Great auricular nerve

The great auricular nerve is a cutaneous nerve of the head. It originates from the cervical plexus, with branches of spinal nerves C2 and C3. It provides sensory innervation to the skin over the parotid gland and the mastoid process of the temporal bone, and surfaces of the outer ear.

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
Fromcervical plexus (C2-C3)
Innervatessensation of inferior part of auricle and parotid region of the face.
Identifiers
Latinnervus auricularis magnus
TA98A14.2.02.018
TA26385
FMA6872
Anatomical terms of neuroanatomy

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 nerves (C2-C3).[1]

Course and relations

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]

Fate

Upon reaching the parotid gland, it divides into an anterior branch and a posterior branch.[1]

Branches

Anterior branch

The anterior branch (ramus anterior; facial branch) is distributed to the skin of the face over the parotid gland.[1]

It communicates with the facial nerve inside the parotid gland.[1]

Posterior branch

The posterior branch (ramus posterior; mastoid branch) 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 parotid gland (anterior branch), skin over the mastoid process (posterior branch), and parts of the auricle (posterior branch).[1]

Clinical significance

The great auricular nerve may be damaged during surgery on the parotid gland, reducing sensation to the face.[2]

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

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.
    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.
    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.
  2. 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.
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