Greater auricular nerve
Citation, DOI, disclosures and article data
At the time the article was created Chamath Ariyasinghe had no recorded disclosures.
View Chamath Ariyasinghe's current disclosuresAt the time the article was last revised Craig Hacking had no recorded disclosures.
View Craig Hacking's current disclosuresThe greater auricular nerve is a cutaneous branch of the cervical plexus that innervates the skin of the auricle as well as skin over the parotid gland and mastoid process. The greater auricular nerve also supplies branches that innervate the deep layer of the parotid fascia.
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Gross anatomy
Origin
The greater auricular nerve arises from the ventral rami of C2 and C3 spinal nerves , although it receives considerably more fibers from C2.
Course
The greater auricular nerve emerges along the posterior aspect of the sternocleidomastoid muscle at the punctum nervosum (Erb point) and ascends vertically across the oblique sternocleidomastoid muscle. When the greater auricular nerve approaches the inferior pole of the parotid gland it divides into anterior and posterior terminal branches.
Branches and supply
- the anterior (or facial) branch supplies the skin of the face over the parotid gland and communicates with the facial nerve
- the posterior (or mastoid) branch supplies the skin over the mastoid process and on the posterior surface of the auricle
- a small lateral branch of the posterior branch pierces the auricle to supply the lobule and concha
- the posterior branch of the greater auricular nerve communicates with the lesser occipital nerve, auricular branch of the facial nerve and posterior auricular branch of the facial nerve
Relations
The anterior branch of the greater auricular nerve passes though the substance of the parotid gland. The posterior branch passes deep to the parotid gland to supply the deep layer of the parotid fascia.
Along with the other cutaneous branches of the cervical plexus the lesser occipital nerve passes posterior to the sternocleidomastoid muscle at the punctum nervosum roughly midway between the origin and insertion of the muscle.
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Variant anatomy
A rare communication between the anterior branch of the greater auricular nerve and the marginal branch of the facial nerve has been reported in cadaveric studies. Terminal branches of the anterior division have been shown to have a highly variable branching pattern in relation to the parotid gland.
Related pathology
The greater auricular nerve may contribute to atypical headache and migraine in cases of great auricular neuralgia.
References
- 1. Last's anatomy, regional and applied. Churchill Livingstone. ISBN:044304662X. Read it at Google Books - Find it at Amazon
- 2. Moore KL, Agur AMR, Dalley AF. Clinically oriented anatomy. LWW. ISBN:1451119453. Read it at Google Books - Find it at Amazon
- 3. Norton NS. Netter's Head and Neck Anatomy for Dentistry, 2e. Elsevier / Saunders. ISBN:1437726631. Read it at Google Books - Find it at Amazon
- 4. Baker EW, Schuenke M, Schulte E et-al. Head and Neck Anatomy for Dental Medicine. Thieme. ISBN:1604062096. Read it at Google Books - Find it at Amazon
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- Antihelix (ear)
- Helix (ear)
- Tympanic membrane
- Auriculotemporal nerve
- Accessory nerve
- Scalp nerve supply (mnemonic)
- External ear
- Transverse cervical nerve
- Glossopharyngeal nerve
- Cervical plexus
- Supraclavicular nerves
- Superficial cervical plexus nerve block (ultrasound)
- Lesser occipital nerve
- Sternocleidomastoid muscle
- Parotid gland
- Deep layer of the deep cervical fascia
- Punctum nervosum
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