FACIAL NERVE

BY Alvi Fatima
MDS 1ST YEAR
DEPT OF PREVANTIVE AND PEDIATRIC
DENTISTRY
1
 CONTENT
 Introduction
 Embryology of facial nerve
 Functional components
 Nuclei of facial nerve
 Course of facial nerve
 Intracranial
 Extracranial
 Branches of facial nerve
 Greater petrosal nerve
 Nerve to stapedius
 Chorda tympani nerve
 Posterior auricular nerve
 Nerve to posterior belly of diagastric
 Nerve to stylohyoid muscle
 Terminal branches
 Communicating branches
2
 Vascular supply of facial nerve
 Clinical & applied anatomy
 INTRODUCTION

 The Facial nerve is the seventh of twelve paired cranial nerves, it is a mixed nerve with motor and
sensory roots.

 It emerges from the brain stem between the pons and the medulla, controls the muscles of facial
expression

 It functions in the conveyance of taste sensations from the anterior two thirds of the tongue and oral
cavity

 It also supplies preganglionic parasympathetic fibres to several head and neck ganglia
FACIAL NERVE ORIGIN

4
 EMBRYOLOGY

 The facial nerve is developmentally derived from the hyoid arch, which is the second
branchial arch

 The motor division of facial nerve is derived from the basal plate of the embryonic pons

 The sensory division originates from the cranial neural crest

5
• Facial nerve course, branching pattern, and anatomical relationships are established during the first 3
months of prenatal life

• The nerve is not fully developed until about 4 years of age

•The first identifiable Facial Nerve tissue is seen at the third week of gestation- facioacoustic
primordium or crest

6
 Facial nerve embryology: 4th week

•By the end of the 4th week,

the facial and acoustic portions
are more distinct

• The facial portion extends to

placode

• The acoustic portion

terminates on otocyst 7
 Facial nerve embryology: 5th week
 Early 5th week, the geniculate
ganglion forms from distal part
of primordium

 It separates into 2 branches:

main trunk of facial nerve and
chorda tympani
8
 Facial nerve embryology: 6th week
 Near the end of the 5th week, the facial
motor nucleus is recognizable

 The motor nuclei of VI and VII cranial

nerves initially lie in close proximity.

 The internal genu forms as

metencephalon, it elongates and CN VI
nucleus ascends
9
 Facial nerve embryology: 7th week
 Early 7th week, geniculate ganglion is well-defined and facial nerve
roots are recognizable

 The nervus intermedius arises from the ganglion and passes to

brainstem. Motor root fibers pass mainly caudal to ganglion

10
 Early 7th week, geniculate ganglion is well-defined and facial nerve roots are
recognizable

 The nervus intermedius arises from the ganglion and passes to brainstem.
Motor root fibers pass mainly caudal to ganglion

11
 Nucleui of Origin
1. Motor nucleus of facial nerve (SVE):

 It lies in the lower part of the pons

2. Superior salivatory nucleus (GVE):

 It lies in the pons lateral to the main motor nucleus of VII and gives rise to
secretomotor parasympathetic fibers that pass in greater superficial
petrosal nerve and chorda tympani.
12
3. Nucleus solitarus (SVA):

 It lies in the medulla, receives the taste sensation from the anterior 2/3 of the tongue
via the central processes of the cells of the geniculate ganglion of the facial nerve

4. GSA fibers :

 Through these fibers to acoustic meatus & back of auricle through communication
from auricular branch of vagus. These fibers terminate in main sensory nucleus &
spinal nucleus of 5 th nerve
13
 COURSE OF FACIAL NERVE
 Internal course: the motor fibres passes dorsally and medially forming a loop
around the abducent nucleus in the floor of the 4th ventricle forming facial
colliculus

 Superficial origin: at the pontomedullary angle above the inferior cerebellar

peduncle

14
The facial nerve is formed mainly of two parts:

1- Facial nerve proper (motor): arising from facial motor nucleus in pons.

2- Nervus intermedius: it is the sensory root of facial lies position between the facial proper and
vestibulcochlear nerve in the pontocerebellar angle.

 Carrying para-sympathetic fibers (from superior salivary nucleus) and taste fibers ( to the
solitary nucleus).

15
 Course and relations
 Intracranial (intrapetrosal) course

 II- Extracranial course

16
 I- The intrapetrous course:

 The nerve passes laterally with the vestibulocochlear nerve (CN VIII) to the internal auditary
meatus. At the bottom of the meatus the nerve enters the facial bony canal where it runs laterally
above the vestibule of inner ear.

 Reaching the medial wall of the middle ear, it bends sharply backwards above the promontory
(forming its genu) where the genicular ganglion is found

 It then arches downwards in the medial wall of the middle ear to reach the stylomastoid foramen.

17
18
19
II- Extracranial course:

 As it emerges from the stylomastoid foramen, it runs forwards in the substance of the parotid
gland crosses the styloid process, the retromandibular vein and the external carotid artery.

 It divides behind the neck of the mandible into its terminal branches which come out of the
anteromedial surface of the gland.

20
21
 Branches
 Intracranial

 Greater petrosal nerve

 Nerve to stapaedius
 Chorda tympani

 Intratemporal

 Intrameatal
 Labyrinthine
 Tympanic
22
 Mastoid nerve
 Extracranial

 Posterior Auricular Nerve

 Digastric nerve
 Stylohyoid nerve

 The five terminal branches

 Temporal branch
 Zygomatic branch
 Buccal branch
 Marginal mandibular branch
 Cervical branch
23
 Within the facial canal:

 NERVE TO STAPEDIUS-
It arises in the facial canal behind the middle ear & runs forwards through a short canal to
reach & supply stapedius muscle

24
2- Greater superfacial petrosal nerve (GSPN) : arises from the genicular ganglion

 The greater superficial petrosal nerve joins the deep petrosal nerve from the sympathetic
plexus on the internal carotid artery in carotid canal to form the nerve of the pterygoid canal
(vidian nerve) which passes through the pterygoid canal to the pterygopalatine fossa and ends
in the pterygopalatine ganglion

25
 3- Chorda tympani nerve:

 It arises from the facial nerve 6 mm above the stylomastoid foramen and runs upwards to
perforate the posterior bony wall of the tympanic cavity.

 It then passes forwards on the medial surface of the tympanic membrane between its fibrous
and mucous layers crossing the handle of the malleus.

26
27
 It comes out of the tympanic cavity through the petrotympanic fissure to the infratemporal
fossa where it joins the lingual nerve.

 Through the lingual nerve, it supplies both the submandibular and sublingual salivary glands
by secretomotor fibres and taste fibers from the anterior 2/3 of the tongue

28
 II- At the exit from the stylomastoid foramen

1- Posterior auricular nerve: to the auricularis posterior and the occipital belly of the
occipitofrontalis muscle.

2- Digastric branch: to the posterior belly of digastric muscle

3- Stylohyoid branch: to the stylohyoid muscle

29
 TERMINAL BRANCHES
 The temporal branches of the facial nerve (frontal branch of the facial nerve) crosses the
zygomatic arch to the temporal region, supplying theauricularis anterior and superior, and
joining with the zygomaticotemporal branch of the maxillary nerve, and with the
auriculotemporal branch of the mandibular nerve.

 The more anterior branches supply the frontalis, the orbicularis oculi, and corrugator
supercilii, and join the supraorbital and lacrimal branches of the ophthalmic.

 The temporal branch acts as the efferent limb of the corneal reflex

30
 The zygomatic branches of the facial nerve (malar branches) run across the zygomatic bone
to the lateral angle of the orbit.

 Here they supply the Orbicularis oculi, and join with filaments from the lacrimal nerve and
the zygomaticofacial branch of the maxillary nerve.

 The Buccal Branches of the facial nerve (infraorbital branches), of larger size than the rest
of the branches, pass horizontally forward to be distributed below the orbit and around the
mouth.

31
 The marginal mandibular branch of the facial nerve passes forward beneath the platysma
and depressor anguli oris.

 It supplies the muscles of the lower lip and chin, and communicating with the mental branch
of the inferior alveolar nerve.

32
 The cervical branch of the facial nerve runs forward

 It forms a series of arches across the side of the neck over the suprahyoid region.

 One branch descends to join the cervical cutaneous nerve from the cervical plexus; others
supply the Platysma. Also supplies the depressor anguli oris.

33
 The marginal mandibular branch of the facial nerve passes forward beneath the platysma
and depressor anguli oris.

 It supplies the muscles of the lower lip and chin, and communicating with the mental branch
of the inferior alveolar nerve.

34
 The cervical branch of the facial nerve runs forward

 It forms a series of arches across the side of the neck over the suprahyoid region.

 One branch descends to join the cervical cutaneous nerve from the cervical plexus; others
supply the Platysma. Also supplies the depressor anguli oris.

35
36
 BRANCHES

BRANCHES OF COMMUNICATION BRANCHES OF DISTRIBUTION

37
 Branches of Communication
Branches of Communication Vestibulocochlear nerve
Geniculate ganglion A. Greater petrosal nerve
B. Lesser petrosal nerve
C. External petrosal nerve
Facial canal Vagus nerve
Stylomastoid foramen IX & X cranial nerve
Greater auricular nerve
Auriculotemporal nerve
Behind ear Lesser occipital
Face V nerve
Neck Transverse cutaneous nerve

38
39