The cervical branch is the lowest terminal branch of the facial nerve (CN VII), leaving the lower pole of the parotid gland behind the angle of the mandible to descend into the neck. It supplies the platysma, the thin sheet of muscle in the superficial fascia of the neck that tenses the neck skin and helps depress the mandible and the corner of the mouth. It often communicates with the transverse cervical nerve of the cervical plexus.
| Origin | Cervicofacial division of the facial nerve (CN VII) within the parotid gland |
|---|---|
| Course | Leaves the lower pole of the parotid gland behind the angle of the mandible and descends into the upper neck deep to platysma, which it enters on its deep surface |
| Motor |
The cervical branch is frequently divided or stretched during neck dissection, submandibular gland excision and upper neck incisions, because it lies just deep to platysma in the surgical plane. Injury weakens platysma and can produce lower lip asymmetry when the patient grimaces, a pattern called marginal mandibular pseudo-paralysis. It is distinguished from true marginal mandibular injury because the patient can still evert the lower lip using mentalis. The deficit is usually mild and often improves over several months.
Division or stretch of the branch during neck dissection or submandibular surgery weakens platysma and causes lower lip asymmetry on grimacing, with preserved lower lip eversion and usually a good recovery.
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