Lore's fascia and the platysma-auricular ligament are distinct structures.

Abstract

Lore's fascia and the platysma-auricular ligament are discreet fascial structures anterior and inferior to the auricle respectively. The nomenclature and descriptions of these structures have been presented inconsistently in the literature. There is also concern that placement of platysma suspension sutures into these structures may risk damage to the underlying facial nerve trunk. The aim of this study was to clarify the anatomy of Lore's fascia and the platysma-auricular ligament, and their relationship to the facial nerve trunk. A cadaveric study utilising twelve fresh cadaveric hemi-faces was undertaken, investigating the anatomy of Lore's fascia and the platysma-auricular ligament. This comprised dissection of the periauricular fascial layers and identification of the relationship of these two structures to the facial nerve trunk. A histological study of Lore's fascia was performed. Lore's fascia and the platysma-auricular ligament were identified in all 12 hemi-faces. The structures were anatomically distinct in all cases. The relationship of the facial nerve was documented in each case, with the facial nerve trunk found to lie at least 2 cm deep to the most superficial parts of both structures. Lore's fascia was demonstrable with histology. Lore's fascia and the platysma-auricular ligament are separate and consistently demonstrable structures. Both are suitable for platysma suspension sutures in terms of facial nerve trunk safety, and Lore's ligament can be used as a guide to facial nerve preservation in parotidectomy.