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Parotid Gland

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Parotid Gland Presentation Transcript

  • 1. Parotid Gland
    TA: Dani
    October 3rd, 2009
  • 2. Parotid Gland
    Largest salivary gland
    Lies below external auditory meatus wedged between ramus of mandible and SCM
    Enclosed within parotid fascia
  • 3. Parotid Gland
    Portion of parotid fascia forms the stylomandibular ligament which separates the parotid and submandibular glands; preventing pus from being readily spread between the two
    Consists of superficial and deep parts with facial nerve lying between
  • 4. Parotid Gland
    Structures traversing parotid:
    Facial nerve
    Retromandibular vein
    Auriculotemporal nerve
    Lymph nodes
    External carotid artery which divides within parotid gland into its terminal branches
    Superficial temporal
    Maxillary
  • 5. Parotid Gland
    Parotid duct (Stenson’s duct) crosses masseterbelow the zygomatic arch and pierces buccinator to open in the mouth opposite upper second molar tooth
  • 6. Innervation
    Auriculotemporal nerve
    Conveys sensory, parasympathetic (secretory) and sympathetic (vasoconstriction) fibers to parotid gland
    Parasympathetic fibers reach gland by circuitous route
    Preganglionic parasympathetic secretomotor fibers originating from the inferior salivatory nucleus (medulla) pass through the glossopharyngeal nerve, tympanic nerve, tympanic plexus and lesser petrosal nerve to synapse in the otic ganglion
    Postganglionic fibers then pass to the parotid gland by way of the auriculotemporal nerve
  • 7. Blood Supply
    Arteries
    External carotid
    Maxillary
    Superficial temporal
    Transverse facial
    Veins
    Primarily retromandibular and its tributaries
  • 8. Lymphatic Drainage
    Drain into parotid nodes (superficial and deep) which, in turn, drain directly or indirectly into superficial and deep cervical nodes
  • 9. Relationships of Parotid Gland
    Superiorly
    Superficial temporal artery and vein
    Auriculotemporal nerve
    Temporal and zygomatic branches of CNVII
    Anteriorly
    Tranverse facial artery
    Parotid duct
    Buccal and mandibular branches of CNVII
  • 10. Relationships of Parotid Gland
    Posteriorly
    Occipital vein
    Posterior auricular artery
    Inferiorly
    Cervical branch of CNVII
  • 11. Clinical Notes
    Malignant tumor of parotid can involve the facial nerve and produce facial palsy
    The chief hazard in surgery of the parotid gland is the facial nerve
    Pain sensation in the parotid gland (from mumps for example) is carried by the mandibular nerve (auriculotemporal branch)
  • 12. Clinical Notes
    Facial Nerve Palsy
    Paralysis of muscles of facial expression and affects taste (chorda tympani), lacrimation (greater superficial petrosal nerve) and hearing (nerve to stapedius)
    Paralysis of stapedius results in hyperacusis (increased perception of loudness)
    Paralysis of muscles of facial expression is manifested in some of the following ways
    Collection of food between cheek and teeth (buccinator)
    Inability to shut the eye (orbicularisoculi)
    Inability to wrinkle the forehead (occipitofrontalis and corrugatorsupercilii)
    Sagging of corner of mouth (levator angular orisand zygomatic muscles)
  • 13. Clinical Notes
    Trigeminal Neuralgia
    Characterized by severe facial pain along the areas innervated primarily by the mandibular and maxillary divisions of the trigeminal nerve
    Relieved by injecting alcohol or novocaine into the trigeminal ganglion