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Facial nerve

Medicine (Queen's University Belfast)

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Facial nerve
• Intermediofacial nerve / nervous intermedius
• Nerve of the second pharyngeal arch (hyoid arch)

Both sensory and motor nerve

• Facial movements
• Taste
• Salivation, lacrimation
• Facial nerve nuclei
• Main motor nucleus
• Parasympathetic
nucleus
• Sensory nucleus

Motor -
Muscles of facial expression:
Lacrimal gland, submandibular gland
&
sublingual glands

Sensory - taste
Anterior 2/3rd of tongue

Main Motor Nucleus

• Lies deep in the reticular formation of the lower part of the pons
– Part of the nucleus that supplies the muscles of upper part of the face
receives corticonuclear fibres from both hemispheres
– The part that supplies lower part of the face receives fibres from opposite
hemisphere

Facial nerve runs in:

• Intracranial course
• Intraosseous course (in facial canal)
• Enters the internal auditory meatus alongside the eighth cranial
nerve.
• In the facial canal
• Greater superficial petrosal nerve
• Branches to sympathetic plexus
• Nerve to the stapedius muscle
• Chorda tympani
• Intraglandular course (in parotid glands)
• Nerve exits the temporal bone through the stylomastoid
foramen in the base of the skull and enters the parotid gland
where it branches into five divisions.

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Muscles supplied by each

division
• Temporal
• forehead
muscles
• Zygomatic
• orbicularis oculi
around each eye
• Buccal
• cheek and upper
lip
• Mandibular
• lower lip
• Cervical
• Platysma

The facial nerve may be damaged by:

• Compression in the internal auditory meatus
• Infections in the middle ear
• Parotid tumours
• Facial trauma (deep wounds and cuts)
• Maxillofacial surgery
• Unknown causes (bell’s palsy)

Lesion of facial nerve:

• Flaccid paralysis of muscles of facial expression
• Loss of corneal reflex ( efferent limb )
• Loss of taste from the anterior 2/3rd of the tongue
• Loss of lacrimation - dry eye with soreness and ulceration of the conjunctiva and
cornea
• Paralysis of stapedius muscle – (this muscles tenses the ossicular chain in the middle
ear damping loud sounds). If the muscle does not operate, even quiet sounds seem
unduly loud.

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