Dissection Report of Combined Variations of the Facial Nerve, Cervical Plexus, and Superficial Venous System in the Cervicofacial Region

The cervicofacial region contains densely layered neural and venous structures with clinically significant anatomic variability. Variations involving the extratemporal facial nerve (FN), its communications with the cervical plexus (CP), and the superficial venous system may increase surgical risk during parotid, submandibular, and upper cervical procedures. A stepwise cervicofacial dissection was performed on an 82-year-old male donated cadaver. The branching pattern of the extratemporal FN, intrafacial interconnections, communications with CP branches, and relationships to the retromandibular vein (RMV), facial vein (FV), and external jugular vein (EJV) were documented descriptively. Within the parotid gland, the FN formed a superficial plexiform network lying anterior to the RMV and external carotid artery. Inferior FN divisions extended beyond the lower pole of the parotid gland, forming a dense lower facial plexus. The marginal mandibular branch demonstrated a low-lying cervical course, remaining superficial to the FV and crossing anterior to the facial artery in the submandibular region. Distinct communication between the FN cervical branch and the transverse cervical nerve was identified within the superficial fascial plane. This neural communication coursed adjacent to the venous junction forming the EJV, creating a localized neurovenous convergence zone. This specimen demonstrates the coexistence of FN branching variability, FN-CP communications, and superficial venous convergence within a single cervicofacial region. Recognition of cumulative neurovascular variation is essential for safe surgical planning during parotid, submandibular, and upper cervical procedures.