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The Parotid Temporal Regions E-Learning
The Parotid Temporal Regions E-Learning
edited by :
C.W.T
Suliman Qaralleh
Parotid Region
Extends between: the ramous of the mandible anteriorly & the mastoid process posteriorly
2. Middle: Retromandibular V. & the terminal part of superficial temporal and maxillary veins
3. Deep: ECA & its terminations ( the beginning part of maxillary a. and superficial temporal a.)
4. Parotid L.N.: distributed within & on the gland drain into DCLN ( Deep Cervical Lymph Nodes )
Parotid Gland
Largest S. G.
Wedge-shaped gland: Base:inferior-posteriorly to the zygomatic arch Apex: inferiorly to the neck of the mandible Covered by C.T. sheath (parotid capsule) derived from investing layer of deep cervical fascia * P. gland is Divided by Facial n. into superficial & deep parts
Glenoid Process: upward to into the posterior part of the mandibular fossa
Pterygoid process: forward deeply between the ramous of the mandible and the medial pterygoid muscle
The external carotid artery (ECA) will provide blood supply to the parotid tissue, the vein is the retromandibular vein so it will provide the drainage to it , the sensation over the parotid gland come from the great auricular nerve and it takes from the glossopharyngeal nerve (IX) for secretion which is the lesser petrosal nerve Read Your Text For additional Blood Supply, Innervation & Lymph Drainage of Parotid Gland
Clinical: Mumps
A viral infection to parotid gland causing swelling & pain
between the ramous of the mandible and the mastoid process When the mouth is opened
Parotid duct may also become obstructed with stones (calculi) & cause a painful swelling
Parotidectomy
Surgical removal of the parotid gland
Most common cause: cancer * 80% of salivary gland tumors occur in Parotid g.
Risks of surgery:
1. Facial n. (VII)
2. ECA 3. Retromandibular vein
5. Auriculotemporal nerve: from the posterior division of mandibular nerve pass posterior to superficial temporal vessels
Clinical Case
A 44-year-old female with swelling over the parotid gland on the right side visited you in the clinic. She stated that she first noticed the swelling 3 months previously, and since that time it had rapidly increase in size. Recently, she noticed that her right side of her face felt weak and she could no longer whistle for her cat. On examination, a hard swelling deeply attached to the parotid gland was identified. On testing the facial muscles, it was found that the muscles on right side were weaker than those on left side. Before starting any further management, answer the following questions?
Q1. What is (are) the cutaneous innervation of the skin over the parotid region? Q2. What muscles control her whistling? Q3. What is the connection between the right side facial weakness & the parotid swelling? Q4. What is the diagnosis? Q5. What is the treatment? Q6. What is (are) the structure(s) that may be endangered of such kind of treatment?