Amiens, Avenue Laennec, 80000, Amiens, France

    Jérémie Bettoni, Matthieu Olivetto & Sylvie Testelin

  3. EA CHIMERE, Picardie Jules Verne University, Avenue Laennec, 80000, Amiens, France

    Stéphanie Dakpé

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  1. Alan Caillouey
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  2. Jérémie Bettoni
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  4. Stéphanie Dakpé
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  5. Sylvie Testelin
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Contributions

AC: protocol development, data collection, analysis, and management/manuscript writing. JB: protocol development data collection, analysis, and management/manuscript writing. MO: project development. SD: project development. ST: project development, manuscript writing. All authors contributed to the study and read and approved the final manuscript.

Corresponding author

Correspondence to Alan Caillouey.

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This study is in compliance with local ethical standards and in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Caillouey, A., Bettoni, J., Olivetto, M. et al. Masseteric nerve position on the “temporomandibular joint–chin tip” artificial axis: an anatomical study. Surg Radiol Anat 44, 1017–1023 (2022). https://doi.org/10.1007/s00276-022-02972-1

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  • DOI: https://doi.org/10.1007/s00276-022-02972-1

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