Background and Aim: Facial nerve injury during parotid surgery is a feared complication that can result in facial paralysis with serious implications for the patient’s quality of life (QoL). Recognition of the key landmarks of the facial nerve trunk in the parotid gland is required for safe surgery. This study aimed to investigate two new anatomical findings in parotid surgery reported at a university hospital in Rasht and Isfahan, Iran.

Methods and Materials/Patients: This cross-sectional study included 93 patients who underwent parotidectomy surgery. Our study evaluated the frequency of tail and vascular signs in parotid surgery as two new anatomical findings. Statistical analyses were performed using SPSS software, version 19 (Kolmogorov-Smirnov test, independent t-test, Mann-Whitney U test). The level of significance was set at P<0.05. Results: Ninety-three patients were enrolled in this study, with an average age of 49.48 years, of whom 48(51.7%) were men and 45(48.3%) were women. Of the 93 patients in the study, vascular signs were observed in 70(75.2%) and tail signs were observed in 60(64.5%) patients. Both signs were present in 55 cases (59.1%). McNemar’s test showed a significant difference between the presence of vascular and tail signs. The diameter of the facial nerve was 2.612±4341 mm, and the diameter of the greater auricular nerve was 2.654±4345 mm.

Conclusion: Given the relatively high prevalence of these two anatomical findings and the importance of preserving the facial nerve during parotid surgery, using markers and landmarks in the surgical field will greatly aid in locating and preserving it. Further studies are needed to investigate the extent of these two anatomical findings and their importance in locating and preserving the facial nerve.