Communication of the Anterior Branch of the Great Auricular Nerve with the Cervical Branch of Facial Nerve and its Variant Nerve Endings Deep in the Parotid Gland

Abstract

SUMMARY:The communications between the branches of cervical plexus and cervical branch of facial nerve are common and are well known. However, this communication usually occurs between the transverse cervical nerve and cervical branch of facial nerve. During routine dissection classes for the Medical undergraduate students, we came across an anatomical variant of anterior division of great auricular nerve. This variation was found in a 60-year-old male cadaver of South Indian origin and it was unilateral. The great auricular nerve arose from the loop of ventral rami of C2 and C3 spinal nerves and divided into anterior and posterior branches. The anterior branch ran obliquely upwards and forwards on the surface of the sternocleidomastoid muscle along with the external jugular vein towards the apex of parotid gland and divided into many branches. One of these branches gave a communicating branch to cervical branch of facial nerve outside the parotid gland. Nerve endings of the remaining branches were found to penetrate the interlobular septa and a few of them were seen deep in the gland along the ducts and near the vessels. The functional significance of anatomic variations of nerve endings in relation to ducts, thin vessels deep in the parotid gland, observed in the present case are yet to be evaluated.

Variability of the Cervical Branch Depending on the Facial Nerve Branching Pattern and Anthropometric Type of the Head

“…In the current study, connections of the cervical branch with the mandibular branch were determined in 24% of cases, among which single, double, and multiple connections were observed. Connections of the cervical branch with the greater auricular nerve have also been reported by others [23,36]. This study showed the cervical branch's single, double, and triple connections with the greater auricular nerve in 38.7% of cases.…”

Localization of cervical branches of facial nerve innervating platysma bands

“…Moreover, Pablo Scolovsky et al( 2008) [21] stated that anastomosis between the cervical branch of facial nerve and the cervical plexus were at the level of the anterior border of the sternocleidomastoid muscle and the number of cervical branches anastomosed with the transverse cervical cutaneous nerve via an average of 5 branches (3-9 branches) in 5 cadaveric dissections. In addition, Rao sirasinagandla et al(2013) [28] encountered an anatomical variation during dissection class to the first year medical students that one branch of transverse cervical cutaneous nerve(TCN) gave a communicating branch to cervical branches (CN) of facial nerve posterior to the submandibular gland and the another TCN was noted to be communicated with the CB of facial nerve within the parenchyma of the parotid gland.…”

“…Additionally, Salinas et al (2009) [25] described that the great auricular nerve(GA) and the transverse cervical nerve(TCN) joined together and then communicated with the main cervical branch(CB) was found in one specimen. Furthermore, Rao et al (2012) [28]founded that an anatomical variant of the anterior division of the great auricular nerve(GA) with the cervical branch of the facial nerve(CN) outside the parotid gland was found in the 60-year-old South Indian male cadaver.…”

“…No anastomoses among facial branches were found In 16 cases (35.55%) Furthermore, Salinas et al(2009) [25] described that the great auricular nerve(GA) and the transverse cervical nerve(TCN) joined together and then communicated with the main cervical branch(CB) was found in one specimen. In addition, Rao et al (2012) [28] expressed that an anterior division of the great auricular nerve(GA) with the cervical branch of the facial nerve(CN) outside the parotid gland was found in the 60-year-old South Indian male cadaver. However, this study has some limitations due to anatomical destruction of platysma muscle from cadaver preservative procedure.…”