Surgical anatomy of the parotid duct with emphasis on the major tributaries forming the duct and the relationship of the facial nerve to the duct

Abstract

Although there is a great amount in the literature to describe the anatomy of the parotid gland as a whole, little attention is given to the parotid duct. The purpose of this study is to examine the surgical anatomy of the parotid duct with special emphasis placed on the major tributaries forming the parotid duct and the relationship of the facial nerve to the duct. Twenty-nine fresh cadaver halves were dissected and the branching pattern of the ducts, position within the parotid, and their relationship to the facial nerve were studied. Of the complete heads studied, the parotid duct had the same pattern in 78.6% on the right and left sides. The parotid ducts in 31.0% of the half heads presented as a single discernible duct from parotid papilla to within the gland. In 62.1% of the half heads, the ducts were formed by a branching pattern within the gland. In the ducts with a branching pattern, 48.3% displayed a bifurcated pattern, 6.9% were trifurcated, and 6.9% had multiple branches. In 6.9% of the half heads studied, the parotid ducts bifurcated distal to the parotid gland. In all cases, the deep lobe of the parotid enveloped the parotid duct; only small ductules connected the superficial lobe with the duct. The facial nerve and its branches were always observed lateral to the parotid duct. Because one dissects lateral to the facial nerve during a superficial parotidectomy, generally the parotid duct remains intact and potential complications such as facial paralysis, sialoceles, and fistulizations are thereby minimized.

Congenital Anomalies and Anatomical Aberrations in Head & Neck Oncology– A Single Institution Experience

“…These were arranged in order of increasing complexity, beginning with the simple type and ending with those exhibiting a markedly plexiform arrangement. The classification reported by Davis et al [7] followed the scheme described by McCormack et al…”

Surface anatomy of the parotid duct and its clinical relevance

“…Richards et al, observed that the facial nerve performed a loop above, or lateral to, the PD (Richards et al, ).…”

Reconstruction of Traumatically Avulsed Parotid Duct Using Buccal Mucosa Flap: Report of a New Technique

“…10 The course of the duct can be marked by an imaginary line joining the ipsilateral tragus and the midpoint of upper lip. 10 Any facial injury involving this imaginary line should raise the clinical suspicion of parotid duct injury.…”

“…10 The course of the duct can be marked by an imaginary line joining the ipsilateral tragus and the midpoint of upper lip. 10 Any facial injury involving this imaginary line should raise the clinical suspicion of parotid duct injury. 1,2 Iatrogenic intraoperative injuries to the duct are often underreported while traumatic injuries are frequently overlooked especially in settings involving multiple injuries.…”