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ENT · Head and neck tumours: tragal pointer landmark
Sample itemDuring superficial parotidectomy, which landmark helps to locate the main trunk of the facial nerve at its exit from the stylomastoid foramen?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Tragal pointer
The cartilaginous tragal pointer points toward the facial nerve trunk, which lies about 1 cm deep and slightly inferior to it. Other landmarks are the posterior belly of the digastric, the tympanomastoid suture and the styloid process. Retrograde dissection from a peripheral branch is used when the trunk is hard to find.
Option by option
A. Angle of the mandible
The angle of the mandible does not indicate the nerve trunk.
B. Greater cornu of the hyoid
The hyoid is far below the surgical field of the parotid.
C. Root of the zygomatic arch
The zygomatic arch root is a landmark for the temporal branch region, not the stylomastoid exit.
D. Tragal pointer (correct)
Correct. The pointer of the tragus directs the surgeon to the nerve trunk.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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