Proposed classification of auriculotemporal nerve, based on the root system

An unusual finding of the auriculotemporal nerve: possible risk factor during preauricular skin incisions

The auriculotemporal nerve (ATN) is a branch of the mandibular nerve and has been implicated for some migraines and its role in Frey's syndrome is well known. An adult cadaver was found to have a duplicated ATN. The anterior trunk ascended as the superficial temporal artery and gave off the branches to the temporomandibular joint, parotid gland, external acoustic meatus and temporal region and communicated with a posterior trunk of the ATN. The posterior trunk ascended via the subcutaneous tissues 1 mm anterior to the auricle and gave off the branches to the anterior auricular region, temporal region and communicated with the anterior trunk. Such a duplicated ATN might be injured with preauricular skin incisions. Knowledge of such an anatomical variation might assist surgeons in iatrogenic injury of the ATN.

Sensation loss after superficial parotidectomy: A prospective controlled multicenter trial

BACKGROUND

The purpose of this study was to evaluate the occurrence of hypoesthesia after superficial parotidectomy depending on preservation of posterior branch of the great auricular nerve (GAN).

METHODS

This prospective, controlled, double blind, multicenter trial included 130 patients. The posterior branch was preserved in 93 patients (GAN group), and ligated in 33 patients (non-GAN group). In 4 patients, GAN status was unknown. Included patients underwent sensory testing (TouchTest) and subjective evaluation at 6, 12, and 24 months after surgery.

RESULTS

Better improvement of sensation was present in the GAN group. After 12 months, 59% of the patients in the GAN-group showed positive test results in the lobule, versus 24% of the non-GAN group (p = .013). Additionally, after 24 months, 71% of the patients in the GAN-group showed a positive test in the antitragus, versus 31% in the non-GAN group (p = .045). Hypoesthesia equally limited quality of life in both groups (all p > .05).

CONCLUSION

Preservation of the posterior branch of the GAN led to significantly better improvement of sensation in the lobule and antitragus, and should be recommended during parotidectomy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 520-526, 2017.

Parotid Branches of the Auriculotemporal Nerve: An Anatomical Study With Implications for Frey Syndrome

The auriculotemporal nerve is one of the many branches of the mandibular division of the trigeminal nerve. Of these, its superficial temporal branch has been most described. Although the parotid branches, secretomotor fibers to the parotid gland, are well known as the cause of Frey syndrome, there have been almost no descriptions of their anatomy. In this study, the authors dissected the parotid branches of the auriculotemporal nerve to elucidate their anatomy. A total of 10 sides from 7 adult and embalmed cadaver heads were used in this study. The specimens were derived from 3 males and 4 females, the age of cadavers at death ranged from 65 to 92 years old. Measurements included their diameter and the distance of their branching point from the main trunk of the auriculotemporal nerve from the middle of the tragus. Three of 10 sides had 2 parotid branches and 7 sides were found to have 1 parotid branch. The vertical distance between middle of the tragus to branching point of the parotid branch ranged from 1.79 to 16.17 mm. The horizontal distance between middle of the tragus to branching point of the parotid branch ranged from 3.03 to 12.62 mm. The diameter of the parotid branch ranged from 0.31 to 0.49 mm. An improved knowledge of the parotid branch of the auriculotemporal nerve might decrease injury to these structures with the potential for postoperative.

Anatomical study of the superficial temporal branches of the auriculotemporal nerve: Application to surgery and other invasive treatments to the temporal region

BACKGROUND AND AIM

The auriculotemporal nerve (ATN) is one of the branches of the mandibular division of the trigeminal nerve, which gives rise to many branches to the retromandibular and temporal regions. Of these, the superficial temporal branch can occasionally be the cause of migraine headaches and auriculotemporal neuralgia. The purpose of this study was to elucidate the anatomy of the superficial temporal branch, which has never been described in detail.

METHODS

A total of 14 sides of cadaveric heads were used for this study. The number of superficial temporal branch was counted, and the horizontal and vertical distances from the middle of the tragus to the branching point were measured.

RESULTS

Three of 14 sides had two main trunks, and 11 sides had one main trunk. Each of the duplicated ATN had already branches into two main trunks as they left the retromandibular space. The number of superficial temporal branches ranged from two to seven. The vertical and horizontal distances from the middle of the tragus to the branching point of the superficial temporal branch ranged from 6.19 to 25.65 mm and from 3.45 to 11.88 mm, respectively. The communicating branches occasionally formed a loop or so-called "ansa," and a double ansa was identified in one case.

CONCLUSIONS

These data can provide surgeons a better view of the course of these distant branches, so that skin incisions can be better planned.