ANATOMY OF PAROTID GLAND

1. PAROTID GLAND
Lecture By:
Dr. Chitransha

2.  DEFINITION : These are
compound tubuloacinar exocrine
glands found in oral cavity that
secrete complex fluid known as
saliva.

3.  CLASSIFICATION OF SALIVARY
GLANDS
Based on size
Based on type of secretory cells.

4. Based on size:
1. Major salivary glands
2. Minor salivary glands

5. Major Salivary Glands
 Collection of secretory cells
aggregated into large bilaterally
paired extraoral glands with
extended duct system through
which the gland secretions reach
the mouth.
 Parotid
 Submandibular
 Sublingual

7. Minor Salivary Glands
 Collection of secretory cells
scattered throughout the mucosa &
submucosa of the oral cavity with
short ducts opening directly onto
mucosal surface.
Eg. :
 Serous glands of Von Ebner.
 Anterior lingual glands.
 Buccal, labial, palatal glands,

8.  Based on type of secretory cells
I. Serous : Parotid
II. Mixed (seromucous):
Submandibular
III. Mucous: Minor salivary glands

9. OBJECTIVES
1) Introduction
2) Situation
3) Shape,
measurements &
presenting parts
4) Capsule
5) Relations
6) Structures within
the parotid gland
7) Parotid duct
8) Blood supply
9) Nerve supply
10) Lymphatic
drainage
11) Applied
anatomy

10. INTRODUCTION
 Largest salivary gland.
 Serous type.
 Produce saliva.
 Keeps the oral
cavity moist.
 Helps in chewing
& swallowing.

11. Situation
 Parotid region
 Parotid = para (around) + otic (ear)

12. Shape, measurements and
parts Shape: • Inverted pyramidal
 Weight: • 15-25 grams
 Presenting parts:
• Apex
• Base -(superior
surface)
• 3 Surfaces
• 3 Borders

13. 3 Surfaces
1. Superficial or lateral
2. Anteromedial
3. Posteromedial

14. 3 Borders
 Anterior
 Posterior
 Medial

15. Coverings (capsule)
 2 capsules:
a) Inner true capsule
b) Outer false capsule
 True capsule: condensation of
fibrous stroma of gland.
 False capsule (parotid sheath):
Investing layer of deep cervical
fascia- parotidomassetric fascia.

16. False Capsule
 Splitting of investing layer of deep
cervical fascia
 Superficial lamella – Parotido-
masseteric fascia
 Deep lamella- thin
Lower border form Stylomandibular
ligament (separates parotid from
submandibular gland)

18. Parts & their Relations
 Apex: (directed below)
 Overlaps post. belly of digastric
 Apex appears in carotid triangle
 Structures passing through apex
1. Cervical br. of facial nerve
2. Anterior division of
retromandibular vein
3. Formation of ext. jugular vein

20. Base
 Directed upwards & concave
 Relation:
Ext. acoustic meatus
post. Part of TMJ
 Structures passing thro’ base:
1. Temporal br. of facial nerve
2. Superficial temporal vessels
3. Auriculo-temporal nerve

22. Superficial or lateral surface
 Covered by skin, superficial fascia
with lymph nodes & great
auricular nerve, Posterior fibres of
platysma.
 Superficial lamella of parotid
sheath (Parotido- masseteric
fascia)

24. Antero-medial surface
 Grooved for ramus of mandible.
 Relations:
 Postero-inferior part of masseter
Ramus of mandible
Capsule of TMJ
 Medial pterygoid muscle
 Outer lip of groove transmits-
branches of facial nerve
Inner lip of groove transmits –
maxillary artery

26. Postero-medial surface
 Mastoid process with attached
muscles.
 Facial nerve pierces & enter the
gland
 Styloid process with attached
muscles
 Deep to styloid – ICA, IJV & last 4
cranial nerves
 ECA in a groove (before piercing

28. Anterior border
 Separates superficial & anteromedial
surface.
 Structures passing thro’ this border
(above downwards)
 Zygomatic br. of facial N
 Transverse facial vessels
 Upper buccal br. of facial N
 Parotid duct
 Lower buccal br. of facial N
 Marginal mandibular br. of facial N

30. Posterior border
 Structures
passing thro’
this border
Posterior
auricular
branch of facial
nerve
Posterior
auricular

31. Medial border
 Pharyngeal border
 Related to wall of pharynx

32.  Structures passing through the
parotid From outside inwards:-
1. Facial nerve & its branches
2. RMV
3. ECA

36. Parotid duct (Stensen’s duct)
 5 cm length & 3 mm width
 Emerges thro’ anterior border of the
gland.
 Runs on the masseter between
upper & lower buccal nerves.
 At anterior border of masseter turns
medially.
 Opens in to vestibule of mouth –opp.
crown of upper 2nd molar tooth.

40. Blood supply
 Arterial supply: Branches from
external carotid artery (superficial
temporal & maxillary artery).
 Venous drainage: Drain into
tributaries of external jugular vein.

41. Nerve supply
1. Parasympathetic –
secretomotor (watery)
2. Sympathetic – secretomotor
(mucous rich sticky) &
vasomotor (blood vessels)
3. Sensory – auriculotemporal
nerve (gland) & great auricular
nerve ( parotid fascia)

42. Parasympathetic (secretomotor)
supply
It is provided through auriculotemporal
nerve. The preganglionic fibres arise from
the inferior salivatory nucleus in the
medulla and pass successively through
glossopharyngeal nerve, tympanic branch
of glossopharyngeal (Jacobson’s nerve),
tympanic plexus and lesser petrosal nerve
to relay into otic ganglion. Postganglionic
fibres arise from the ganglion and pass
through the auriculotemporal nerve to
supply the parotid gland.
The stimulation of parasympathetic supply
produces watery secretion.

44. Sympathetic supply
 The preganglionic sympathetic fibres
arise from the lateral horn of T1
spinal segment relay in superior
cervical sympathetic ganglion.
 postganglionic fibres is derived from
sympathetic plexus around
external carotid artery & supply
through auriculotemporal nerve.
 The sympathetic fibres are
vasomotor and their stimulation
produces thick sticky secretion.

46. Sensory supply
It is derived from:
(a) Auriculotemporal nerve.
(b) Great auricular nerve (C2
and C3).

47. Lymphatic drainage
 Superficial parotid nodes (
superficial fascia)
 Deep parotid nodes ( within the
gland)

48. Applied anatomy
 Mumps: Viral Infection of the
parotid gland.
 Mumps (parotiditis / non-
suppurative)
 Parotid abscess: The parotid
abscess occur by spread of
infection from the oral cavity.
 Bell’s palsy.

49. Sialography of the Parotid
Duct
Blockage of the Parotid Duct
Parotidectomy

50. Mixed parotid tumor
 Facial nerve not involved.
 It is slow-growing lobulated
painless tumor of parotid gland.
 It is so called because of its mixed
histological appearance.
 Currently it is termed pleomorphic
adenoma. After many years of
slow benign growth, it may undergo
a malignant change.

51. Frey's Syndrome
 Auriculo-temporal nerve syndrome.
 Penetrating wound of parotid
injured to auriculotemporal
(secretomotor) & great auricular
nerve.
 During healing
process Secretomotor fibres of
auriculotemporal nerve grow out
& join with distal end of great
auricular nerve and reach sweat
glands.

53.  The presenting features of Frey’s
syndrome are:
When a person eats, the ipsilateral
cheek (parotid region) becomes
red, hot, and painful & sweating.