Great auricular nerve

Template:Short description Template:Infobox nerve The great auricular nerve is a cutaneous (sensory) nerve of the head. It originates from the second and third cervical (spinal) nerves (C2-C3) of the cervical plexus. It provides sensory innervation to the skin over the parotid gland and the mastoid process, parts of the outer ear, and to the parotid gland and its fascia.

Pain resulting from parotitis is caused by an impingement on the great auricular nerve.

Structure

The great auricular nerve is the largest of the ascending branches of the cervical plexus.<ref name=":33">Template:Cite book</ref>

Origin

It arises from the second and third cervical (spinal) nerves (C2-C3),<ref name=":33" /> with the predominant contribution coming from C2.<ref name=":0223">Template:Cite book</ref>

Course and relations

The great auricular nerve is a large trunk that ascends almost vertically over the sternocleidomastoid.<ref name=":0223"/> It winds around the posterior border of the sternocleidomastoid muscle, then perforates the deep fascia before ascending alongside the external jugular vein upon that sternocleidomastoid muscle beneath the platysma muscle to the parotid gland.<ref name=":33" /> Upon reaching the parotid gland, it divides into an anterior branch and a posterior branch.<ref name=":33" />

Branches

Anterior branch

The anterior branch (or facial branchTemplate:Citation needed) is distributed to the skin of the face over the parotid gland.<ref name=":33" />

It communicates with the facial nerve (CN VII) inside the parotid gland.<ref name=":33" />

Posterior branch

The posterior branch (or mastoid branchTemplate:Citation needed) innervates the skin over the mastoid process, on the back of the auricle (save for its upper part), of the lobule, and of the lower part of the concha.<ref name=":33" />

The posterior branch communicates with the lesser occipital nerve, the auricular branch of the vagus, and the posterior auricular branch of the facial.<ref name=":33" />

Distribution

The great auricular nerve is distributed to the skin of the face over the angle of the mandible<ref name=":0223"/> and parotid gland (via anterior branch<ref name=":33" />),<ref name=":33" /><ref name=":0223" /> skin over of the mastoid region<ref name=":0223" /> (i.e. skin over the mastoid process<ref name=":33" />) (via posterior branch<ref name=":33" />), parts of the auricle (posterior branch<ref name=":33" />),<ref name=":33" /><ref name=":0223" /> and the parotid gland and parotid fascia.<ref name=":0223" />

Clinical significance

The great auricular nerve may be damaged during surgery on the parotid gland, reducing sensation to the face.<ref>Template:Cite journal</ref>

Pain resulting from parotitis is caused by an impingement on the great auricular nerve.<ref>Template:Cite web</ref>

The intermingling of the great auricular nerve and the facial nerve (CN VII) is thought to be responsible for the pathogenesis of Frey's syndrome following parotidectomy.<ref name=":33" />

Additional images

• 
  Dermatome distribution of the trigeminal nerve, also showing the sensory distribution of the great auricular, lesser occipital, and greater occipital nerves.
• 
  Side of neck, showing chief surface markings.

References

<references />

External links

• Diagram at aapmr.org Template:Webarchive
• Template:SUNYAnatomyFigs - "Diagram of the cervical plexus."