Anatomic danger zones in cutaneous surgery of the head and neck
- Shawn Allen, MD
Shawn Allen, MD
- Assistant Clinical Professor, Department of Dermatology
- University of Colorado
- Director, Dermatology Specialists of Boulder, PC Boulder, CO
This topic will discuss how to identify the anatomical danger zones in the head and neck area to avoid injuries during cutaneous surgery. Basic dermatologic procedures are discussed separately. (See "Dermatologic procedures".)
Surgeons operating in the head and neck area must have an in-depth understanding of the regional anatomy to achieve good surgical outcomes and avoid complications. The surgical risk of injury to nerves or other relevant anatomic structures should be discussed with the patient preoperatively, and informed written consent should be obtained. (See "Informed procedural consent".)
There are eight danger zones in the head and neck area where the motor or sensory nerves travel more superficially or nerve roots emerge from the skull foramina. Key structures to avoid during surgery include :
●The supraorbital and supratrochlear branches of the ophthalmic branch of the trigeminal nerve and accompanying blood vessels
●The infraorbital branches of the maxillary branch of the trigeminal nerve and the infraorbital vessels
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- TYPES OF NERVE INJURY
- CONSEQUENCES OF NERVE INJURY
- Sensory nerve injury
- Motor nerve injury
- DANGER ZONES
- Sensory nerves
- - Trigeminal nerve
- Supraorbital and supratrochlear nerves
- Infraorbital nerve
- Mental nerve
- Motor nerves
- - Facial nerve
- Temporal (frontal) nerve
- Marginal mandibular nerve
- Buccal and zygomatic nerves and parotid Stensen's duct
- Mixed motor and sensory nerves
- - Posterior triangle of the neck
- Parotid gland
- SUMMARY AND RECOMMENDATIONS