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GLAND
“para=around;otic =ear
SUBMITTED BY
SAMEENASAMSUDE
!RD BDS
DEPARTMENT O" ORALAND MA#ILO"A$IAL SURGE
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INDE# INTRODU$TION
SAPE%LOBES%PRO$ESSES O" TE GLAND SUR"A$ES SUR"A$E MAR&ING PAROTID DU$T RELATIONS STRU$TURES 'ITIN TE PAROTID GLAND BLOOD SUPPLY%NER(E SUPPLY%LYMPATI$
DRAINAGE PAROTID LYMP NODES $LINI$AL ANATOMY
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INTRODU$TION
Located in t)eparotid re*ion
Lar*e+t +a,i-ar.*,and/
Serou+ in t.pe/ 01*ra2+ Ectoder2a, in
ori*in De-e,op+ 3ro2
4ucca,epit)e,iu2/
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Stylomandibular Ligament
S u b m a n
d i b u l a r
G l a n d
Parotid Gland
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Shape, Lobes, &Processes of The Gland
It is covered by a capsule derived from the deep cervical fasciaAttached superiorly to the zygomatic arch & Deeply, it is attached to the angle
of mandible and styloid process, forming the stylomandibular ligament.
it seperates parotid gland from the submandibular gland
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It is pyramidal in shape, with its base above &apex behindthe angle of the mandible.
L!"# A$D %'"##"# (he facial nerve &its branches pass forward within the
gland & divide it into superficial& deep lobes. (he superior margin of the gland extends upward behind
()* to form glenoid process. (he anterior margin of the gland extends forward superficial
to the masseter to form the facial process. A small part of the facial process may be separate from the
main gland to form accessory part +which lies above the
parotid duct. (he deep part may extend between the medial pterygoid &
the ramus of the mandible to form the pterygoid process.
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SUR"A$ES
05 Latera, 6+uper7cia,8
95Antero2edia,
!5Po+tero2edia,
BORDERS
05Anterior 95po+terior!5Media,
Po,e+ 6end+8:
05Upper end 64a+e8: around et/acou+tic 2eatu+
Lo<er end: 4et<een an*,e o3 t)e2andi4,e +terno2a+toid
Surfaces of The Gland
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Superfcial surace
Anteromedial suracePosteromedial surace1- Suraces
2- Borders
Anterior borderPosterior border
3- Base and Apex
Base
Apex
edial border
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Super7cia, +r3ace Antero 2edia,
+ur3ace Po+tero2edia,
+ur3ace
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RELATIONS ON TE
SUPERIOR SUR"A$E
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05 S>in
95 Super7cia, "a+ciaandP,at.+2a
!5 Great Auricu,arNer-e
?5 Super7cia, ParotidL.2p) Node+
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Ma++eter
Media, pter.*oid
!acial ner"e trun#
Ra2u+ o3 2andi4,e
astoid process
RELATIONS O" ANTEROMEDIALSUR"A$E
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RELATIONS O" TEPOSTERO MEDIAL SUR"A$E
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B- Styloid Process
Stylop$aryngeusmuscleStyloglossusmuscleStylo$yoidmuscle
%nternal &ugular "ein
%nternal carotid artery
Accessory ner"e
'agus ner"e ner"e
Glossop$aryngeal ner"e
(ypoglossal ner"e
A- astoid Process
Sternomastoid mu
Posterior belly odigastric muscle
)- )ontents o carotid s$eat$
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RELATIONS O"ANTERIOR BORDER
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*ygomatic branc$ oacial ner"e +rans"erse acialartery
Parotid ductand
accessory parotid
,pper buccal branc$ oacial ner"eLoer buccal branc$ oacial ner"e
andibular branc$ oacial ner"e
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Ma+toid Proce+
Sterno2a+toid Mu+c,e
POSTERIOR BORDER
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T)e Media, BorderSeparate+ antero2edia, andpo+tero2edia, +ur3ace+
and i+ re,ated to 2edia, <a,, o3p)ar.n
MEDIAL BORDER
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SUR"A$E MAR&ING
T)e parotid *,and i+ 2ar>ed 4. @oinin*t)e 3o,,o<in* ? point <it) Eac) ot)er/
0/T)e 7r+t point at t)e upper 4order o3 t)e)ead o3 t)e 2andi4,e/
9/T)e +econd point @u+t a4o-e t)e centre o3t)e 2a++eter 2u+c,e/
!/T)e t)ird point po+teroin3erior to t)ean*,e o3 t)e 2andi4,e
?/T)e 3ourt) point on t)e upper part o3 t)eanterior 4order o3 t)e 2a+toid proce++/
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PAROTID DU$T T)i+ i+ a t)ic> <a,,ed tu4e It appear+ at t)e anterior 4order o3 t)e
*,and It run+ anterior,. acro++ t)e 2a++eter
%4e,o< t)e acce++or. parotid *,and% <it)t)e .*o2atic 4ranc)e+ o3 t)e 3acia, ner-e/
It i+ 1 c269 inc)e+8in ,en*t) T)e duct pa++e+ t)e 4ucca, pad o3 3at and
pierce+ t)e 4uccop)ar.n*ea, 3a+cia% andt)e 4uccinator+ 2u+c,e to open in to t)e-e+ti4u,e o3 t)e 2out) on a +2a,, papi,,aoppo+ite to t)e 9nd 2o,ar toot).
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PAROTID PAPILLA
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Parotid Papilla
/pening oParotid 0uct
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Relations of The Parotid Gland
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• Latera, 6+uper7cia,8 +ur3ace:
• S>in% +uper7cia, 3a+cia/•
Great auricu,ar ner-e• Preauricu,ar 6+uper7cia, parotid8 ,.2p) node+• In-e+tin* ,a.er o3 deep cer-ica, 3a+cia/
• T)e antero2edia, re,ation+: 9 2u+c,e+ and one
4one
• )asseter muscle• (emporomandibular -oint• %osterior border of the ramus of the mandible
• )edial pterygoid muscle.• from anterior border
• zygomatic branch of facial nerve, transverse facial artery,parotid duct, buccal & mandibular branches of facial nerve.
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(he posteromedial relations (he mastoid process (he sternocleidomastoid muscle (he posterior belly of the digastric (he styloid process &its attached muscles styloglossus,
stylohyoid &stylopharyngeus & stylohyoid ligament. (he carotid sheath with the I'A,I*/,0&LA#( 1 cranial n.
(he superior relations (he external auditory meatus !ac2 of the temporomandibular -oint (he upper end is pierced by the auriculotemporal n., the
superficial temporal vessels& temporal branch of facial
Lower end or apexemerges from it 3 divisions of retromandibular vein & cervical
branch of facial n.
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Structures Within The Parotid Gland
From lateral to medial are
The facial nerve.
The retromandibular vein
The external carotid artery
Deep parotid lymph nodes.
Auriculotemporal nerve
Facial Nerve
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Facial Nerve
"merges from the stylomastoid
foramen & enters the gland.
It divides into its 4 terminal
branches which leave the gland on its
anteromedial surface.
1-The temporal, 2-The zygomatic , 3-The buccal: 4-The marginal
mandibular: 5-The cervical:
.
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Terminal Branches of The Facial Nerve
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Retromandibular ein
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It is formed within the parotid gland by the union of thesuperficial temporal & maxillary veins.
It divides into ant. &post. divisions, which leave the lowerend of the gland.
(he anterior division -oins the facial vein to end in INTERNAL JUGULAR VEIN .
(he posterior division unites with the posterior auricularvein to form the ETERNAL JUGULAR VEIN.
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The !"ternal #arotid $rter%
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Parotid L%mph Nodes(hey are situated on or within the parotid gland.
(he superficial no!es receive lymp" from#
(he scalp above the parotid gland
(he lat. #urface of the auricle
(he ant. wall of the external
auditory meatus
Lat. %art of the eyelids
T"e !eep no!es receive lymp" from#
(he ext. acoustic meatus, middle ear,
auditory tube & deeper parts of chee2 .
(he efferent lymph vessels drain into the deep cervical L$.
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$e pre-auricular superfcial nodes
0eep Parotid Lymp$ odesinside +$e Gland
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BLOOD SUPPLY%LYMPATI$DRAINAGE
!lood supply
The external carotid artery & it terminal
branche!The vein drain into the retromandibular vein!
Lymphatic drainage
"arotid #$ deep cervical #$ !
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4xternal carotid and superfcial temporal arteries
4xternalcarotidartery
Parotid
Superfcial +emporalartery
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NER(E SUPPLY %arasympathetic
+ secretomotor
The preganglionic %iber: arie %rom the in%! alivarynucleu o% glossopharyngeal nerve to tympanic br!Then tympanic plexu !The nerve %iber reach theotic ganglion via the lesser petrossal nerve & relay!
Postganglionic fibers reach the parotid gland viathe auriculotemporal nerve!
+ympanic Branc$ +ympanic Plexus
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%neriorSali"ary ucleu
Glossop$aryngealer"e
y p
er"e o 5acobsony p
Lesser Superfcial Petrosal er"e
'3
/tic Ganglion
Auriculotemporal er"e
Parotid Gland
Superior )er"ical Gangl4xternal )arotid Artery
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$LINI$AL ANATOMY
PAROTID S'ELLINGS +$ese are "ery painul due to t$e
underlying nature o parotid ascia.
MUMPS %t is an inectious disease o t$e sali"ary
gland due to "iral inection.
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A""E$TION O" "A$IALNER(E 'ITIN TE GLAND
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Parotid a4+ce++ )aused by t$e spread o inection rom t$e mout$
ca"ity.an abscess may also orm due to suppurationo t$e parotid lymp$ nodes draining an inected area.
MI#ED PAROTID TUMOUR
Sloly groing lobulated painless tumour it$out t$ein"ol"ement o t$e acial ner"e.
alignant c$ange o suc$ a tumour is indicated by
pain6rapid grot$6fxity it$ $ardness6in"ol"ement ot$e acial ner"e6and enlargement o cer"icallymp$nodes.
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+(A7 8/,