{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:50:27Z","timestamp":1791989427060,"version":"4.4.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In the preauricular region, the frontotemporal branch of the facial nerve is vulnerable to injury, which can result in facial palsy and poor cosmesis after surgical interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The purpose of this study was to describe variations in the branching patterns of the frontotemporal branch of the facial nerve and the relation between this branch and the surrounding anatomic landmarks. Based on our findings, we propose a Danger Zone and Safe Zones for preauricular interventions to avoid frontal branch injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Twenty cadaveric half-heads, 10 freshly frozen and 10 embalmed, were dissected. The anatomy of the auriculotemporal nerve, facial nerve, and variations of its branching pattern in the preauricular region were investigated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean [standard deviation] number of frontotemporal branches crossing the zygomatic arch was 2.05 [0.6]. Beginning from the X point at the apex of the intertragal notch, frontal branches ran over the zygomatic arch at a distance extending from 10 to 31 mm anterior to the tragus, which can be defined as the Danger Zone for frontal branches. Safe Zones A and B are triangular regions located behind and in front of the Danger Zone, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Mapping of these Safety and Danger Zones is a reliable and simple approach in preauricular interventions to avoid frontal branch injury because the facial nerve typically has multiple frontal branches. This approach provides practical information for surgeons rather than estimating the trajectory of a single frontal branch from Pitanuy's line.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaa232","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T15:36:25Z","timestamp":1596900985000},"page":"398-407","source":"Crossref","is-referenced-by-count":17,"title":["Defining a Preauricular Safe Zone: A Cadaveric Study of the Frontotemporal Branch of the Facial Nerve"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1345-3549","authenticated-orcid":false,"given":"Arda","family":"Kucukguven","sequence":"first","affiliation":[{"name":"Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive, and Aesthetic Surgery , Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Ulkir","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine, Department of Anatomy , Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meric","family":"Bilgic Kucukguven","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery , Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Deniz","family":"Demiryurek","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine, Department of Anatomy , Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Vargel","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive, and Aesthetic Surgery , Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,8]]},"reference":[{"issue":"4","key":"2022112516194217600_CIT0001","first-page":"385","article-title":"Surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial halves","volume":"102","author":"Davis","year":"1956","journal-title":"Surg Gynecol Obstet."},{"issue":"3","key":"2022112516194217600_CIT0002","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1001\/jamafacial.2016.1462","article-title":"Association among facial paralysis, depression, and quality of life in facial plastic surgery patients","volume":"19","author":"Nellis","year":"2017","journal-title":"JAMA Facial Plast Surg."},{"issue":"1","key":"2022112516194217600_CIT0003","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/ams.ams_200_17","article-title":"Facial nerve injury in temporomandibular joint approaches","volume":"8","author":"Moin","year":"2018","journal-title":"Ann Maxillofac Surg."},{"issue":"4","key":"2022112516194217600_CIT0004","doi-asserted-by":"crossref","first-page":"751e","DOI":"10.1097\/PRS.0000000000002166","article-title":"Anatomical considerations to prevent facial nerve injury: insights on frontal branch and cervicofacial trunk nerve anatomy in SMAS face lifts","volume":"137","author":"Visconti","year":"2016","journal-title":"Plast Reconstr Surg."},{"issue":"5","key":"2022112516194217600_CIT0005","doi-asserted-by":"crossref","first-page":"375","DOI":"10.14639\/0392-100X-1089","article-title":"Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring","volume":"37","author":"Carta","year":"2017","journal-title":"Acta Otorhinolaryngol Ital."},{"issue":"2","key":"2022112516194217600_CIT0006","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1177\/0194599812467299","article-title":"Postoperative facial nerve function in pediatric parotidectomy: a 12-year review","volume":"148","author":"Owusu","year":"2013","journal-title":"Otolaryngol Head Neck Surg."},{"issue":"4","key":"2022112516194217600_CIT0007","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.fsc.2013.07.007","article-title":"Complications in facelift surgery: avoidance and management","volume":"21","author":"Chaffoo","year":"2013","journal-title":"Facial Plast Surg Clin North Am."},{"issue":"5","key":"2022112516194217600_CIT0008","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1097\/00006534-200010000-00033","article-title":"National plastic surgery survey: face lift techniques and complications","volume":"106","author":"Matarasso","year":"2000","journal-title":"Plast Reconstr Surg."},{"issue":"10","key":"2022112516194217600_CIT0009","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/0278-2391(92)90488-L","article-title":"Facial-nerve function following temporomandibular-joint surgery using the preauricular approach","volume":"50","author":"Weinberg","year":"1992","journal-title":"J Oral Maxil Surg"},{"issue":"1-2","key":"2022112516194217600_CIT0010","first-page":"19","article-title":"Preauricular approach to the temporomandibular joint: a postoperative follow-up on nerve function, hemorrhage and esthetics","volume":"21","author":"Nellestam","year":"1997","journal-title":"Swed Dent J."},{"issue":"2","key":"2022112516194217600_CIT0011","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s10006-015-0543-0","article-title":"Patterns and surgical significance of facial nerve branching within the parotid gland in 43 cases","volume":"20","author":"Gataa","year":"2016","journal-title":"Oral Maxillofac Surg."},{"issue":"2","key":"2022112516194217600_CIT0012","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1055\/s-0034-1393726","article-title":"Retrospective study of facial nerve function following temporomandibular joint arthroplasty using the endaural approach","volume":"8","author":"Liu","year":"2015","journal-title":"Craniomaxillofac Trauma Reconstr."},{"issue":"2","key":"2022112516194217600_CIT0013","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1097\/PRS.0b013e3181c82e9d","article-title":"The course of the frontal branch of the facial nerve in relation to fascial planes: an anatomic study","volume":"125","author":"Agarwal","year":"2010","journal-title":"Plast Reconstr Surg."},{"issue":"9","key":"2022112516194217600_CIT0014","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.joms.2003.10.013","article-title":"The deep subfascial approach to the temporomandibular joint","volume":"62","author":"Politi","year":"2004","journal-title":"J Oral Maxillofac Surg."},{"issue":"2","key":"2022112516194217600_CIT0015","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/0030-4220(86)90028-9","article-title":"The risk of damage to facial nerve, superficial temporal vessels, disk, and articular surfaces during arthroscopic examination of the temporomandibular joint","volume":"62","author":"Westesson","year":"1986","journal-title":"Oral Surg Oral Med Oral Pathol."},{"issue":"2","key":"2022112516194217600_CIT0016","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0300-9785(85)80089-2","article-title":"Arthroscopy of the temporomandibular joint. An autopsy study","volume":"14","author":"Holmlund","year":"1985","journal-title":"Int J Oral Surg."},{"issue":"11","key":"2022112516194217600_CIT0017","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/0278-2391(82)90141-0","article-title":"Morbidity associated with the preauricular and perimeatal approaches to the temporomandibular joint","volume":"40","author":"Dolwick","year":"1982","journal-title":"J Oral Maxillofac Surg."},{"issue":"9","key":"2022112516194217600_CIT0018","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1016\/S0278-2391(99)90325-7","article-title":"Subjective and objective assessment of the temporalis myofascial flap in previously operated temporomandibular joints","volume":"57","author":"Smith","year":"1999","journal-title":"J Oral Maxillofac Surg."},{"issue":"4","key":"2022112516194217600_CIT0019","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1097\/PRS.0b013e3181d18136","article-title":"The frontal branch of the facial nerve across the zygomatic arch: anatomical relevance of the high-SMAS technique","volume":"125","author":"Trussler","year":"2010","journal-title":"Plast Reconstr Surg."},{"key":"2022112516194217600_CIT0020","doi-asserted-by":"crossref","first-page":"752","DOI":"10.3389\/fneur.2017.00752","article-title":"Neuroprosthetics for auricular muscles: neural networks and clinical aspects","volume":"8","author":"Liugan","year":"2017","journal-title":"Front Neurol."},{"issue":"4","key":"2022112516194217600_CIT0021","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/00006534-196610000-00010","article-title":"The frontal branch of the facial nerve: the importance of its variations in face lifting","volume":"38","author":"Pitanguy","year":"1966","journal-title":"Plast Reconstr Surg."},{"issue":"5","key":"2022112516194217600_CIT0022","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s00276-014-1386-3","article-title":"The frontal branch of the facial nerve: can we define a safety zone?","volume":"37","author":"de Bonnecaze","year":"2015","journal-title":"Surg Radiol Anat."},{"issue":"2","key":"2022112516194217600_CIT0023","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/1090820X12473104","article-title":"The extratemporal facial nerve and its branches: analysis of 42 hemifacial dissections in fresh Persian (Iranian) cadavers","volume":"33","author":"Farahvash","year":"2013","journal-title":"Aesthet Surg J."},{"issue":"7","key":"2022112516194217600_CIT0024","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1002\/ca.22162","article-title":"Clinically relevant landmarks of the frontotemporal branch of the facial nerve: a three-dimensional study","volume":"25","author":"Davies","year":"2012","journal-title":"Clin Anat."},{"issue":"12","key":"2022112516194217600_CIT0025","doi-asserted-by":"crossref","first-page":"2466","DOI":"10.1016\/j.joms.2007.04.013","article-title":"In situ location of the temporal branch of the facial nerve","volume":"65","author":"Miloro","year":"2007","journal-title":"J Oral Maxillofac Surg."},{"issue":"6","key":"2022112516194217600_CIT0026","first-page":"1038","article-title":"An anatomicosurgical study of the temporal branch of the facial nerve","volume":"33","author":"Ammirati","year":"1993","journal-title":"Neurosurgery."},{"issue":"5","key":"2022112516194217600_CIT0027","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1097\/00006534-199705000-00003","article-title":"The temporal branch of the facial nerve: how reliably can we predict its path?","volume":"99","author":"Gosain","year":"1997","journal-title":"Plast Reconstr Surg."},{"issue":"5","key":"2022112516194217600_CIT0028","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S0007-1226(97)90538-5","article-title":"Laser scanning for the identification of repeatable landmarks of the ears and face","volume":"50","author":"Coward","year":"1997","journal-title":"Br J Plast Surg."},{"issue":"2","key":"2022112516194217600_CIT0029","doi-asserted-by":"crossref","first-page":"371e","DOI":"10.1097\/PRS.0000000000002980","article-title":"What is the lobular branch of the great auricular nerve? Anatomical description and significance in rhytidectomy","volume":"139","author":"Sharma","year":"2017","journal-title":"Plast Reconstr Surg."},{"issue":"2","key":"2022112516194217600_CIT0030","doi-asserted-by":"crossref","first-page":"245e","DOI":"10.1097\/PRS.0b013e3182789c5c","article-title":"Relationship of the zygomatic facial nerve to the retaining ligaments of the face: the sub-SMAS danger zone","volume":"131","author":"Alghoul","year":"2013","journal-title":"Plast Reconstr Surg."},{"issue":"5","key":"2022112516194217600_CIT0031","doi-asserted-by":"crossref","first-page":"NP223","DOI":"10.1093\/asj\/sjz186","article-title":"A simple clinical application for locating the frontotemporal branch of the facial nerve using the zygomatic arch and the tragus","volume":"40","author":"Green Sanderson","year":"2019","journal-title":"Aesthet Surg J"},{"issue":"5","key":"2022112516194217600_CIT0032","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1097\/00006534-197311000-00013","article-title":"Surgical anatomy of the facial nerve, as related to ancillary operations in rhytidoplasty","volume":"52","author":"Correia","year":"1973","journal-title":"Plast Reconstr Surg."}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjaa232\/33619166\/sjaa232.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/41\/4\/398\/47267227\/sjaa232.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/41\/4\/398\/47267227\/sjaa232.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T16:20:12Z","timestamp":1669393212000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/41\/4\/398\/5889944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,8]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,8,8]]},"published-print":{"date-parts":[[2021,3,12]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjaa232","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2020,8,8]]}}}