PAROTID GLAND

INTRODUCTION
• 3 pairs of large salivary glands…..parotid, submandibular and
subligngual
• Produce saliva…..
– to keep oral cavity moist
– helps in chewing and swallowing
– Also contains enzymes…help in digestion
 PAROTID GLAND
• Para= around otic= ear
• Largest of all glands
• 15g weight
• Situated below ext acoustic
meatus…b/w ramus of mandible
and SCM
• Anteriorly….gland overlaps
masseter muscle….coz of this
muscle …..part of parotid extends
to form ACCESSORY PAROTID
GLAND
• Which lie in b/w zygomatic arch
and parotid duct
 PAROTID CAPSULE
• Investing layer of deep cervical fascia forms the capsule for
gland
• Fascia splits b/w angle of mandible and mastoid process to
enclose the gland
• Superficial lamina …thick and tightly adherent to gland
…..attached above to zygomatic arch
• Deep lamina…..thin and is attached to styloid process,
mandible and tympanic membrane
• Portion of deep lamina b/w styloid process and mandible is
thickened to form stylomandibular ligament ….separating the
parotid from submandibular gland
 EXTERNAL FEATURES
• Gland resembles three sided pyramid
• Apex directed downward and have 4 surfaces
– Superior…..forming the base of pyramid
– Superficial
– Anteromedial
– Posteromedial
• Surfaces are separated by 3 borders
– Anterior
– Posterior
– Medial
 RELATIONS
• Apex:
– overlaps the post belly of digestric
– And the adjoining areas of carotid triangle
– Cervical br of facial nerve and two div of retromandibular
vein emerges through it
• Superior surface:
related to
– Cartilagenous part of ext
acoustic meatus
– Post surface of TMJ
– Superficial temporal
vessels
– Auriculotemporal nerve
• superficial: largest of all surfaces…covered by
– Skin
– Superficial fascia containing ant br of great auricular nerve,
preauricular or parotid lymph nodes and post fibers of
platysma and risorius
– Parotid fscia….thick and adherent to gland
– Few deep parotid lymph nodes
• Anteromedial surface: grooved by post border of ramus
of mandible…..related to
– Masseter
– Lat surface of TMJ
– Post border of ramus of mandible
– Medial pterygoid
– Emerging br of facial nerve
• Posteromedial surface : is moulded to mastoid and
styloid processand the structures attached to them
– Mastoid process with SCM and post belly of digastric
– Styloid process with structures attached to it
Ext carotid artery enters the gland through this and int carotid
A lies deep to styloid process
• Borders :
1. ANTERIOR: separates the superficial surface from
anteromedial surface ….extends from ant part of sup
surface to apex….following structures emerges at the border
 Parotid duct
 Most of the terminal br of facial nerve
 Transverse facial vessels
 Accessory parotid gland lies here
2. POSTERIOR: Separates the superficial surface from
posteromedial surface…..overlaps the SCM
3. MEDIAL: separates the anteromedial surface from
posteromedial surface …..related to lateral wall of pharynx
Structures within parotid
gland
 From medial to lateral side structures are
1. ARTERIES:
– Ext carotid A enters through its posteromedial surface
– Maxillary A leaves the gland through its anteromedial
surface
– Superficial temporal A emerge at ant part of superior
surface
– Post auricualr A may arise within the gland
2. VEINS:
 Retromandibular v is formed behind the gland then divides
into post and ant br to emerge at the apex of the gland
3. NERVE:
 Facial N enters the gland through upper part of
posteromedial surface and then divides into terminal brs
within the gland….brs leave gland through its anteromedial
surface and appear on surface at ant border
PAROTID DUCT
• Thick walled
• 5cm long
• Emerges from the middle of ant
border…..then run forward and
slightly downward on masseter
• RELATIONS….
– Superiorly…..accessory parotid
gland, buccal br of facia nerve
• At the ant border of masseter it
turns medially and pierces
– Buccal pad of fat
– Buccopharyngeal fascia
– Buccinator….obliquely
• Duct run forward for a short
distance b/w buccinator and
oral mucosa
• Finally duct turns medially
and opens into vestibule of
mouth opposite the crown of
upper second molar tooth
 BLOOD SUPPLY

• Supplied by ext carotid artery and its branches

• Veins drain into ext jugular vein
 NERVE SUPPLY
• PARASYMPATHETIC……are secretomotor….reach gland
through auriculotemporal nerve
• SYMPATHETIC……………are vasomotor……derived from
plexus around ext carotid artery
• SENSORY…………………come from auriculotemporal nerve
but parotid fascia is innervated by sensory fibers of great
auricular nerve
 LYMPHATIC DRAINAGE
• First to parotid nodes and from there to upper deep cervical
PAROTID LYMPH NODES