ABSTRACT
Locating the Main Trunk During total parotidectomy, it is essential to locate the facial nerve. This is done
by mobilizing the parotid superiorly and the sternocleidomastoid laterally, which will reveal the posterior belly of the digastric. A key landmark in identifying the main trunk is the cartilaginous tragal pointer. It is located by following the posterior belly of the digastric towards its insertion at the mastoid, and releasing the parotid attachment to the cartilage of the external auditory canal. The main trunk lies about 1 cm deep and slighdy inferior and medial to the tragal pointer. A branch of the occipital artery often can be found in close proximity, lateral to the nerve.
