Stylomastoid foramen

Exit foramen · CN VII

The opening between the styloid and mastoid processes on the base of the skull where the facial nerve leaves the facial canal, having already given off the greater petrosal nerve, the nerve to stapedius and the chorda tympani inside the temporal bone. Just after emerging it gives the posterior auricular nerve and branches to the posterior belly of digastric and stylohyoid, then enters the parotid gland.

Traced from the start

  1. Pons
  2. Facial nerve (CN VII)
  3. Stylomastoid foramen

Detail

Transmits
Facial nerve (VII) motor trunk, stylomastoid artery
Landmark
Deep between the mastoid tip and the styloid process, medial to the parotid; the mastoid is poorly developed in infants so the nerve lies superficially
Already given off
Greater petrosal (lacrimation), nerve to stapedius, chorda tympani (taste and salivation) — so a lesion at or beyond this point affects movement only

When it goes wrong

Forceps delivery or pressure on the undeveloped mastoid of a newborn

Transient lower motor neurone facial palsy that recovers over weeks

Lesion at or distal to the foramen (parotid carcinoma, parotidectomy, facial laceration)

Lower motor neurone facial weakness with taste, lacrimation and hearing all spared, distinguishing it from a lesion inside the facial canal

Mastoid surgery or a postauricular incision placed too low in an infant

Iatrogenic facial nerve injury at its exit

Practise this structure

2 questions in the bank tagged Facial Nerve.