SURGICAL ANATOMY OF
PAROTID GLAND
Dr Harpreet Singh
Dept of surgery
There are 3 pairs of salivary glands – parotid,
submandibular and sublingual.
There are multiple minor salivary glands
located in mucosa of cheek, lips, palate, base of
tongue etc
Parotid is largest of the all salivary glands
Weight – 15 gms
Situated below
external acoustic
meatus, between the
ramus of mandible
and SCM. The gland
overlaps these
structures.
Anteriorly , the gland also overlaps the masseter muscle.
A part of this forward extension is often detached, and is
known as the acessory parotid, it lies between the
zygomatic arch and the parotid duct.
Parotid capsule
The investing layer of the deep cervical fascia
forms a capsule for the gland
The fascia splits between the angle of
mandible and mastoid process to enclose the
gland. Fascia forms –
Superficial lamina of parotid capsule
Deep lamina of parotid capsule
Superficial lamina of parotid capsule
Thick
Adherent to gland
Attached to zygomatic arch
Deep lamina of parotid capsule
It is thin
Attached to –
Tympanic plate
Styloid process
Mandible
Stylomandibular
ligament
A portion of deep
lamina extending
between styloid
process and
mandible is
thickened to form
stylomandibular
ligament
Stylomandibular ligament separates the parotid
gland from submandibular salivary glands
External features –
Gland resembles 3 sided pyramid, apex directed
downwards
Structures in the parotid gland
Arteries with in parotid gland
Veins with in parotid gland
Nerves with in parotid gland
Deep lobe of parotid
Parotid duct
5cms long
It emerges from the middle of
the anterior border of the gland.
It runs forwards on the
masseter.
At the anterior border of
masseter it turns medially and
pierces buccinator and buccal pad
of fat.
Duct opens into vestibule of the mouth opposite the crown of
upper second molar tooth
Because of its oblique course of duct through the buccinator,
inflation of duct is prevented during blowing
Relations of parotid duct
Superiorly – acessory parotid
gland, upper buccal branch of
facial nerve, transverse facial
vessels
Inferiorly – lower buccal branch of
the facial nerve
Blood supply
Arterial supply – external carotid artery
and its branches that arise near gland
Venous drainage – external jugular vein
Lymphatic drainage
Parotid nodes and then from there to the upper deep
cervical nodes
PARASYMPATHETIC NERVES
These are secretomotor.
Path -
Inferior salivary nucleus
Pre ganglionic fibers - Fibers pass through 9th
nerve, its tympanic branch, tympanic plexus and
lesser petrosal nerve
Relay in otic ganglion
Postganglionic fibers pass through
auriculotemporal nerve (branch of mandibular
nerve, branch of trigeminal nerve) and reach the
parotid gland
SYMPATHETIC NERVES –
These are vasomotor
Derived from the plexus around external carotid
artery
SENSORY NERVES
Comes from auriculotemporal nerve
But parotid fascia is innervated by sensory fibers of
greater auricular nerve (C-2)
Superior salivary nucleus – it lies in the lower
part of pons. It sends fibers through the facial
nerve and its corda tympani branch to the
submandibular ganglion for supply of
submandibular and sublingual salivary glands
Inferior salivary nucleus – lies in the lower part of
the pons just below the superior nucleus. It sends
fibers through the glossopharyngeal nerve to otic
ganglion for supply to parotid gland through
auriculotemporal nerve
Superior salivary nucleus Inferior salivary nucleus
It lies in the lower part of pons Lies in the lower part of the
pons just below the superior
nucleus.
It sends fibers through the facial It sends fibers through the
nerve and its corda tympani branch glossopharyngeal nerve to
to the submandibular ganglion for otic ganglion for supply to
supply of submandibular and parotid gland through
sublingual salivary glands auriculotemporal nerve
Supply - submandibular and Supply - parotid gland
sublingual salivary glands
