Basic classification of the facial region
For ease of study, as well as for precise orientation during surgical interventions, the facial region of the head (regio facialis) is conventionally classified by spatial criteria.
According to classical topographical nomenclature, two main topographical and anatomical territories are distinguished:
- Anterior facial region — encompasses the central structures forming the facial skeleton and the initial parts of the respiratory and digestive tracts.
- Lateral facial region — located more laterally, providing support for the masticatory apparatus and containing important deep fascial spaces.
Topography of the anterior facial region
The anterior region is a complex of closely apposed zones. Each has its own Latin name and specific location.
The anterior facial region includes the following topographical units:
- Orbital region (regio orbitalis) — a paired zone corresponding to the location of the visual apparatus.
- Nasal region (regio nasalis) — an unpaired central zone.
- Oral region (regio oralis) — an unpaired zone uniting the structures of the oral opening.
- Mental region (regio submentalis) — directly adjoins the oral region inferiorly and is functionally closely connected with it.
Please note that the mental region is considered precisely in conjunction with the oral region as part of a single anterior facial complex.
Structure of the lateral facial region
The lateral facial region has a more complex multi-layered structure and includes both superficial and deep areas. A correct understanding of this zone is critically important in maxillofacial surgery.
This territory is subdivided into three key regions:
- Buccal region (regio buccalis) — occupies the anterolateral part of the face.
- Parotideomasseteric region (regio parotideomasseterica) — located posterior to the buccal region.
- Deep lateral facial region (regio facialis lateralis profunda) — concealed behind superficial structures and requires special approaches during dissection.
This division allows surgeons and students to clearly differentiate superficial tissues from the deep fascial spaces of the lateral region.
Briefly: answers to topical questions
What are the precise anatomical boundaries of the parotideomasseteric region?
The precise anatomical boundaries of the parotideomasseteric region are defined by the following landmarks:
- Anteriorly — anterior border of the masseter muscle (m. masseter).
- Posteriorly — posterior border of the ramus of the mandible, anterior border of the sternocleidomastoid muscle, and external acoustic meatus.
- Superiorly — zygomatic arch (arcus zygomaticus).
- Inferiorly — inferior border of the mandible.
Which vessels and nerves pass through the substance of the parotid gland?
The following blood vessels and nerves pass through the substance of the parotid gland:
- Facial nerve (n. facialis) — forms a plexus within the gland.
- Auriculotemporal nerve (n. auriculotemporalis).
- External carotid artery (a. carotis externa) — passes together with its terminal branches.
- Retromandibular vein (v. retromandibularis).
What layered structures are identified in the buccal region during dissection?
During dissection of the buccal region, the following layers are identified from superficial to deep:
- Skin — thin and mobile.
- Subcutaneous adipose tissue — loose, contains vessels, nerves, and facial muscles.
- Facial muscles — represented by the buccinator muscle (m. buccinator), zygomatic muscles, and others.
- Buccopharyngeal fascia (fascia buccopharyngea) — covers the outer surface of the buccinator muscle.
- Fat pad of the cheek (corpus adiposum buccae) — enclosed in a dense fascial capsule.
- Mucous membrane of the cheek — lines the vestibule of the oral cavity.
Which fascial spaces are located in the deep lateral facial region?
In the deep lateral facial region and adjacent areas, the following fascial spaces are distinguished:
- Temporopterygoid space (spatium temporopterygoideum) — located between the temporal and lateral pterygoid muscles.
- Masticatory-mandibular space (spatium masticatoriomandibulare) — situated between the masseter muscle and the mandibular ramus.
Which major blood vessels and nerve plexuses does the deep lateral facial region contain?
The deep lateral facial region contains the following major blood vessels and neural structures:
- Maxillary artery (a. maxillaris) — gives off deep temporal arteries here.
- Pterygoid venous plexus (plexus venosus pterygoideus) — located in the temporopterygoid space.
- Mandibular nerve (n. mandibularis) — branches of this third division of the trigeminal nerve pass through the region.
What are the boundaries of the mental region (regio submentalis) and which lymph nodes are located there?
The submental triangle (trigonum submentale) has the following boundaries:
- Apex — mental spine (spina mentalis).
- Sides — anterior bellies of the digastric muscle (m. digastricus).
- Base — hyoid bone.
Lymph drainage from the tip of the tongue is directed to the submental lymph nodes (nodi submentales), and further to the submandibular and deep cervical nodes.
Which nerves provide sensory innervation to the skin of the anterior facial region?
The sensory branches of the trigeminal nerve project onto the face as follows:
- 1st branch (n. ophthalmicus) — cutaneous branches emerge at the level of the supraorbital margin.
- 2nd branch (n. maxillaris) — the infraorbital nerve (n. infraorbitalis) emerges at the level of the infraorbital margin, usually 0.5–0.8 cm below it; it innervates the skin of the infraorbital region, the skin and mucosa of the upper lip, the maxilla, and the upper teeth.
- 3rd branch (n. mandibularis) — the mental nerve (n. mentalis) emerges midway between the alveolar and inferior margins of the mandible; it innervates the skin and mucosa of the lower lip.
To memorize the lateral region of the face, use the mnemonic «ЩОГ» (ShOG): Sh — Shchechnaya (Buccal), O — Okoloushno-zhevatel’naya (Parotideomasseteric), G — Glubokaya lateral’naya (Deep lateral).
Class and exam questions
What are the main regions into which the facial part of the head is divided?
The facial region is topographically divided into two major zones: the anterior and lateral regions of the face.
Which region does the regio submentalis belong to?
The submental region (regio submentalis) adjoins the oral region and belongs to the anterior region of the face.
Is the deep lateral region part of the lateral facial region?
Yes, the deep lateral facial region (regio facialis lateralis profunda) is one of the three constituent parts of the lateral facial region.
What else to study on this topic
- Boundaries and layered structure of the orbital region (regio orbitalis)
- Cellular spaces of the deep lateral facial region
- Topography of the neurovascular bundles of the parotideomasseteric region
- Fasciae and muscles of the buccal region (regio buccalis)
- Surgical approaches in the nasal and oral regions
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