Facial Nerve Buccal Branch — MFDS Part 1 MCQ

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ModerateAnatomy (Head & Neck)Facial Nerve Buccal BranchMFDS Part 1

If an extraoral approach is required to drain a buccal space abscess, which terminal branch of the facial nerve is most at risk as dissection proceeds through the cheek towards the buccal fat pad?

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Correct answer: A — Buccal branch

The correct answer is the buccal branch of the facial nerve. Buccal facial nerve rami cross the cheek in close relationship to the buccal fat pad, commonly traversing its capsule superficially, so they are vulnerable during an extraoral approach to the buccal space. The zygomatic branch courses more superiorly towards the infraorbital and zygomatic regions. The marginal mandibular branch is chiefly endangered by incisions or dissection near the lower border of the mandible. The temporal branch crosses the zygomatic arch towards the forehead, while the cervical branch descends into the upper neck to supply platysma. The original route-unspecified stem was less precise because buccal space infections may also be approached intraorally.

Reference: Gamboa-Bobadilla GM et al. External Approach to Buccal Fat Excision in Facelift: Anatomy and Technique. Aesthetic Surgery Journal, 2020. https://pubmed.ncbi.nlm.nih.gov/31965150/