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Parotid Gland

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    Parotid Gland Parotid Gland Presentation Transcript

    • Parotid Gland
      TA: Dani
      October 3rd, 2009
    • Parotid Gland
      Largest salivary gland
      Lies below external auditory meatus wedged between ramus of mandible and SCM
      Enclosed within parotid fascia
    • 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
    • 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
    • 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
    • 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
    • Blood Supply
      Arteries
      External carotid
      Maxillary
      Superficial temporal
      Transverse facial
      Veins
      Primarily retromandibular and its tributaries
    • Lymphatic Drainage
      Drain into parotid nodes (superficial and deep) which, in turn, drain directly or indirectly into superficial and deep cervical nodes
    • 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
    • Relationships of Parotid Gland
      Posteriorly
      Occipital vein
      Posterior auricular artery
      Inferiorly
      Cervical branch of CNVII
    • 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)
    • 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)
    • 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