Great auricular nerve

The great auricular nerve is a cutaneous (sensory) nerve of the head. It originates from the second and third cervical (spinal) nerves (C2-C3) of the cervical plexus. It provides sensory innervation to the skin over the parotid gland and the mastoid process, parts of the outer ear, and to the parotid gland and its fascia.

Great auricular nerve
The nerves of the scalp, face, and side of neck. (Great auricular visible below ear.)
Plan of the cervical plexus. (Great auricular labeled at top center.)
Details
From	Cervical plexus (C2-C3)
Innervates	Sensation of inferior part of auricle and parotid region of the face
Identifiers
Latin	nervus auricularis magnus
TA98	A14.2.02.018
TA2	6385
FMA	6872
Anatomical terms of neuroanatomy [edit on Wikidata]

Pain resulting from parotitis is caused by an impingement on the great auricular nerve.

Structure

The great auricular nerve is the largest of the ascending branches of the cervical plexus.^[1]

Origin

It arises from the second and third cervical (spinal) nerves (C2-C3),^[1] with the predominant contribution coming from C2.^[2]

Course and relations

The great auricular nerve is a large trunk that ascends almost vertically over the sternocleidomastoid.^[2] It winds around the posterior border of the sternocleidomastoid muscle, then perforates the deep fascia before ascending alongside the external jugular vein upon that sternocleidomastoid muscle beneath the platysma muscle to the parotid gland.^[1] Upon reaching the parotid gland, it divides into an anterior branch and a posterior branch.^[1]

Branches

Anterior branch

The anterior branch (or facial branch^{[citation needed]}) is distributed to the skin of the face over the parotid gland.^[1]

It communicates with the facial nerve (CN VII) inside the parotid gland.^[1]

Posterior branch

The posterior branch (or mastoid branch^{[citation needed]}) innervates the skin over the mastoid process, on the back of the auricle (save for its upper part), of the lobule, and of the lower part of the concha.^[1]

The posterior branch communicates with the lesser occipital nerve, the auricular branch of the vagus, and the posterior auricular branch of the facial.^[1]

Distribution

The great auricular nerve is distributed to the skin of the face over the angle of the mandible^[2] and parotid gland (via anterior branch^[1]),^[1][2] skin over of the mastoid region^[2] (i.e. skin over the mastoid process^[1]) (via posterior branch^[1]), parts of the auricle (posterior branch^[1]),^[1][2] and the parotid gland and parotid fascia.^[2]

Clinical significance

The great auricular nerve may be damaged during surgery on the parotid gland, reducing sensation to the face.^[3]

Pain resulting from parotitis is caused by an impingement on the great auricular nerve.^{[citation needed]}

The intermingling of the great auricular nerve and the facial nerve (CN VII) is thought to be responsible for the pathogenesis of Frey's syndrome following parotidectomy.^[1]

Additional images

• 
  Dermatome distribution of the trigeminal nerve, also showing the sensory distribution of the great auricular, lesser occipital, and greater occipital nerves.
• 
  Side of neck, showing chief surface markings.

References

1. Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). [New York]. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
2. Sinnatamby, Chummy S. (2011). Last's Anatomy (12th ed.). Elsevier Australia. pp. 334–335. ISBN 978-0-7295-3752-0.
3. Brown, J. S.; Ord, R. A. (1 December 1989). "Preserving the great auricular nerve in parotid surgery". British Journal of Oral and Maxillofacial Surgery. 27 (6): 459–466. doi:10.1016/S0266-4356(89)80003-8. ISSN 0266-4356. PMID 2597656.

External links

• Diagram at aapmr.org Archived 2006-02-13 at the Wayback Machine
• Anatomy figure: 25:03-03 at Human Anatomy Online, SUNY Downstate Medical Center - "Diagram of the cervical plexus."