Proximal nerve identification
There are two common ways to identify the main trunk of the facial nerve:
- Identify the tragus of the ear. Dissect down the cartilage of the tragus to its inferior end called the “tragal pointer”. The nerve is found 1 cm inferior, anterior, and medial to the pointer.
- Identify the posterior belly of the digastric muscle. The nerve can be found immediately superior to the upper border of the muscle and at the same depth.
As a landmark for the facial nerve, the styloid process should be used with caution because it is situated immediately deep to the nerve.