(1) Background: Considering that the specialty literature supplies only general data about the variability of the cervical branch of the facial nerve, this study aimed to determine this branch’s variation and individual peculiarities depending on the nerve branching pattern and anthropometric type of the head. (2) Methods: The study was conducted on 75 hemifaces of adult formalized cadavers. Ahead of anatomical dissection, each head was measured to establish the anthropometric type, according to Franco and colleagues. The branching patterns were then distributed according to the Davis classification. (3) Results: The number of cervical branches (CB) of the facial nerve varied from one to five branches, with the following rate: 1 CB (61.3%), 2 CB (28%), 3 CB (6.7%), 4 CB (2.7%), and 5 CB (1.3%). Seven branching patterns of the facial nerve were revealed: Type I in 18.7%, Type II in 14.7%, Type III in 20%, Type IV in 14.6%, Type V in 5.3%, Type VI in 18.7%, and Type NI in 8% (bizarre types). According to the branching pattern, the mean numbers of the cervical branches were as follows: Type I—1.6 ± 1.02; Type II—1.4 ± 0.50; Type III—1.4 ± 0.50; Type IV—1.4 ± 0.67; Type V—2.0 ± 1.41; Type VI—1.8 ± 1.12; and Type-NI—1.8 ± 0.75; p = 0.599. According to the anthropometric type of the head, the mean number of CB in the mesocephalic type (MCT) was 1.5 ± 0.82, in the dolichocephalic type (DCT), 1.7 ± 0.87, and in the brachycephalic type, (BCT) 1.8 ± 1.04; p = 0.668. (4) Conclusions: The cervical branch of the facial nerve varies depending on the facial nerve branching pattern and the anthropometric type of the head. The highest degree of variation was characteristic of BCT and Type V and the lowest, of MCT and Types II, III, and IV.

Background: The expanding number of parotid ablations, reconstructive and aesthetic surgeries of the head and neck, considerably increased the risk of the marginal mandibular branch (MMB) injury. The purpose of our study was to determine the anatomical peculiarities of the MMB depending on the facial nerve branching pattern (FNBP), gender and cephalometric type. Materials and methods: The MMB was dissected on 75 hemiheads of adult embalmed cadavers. The origin, number of branches, topography and connections of the MMB were analyzed. Results: Seven FNBP were identified: Type I (18.7%); Type II (14.7%); Type III (20%); Type IV (14.6%); Type V (5.3%); Type VI (18.7%); Type NI (8%, non-identified types). In males 1–3 MMB were determined and in females 1–4 MMB; p = 0.845. In males, bilaterally were identified 1–3 MMB. In females on the right side were found 1–2 MMB and on the left — 1–4 MMB; p = 0.204. A single MMB was revealed in 41 cases (54.7%), 2 MMB — in 29 cases (38.7%), 3 MMB — in 4 cases (5.3%) and in a single case 4 MMB (1.3%) were determined. Depending on the FNBP, the number of the MMB was: Type I — 1.2 ± 0.43; Type II — 1.5 ± 0.52; Type III — 1.6 ± 0.63; Type IV — 1.5 ± 0.52; Type V — 1.3 ± 0.50; Type VI — 1.9 ± 0.95; Type NI — 1.7 ± 0.82. IGFV = 1.403 (intergroup frequency variation); df = 6 (degree of freedom); p = 0.226. According to the cephalometric type the number of the MMB in mesocephalic type (MCT) was 1.5 ± 0.68; in brachycephalic type (BCT) — 1.6 ± 0.52; in dolichocephalic type (DCT) — 1.9 ± 0.60. IGFV = 1.698; df = 2; p = 0.190. A rare variant of the MMB origin from the temporofacial division of the facial nerve was highlighted in 5.3% of cases. Conclusions: The MMB varies depending on the FNBP, gender and cephalometric type. The highest variation degree was characteristic of females, Type VI and DCT. The lowest variation degree was determined in Type I and in MCT, without gender differences. The risk of iatrogenic lesions of the MMB is conditioned by two important aspects: its anatomical variability and large number of surgical interventions at that level. Keywords: marginal mandibular branch facial nerve branching pattern variants

Background: Knowledge concerning variability of the facial nerve trunk (FNT) direction after its exit through the stylomastoid foramen is of a great clinical significance for maxillofacial surgeons, otorhinolaryngologists, oncologists, specialists in plastic and aesthetic surgery. The aim of our study was to establish the variation of the FNT direction and its peculiarities dependent on branching pattern, gender, anthropometric type and side of the head. Materials and methods: The direction of the FNT and its branching pattern were studied on 75 dissected hemifaces of adult formalized cadavers (59 male/16 female), and the morphometry of the FNT length, width and bifurcation angle was carried out. Results: Seven branching patterns of the facial nerve were established: Type I – 18.7%, Type II – 14.7%, Type III – 20%, Type IV – 14.6%, Type V – 5.3%, Type VI – 18.7%, and Type-NI – 8% (bizarre types). The FNT had a descending direction in 73.3% of cases; ascending FNT – 9.3% (including 5.3% of very short diffuse branching trunks and 1.3% of arch-shaped FNT); horizontal FNT – 10.7%; number variants – 6.7%. The male/female ratio of the descending FNT was 69.5%/87.4%; ascending – 10.2%/6.3%; horizontal – 11.9%/6.3%; number variants – 8.4% (only in male). The right/left ratio of the descending FNT was 62.9%/82.5%; ascending – 11.4%/7.5%; horizontal – 11.4%/10%; number variants – 14.3% (only on the right side). The ratio of the descending FNT in mesocephalic type (MCT) / brachycephalic type (BCT) / dolichocephalic type (DCT) was respectively 70.6%/100%/66.7%; ascending – 12.1%/0%/0%; horizontal – 12.1/0%/11.1%. Numerical variants in MCT – 5.2%, in DCT – 22.2%. The mean number of FNT in MCT/BCT/DCT was respectively 1.07/1.0/1.22. Conclusions: Three main directions are characteristic for FNT: the descending, ascending and horizontal ones, which vary dependent on branching pattern, gender, shape and side of the head. Background: Knowledge concerning variability of the facial nerve trunk (FNT) direction after its exit through the stylomastoid foramen is of a great clinical significance for maxillofacial surgeons, otorhinolaryngologists, oncologists, specialists in plastic and aesthetic surgery. The aim of our study was to establish the variation of the FNT direction and its peculiarities dependent on branching pattern, gender, anthropometric type and side of the head. Materials and methods: The direction of the FNT and its branching pattern were studied on 75 dissected hemifaces of adult formalized cadavers (59 male/16 female), and the morphometry of the FNT length, width and bifurcation angle was carried out. Results: Seven branching patterns of the facial nerve were established: Type I – 18.7%, Type II – 14.7%, Type III – 20%, Type IV – 14.6%, Type V – 5.3%, Type VI – 18.7%, and Type-NI – 8% (bizarre types). The FNT had a descending direction in 73.3% of cases; ascending FNT – 9.3% (including 5.3% of very short diffuse branching trunks and 1.3% of arch-shaped FNT); horizontal FNT – 10.7%; number variants – 6.7%. The male/female ratio of the descending FNT was 69.5%/87.4%; ascending – 10.2%/6.3%; horizontal – 11.9%/6.3%; number variants – 8.4% (only in male). The right/left ratio of the descending FNT was 62.9%/82.5%; ascending – 11.4%/7.5%; horizontal – 11.4%/10%; number variants – 14.3% (only on the right side). The ratio of the descending FNT in mesocephalic type (MCT) / brachycephalic type (BCT) / dolichocephalic type (DCT) was respectively 70.6%/100%/66.7%; ascending – 12.1%/0%/0%; horizontal – 12.1/0%/11.1%. Numerical variants in MCT – 5.2%, in DCT – 22.2%. The mean number of FNT in MCT/BCT/DCT was respectively 1.07/1.0/1.22. Conclusions: Three main directions are characteristic for FNT: the descending, ascending and horizontal ones, which vary dependent on branching pattern, gender, shape and side of the head.

Background: Considering the tortuous course of the facial canal that houses the facial nerve, the stylomastoid artery and the homonymous vein, its morphological features are of great clinical significance in otologic, maxillofacial, oncologic, reconstructive and plastic surgery of the head and neck. The aim of this paper was to determine the individual specific features of the mastoid segment of facial canal and of the stylomastoid foramen. Material and methods: The study was carried out on 82 temporal bones (41 right/41 left), at the Department of anatomy and clinical anatomy of Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova. The morphometry of the mastoid segment of the facial canal and of the stylomastoid foramen was performed. The morphometric parameters were statistically analyzed by descriptive and inferential statistics methods. Results: The mastoid segment exited the facial canal by an obtuse, right and sharp angles, with a mean value of 113.1 ± 21.80° (right/left – 112.1 ± 23.85°/114.1 ± 19.76°), p = 0.701. The mean length of the mastoid segment was 15.1 ± 3.78 mm (right/left – 15.7 ± 3.66 mm/14.5 ± 3.84 mm), p = 0.153. The longitudinal diameter of the stylomastoid foramen had a mean of 3.0 ± 0.93 mm (right/left – 3.3 ± 0.96 mm/2.7 ± 0.81 mm), p = 0.007. The transverse diameter had a mean of 2.6 ± 0.74 mm (right/left – 2.9 ± 0.80 mm/2.4 ± 0.60 mm), p = 0.012. Conclusions: In otologic surgery and particularly in mastoidectomy, it should be taken into consideration that the mastoid segment of the facial canal could exit the temporal bone by a sharp, right and obtuse angles that along with high morphological variability of the stylomastoid foramen might be a predisposal factor for Bell's palsy. Keywords: facial canal facial nerve anatomical variations morphometry

Background: Considering the tremendous role of the carotid artery system for the nourishment of the brain, sensory organs and other morphological structures of the head and neck, knowledge about variation in the course of the carotid arteries is of high clinical significance. Thus, the aim of our study was to determine the variations in the course of the common carotid artery (CCA) and of its main branches, emphasizing the most susceptible variants for stroke development. Material and methods: A retrospective study on 210 computed tomography angiographs of 118 males and 92 females, with a mean age of 64.2 ± 13.82 years was carried out. The RadiAnt DICOM Viewer 2024.1 software for three-dimensional reconstruction, visualization and morphometry of the CCAs was used. For the statistical analysis predefined EXCEL functions were applied. Results: In 25.23% the CCA originated from the bovine arch and in 0.95% from the bicarotid trunk. Variations in the course of the CCA and its main branches were represented by tortuosity (37.61%); kinking (34.28%); coiling (0.95%); “kissing” (2.38%). Passage under the hyoid bone of CCA was registered in 2.38%; of the internal carotid artery (ICA) — in 1.42% and of the external carotid artery (ECA) — in 2.38%. Conclusions: In 1/4 of the cases, the CCA derived from the bovine arch. The most common variations in the carotid arteries course were tortuosity and kinking, followed by “kissing” and coiling. A course under the hyoid bone was established for each carotid artery. All the revealed variants of the carotid arteries course are significant in terms of risk for stroke development, nevertheless, in kinking with sharp angulations the rick is higher. Keywords: common carotid artery internal carotid artery external carotid artery variability