1.
PAROTID GLAND
Lecture by
Dr.N.Mugunthan.MBBS.,MS.,DNB.,MNAMS.,PhD.,
Associate Professor
MGMC&RI

2.
Learning objectives
1) Situation
2) Shape, measurements
& presenting parts
3) Capsule
4) Relations
5) Structures within the
parotid gland
6) Parotid duct
7) Blood supply
8) Nerve supply
9) Lymphatic drainage
10)Applied anatomy
©Dr.N.Mugunthan.

3.
Introduction
Largest salivary gland
Serous type
Produce saliva
Keeps the oral cavity
moist
Helps in chewing &
swallowing
©Dr.N.Mugunthan.

4.
Situation
Parotid region
Parotid = para
(around) + otic (ear)
Fascial lined space
Forms the mould or bed
©Dr.N.Mugunthan.

5.
Shape, measurements and presenting parts
Shape:
• Inverted 3 sided pyramid
Weight:
• 15-25 grams
Presenting parts:
• Apex & base (superior
surface)
• 3 Surfaces
• 3 Borders
©Dr.N.Mugunthan.

6.
3 Surfaces:
1. Superficial or lateral
2. Anteromedial
3. Posteromedial
Presenting parts cont…
©Dr.N.Mugunthan.

7.
3 Borders:
1. Anterior
2. Posterior
3. Medial
Presenting parts cont…
©Dr.N.Mugunthan.

8.
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
©Dr.N.Mugunthan.

9.
Splitting of investing layer
of deep cervical fascia
Superficial lamella –
Parotido-masseteric fascia
Deep lamella-
Stylomandibular ligament
(separates parotid from
submandibular gland)
Coverings (capsule) cont…
©Dr.N.Mugunthan.

10.
Relations
Apex: (directed below)
• Overlaps post.belly of
digastric
• Appears in carotid triangle
Structures passing thro’ apex
1. Cervical br.of facial nerve
2. Ant.division of
retromandibular vein
3. Formation of ext.jugular
vein
©Dr.N.Mugunthan.

11.
Base: (directed upwards &
concave
• Ext. acoustic meatus
• TMJ (post. Part)
Structures passing thro’
base
1) Temporal br. of facial
nerve
2) Superficial temporal
vessels
3) Auriculo-temporal nerve
Relations cont…
©Dr.N.Mugunthan.

12.
Superficial or lateral surface:
Skin
Superficial fascia with
lymph nodes & great
auricular nerve
Post.fibres of platysma
Superficial lamella of
parotid sheath (Parotido-
masseteric fascia)
Relations cont…
©Dr.N.Mugunthan.

13.
Antero-medial surface:
(Grooved for ramus of
mandible)
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
Relations cont…
©Dr.N.Mugunthan.

14.
Postero-medial surface:
(extensive surface)
Mastoid process with
attached muscles
Facial nerve piercing &
enter the gland
Styloid process with
attached muscles
Deep to styloid – ICA,IJV &
last 4 cranial nerves
ECA in a groove (before
piercing the gland)
Relations cont…
©Dr.N.Mugunthan.

15.
Anterior border: (rests on
masseter)
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
Relations cont…
©Dr.N.Mugunthan.

16.
Posterior border: ( rests on
sternomastoid)
Structures passing thro’ this
border
• Post.auricular br.of facial N
• Post.auricular vessels
Relations cont…
©Dr.N.Mugunthan.

17.
Medial border:
(Pharyngeal border)
• Wall of pharynx
Relations cont…
©Dr.N.Mugunthan.

18.
Processes of the gland
Gland is casting over
parotid mould
Some parts of gland
extend beyond the mould
& forms various process
1. Facial process
2. Accessory parotid gland &
its duct
3. Pterygoid process
4. Glenoid process
5. Pre styloid process
6. Post styloid process
©Dr.N.Mugunthan.

19.
Structures passing through the parotid
From outside inwards:-
1. Facial nerve & its
branches
2. Retromandibular vein
3. External carotid artery
(parotid lymph nodes and
part of auriculo-temporal
nerve)
©Dr.N.Mugunthan.

20.
Facial nerve:
• Divides into
I. Temporo-facial division
II. Cervico-facial division
• Temporo-facial division:
1. Temporal branch
2. Zygomatic branch
• Cervico-facial division:
1. Buccal branch
2. Marginal mandibular
branch
3. Cervical branch
Structures passing through the parotid cont…
©Dr.N.Mugunthan.

21.
Facial nerve:
Branching pattern of facial
nerve – pes anserinus
(5 branches radiate like
goose’s foot thro’
ant.border of gland)
Branches of facial nerve
divide the gland into
superficial & deep parts or
lobes,
Connected by isthmus of
glandular tissue
Structures passing through the parotid cont…
©Dr.N.Mugunthan.

22.
Parotid duct (Stensen’s duct)
5cm length & 3mm width
Emerges thro’ ant.border
of the gland
Runs on the masseter
between upper & lower
buccal nerves
At ant.border of masseter
turns medially
©Dr.N.Mugunthan.

23.
Pierces:-
Buccal pad of fat
Buccopharyngeal fascia
Buccinator (obliquely)
Runs between buccinator
& mucous membrane of
cheek
Opens in to vestibule of
mouth –opp. Crown of
upper 2nd molar tooth
Parotid duct (Stensen’s duct) cont…
©Dr.N.Mugunthan.

24.
Blood supply
Arterial supply:
Branches from external
carotid artery
(superficial temporal &
maxillary artery)
Venous drainage:
Drain into tributaries of
external jugular vein
©Dr.N.Mugunthan.

25.
Nerve supply
1. Parasympathetic –
secretomotor (watery)
2. Sympathetic –
secretomotor (mucous
rich sticky) & vasomotor
(blood vessels)
3. Sensory – auriculo-
temporal nerve (gland)
& great auricular nerve
( parotid fascia)
©Dr.N.Mugunthan.

26.
Secretomotor pathway
Parasympathetic : (watery)
Preganglionic neuron:
Inf.salivatory nucleus
Preganglionic fibres:
• Glossopharyngeal nerve
• Tympanic branch
• Tympanic plexus
• Lesser petrosal nerve
• Relay in otic ganlion
©Dr.N.Mugunthan.

27.
Parasympathetic :
(watery) cont…..
Post ganglionic neuron :
• Otic ganglion
Post ganglionic fibres:
• Auriculo-temporal nerve
Secretomotor pathway cont…
©Dr.N.Mugunthan.

28.
Lymphatic drainage
Superficial parotid nodes
( superficial fascia)
Deep parotid nodes
( within the gland)
Efferents drains into jugulo-
digastric group of deep
cervical lymph nodes
©Dr.N.Mugunthan.

29.
Applied anatomy
Accessory Parotid Gland
Mumps (parotiditis / non-
suppurative)
Abscess in the Parotid Gland
Sialography of the Parotid
Duct
Blockage of the Parotid Duct
Frey's Syndrome
Mixed parotid tumour
( facial nerve not involved)
Parotidectomy
©Dr.N.Mugunthan.

30.
 Frey's Syndrome: (Auriculo-temporal
nerve syndrome)
 Penetrating wound of parotid
 Injury to auriculo-temporal
(secretomotor) & great auricular
nerve
 During healing process
 Secreto-motor fibres of auriculo-
temporal nerve grow out & join with
distal end of great auricular nerve
and reach sweat glands
 During eating sweating appear on
the skin covering the parotid region
Applied anatomy cont…
©Dr.N.Mugunthan.

31.
Summary
Situation
Shape, measurements &
presenting parts
Capsule
Relations
Structures within the
parotid gland
Parotid duct
Blood supply
Nerve supply
Lymphatic drainage
Applied anatomy
©Dr.N.Mugunthan.

32.
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