open access
Platysma muscle additionally innervated by a variant anterior branch of the great auricular nerve
, 1, 2,
Affiliations- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Slovenia
- University Clinical Centre Ljubljana
open access
Abstract
Damage to the great auricular nerve, with consequent clinical deficits, is a common surgical complication in facial aesthetic and in head and neck procedures such as parotidectomy, neck dissection, rhytidectomy and platysma flap operations. Hence, a thorough knowledge of nerve anatomy, particularly its potential variations, is critical in reducing the associated operative morbidity. Accordingly, we report an unusual variation of the anterior branch of the great auricular nerve noted in an 81-year-old female cadaver. The nerve was observed to course into the submandibular region anterior and superficial to the internal jugular vein, communicating with the cervical branch of the facial nerve, while independently innervating the platysma muscle. Although several anatomical variations of the branches of the cervical plexus have been documented, our report describes unique innervation of the platysma muscle by the great auricular nerve, which provides a new insight on the motor component of the nerve.
Abstract
Damage to the great auricular nerve, with consequent clinical deficits, is a common surgical complication in facial aesthetic and in head and neck procedures such as parotidectomy, neck dissection, rhytidectomy and platysma flap operations. Hence, a thorough knowledge of nerve anatomy, particularly its potential variations, is critical in reducing the associated operative morbidity. Accordingly, we report an unusual variation of the anterior branch of the great auricular nerve noted in an 81-year-old female cadaver. The nerve was observed to course into the submandibular region anterior and superficial to the internal jugular vein, communicating with the cervical branch of the facial nerve, while independently innervating the platysma muscle. Although several anatomical variations of the branches of the cervical plexus have been documented, our report describes unique innervation of the platysma muscle by the great auricular nerve, which provides a new insight on the motor component of the nerve.
Keywords
anatomic variation, great auricular nerve, rhytidectomy, parotidectomy, platysma muscle
About this articleTitle
Platysma muscle additionally innervated by a variant anterior branch of the great auricular nerve
Journal
Issue
Article type
Case report
Pages
863-866
Published online
2020-02-13
Page views
1992
Article views/downloads
1021
DOI
Pubmed
Bibliographic record
Folia Morphol 2020;79(4):863-866.
Keywords
anatomic variation
great auricular nerve
rhytidectomy
parotidectomy
platysma muscle
Authors
T. Jovanovski
N. Umek
A. Kansky
E. Cvetko
References (12)- Altafulla J, Iwanaga J, Lachkar S, et al. The great auricular nerve: anatomical study with application to nerve grafting procedures. World Neurosurg. 2019; 125: e403–e407.
- Barbour JR, Iorio ML, Halpern DE. Surgical decompression of the great auricular nerve: a therapeutic option for neurapraxia following rhytidectomy. Plast Reconstr Surg. 2014; 133(2): 255–260.
- Baring DEC, Johnston A, O'Reilly BF. Identification of the accessory nerve by its relationship to the great auricular nerve. J Laryngol Otol. 2007; 121(9): 892–894.
- Brennan PA, Webb R, Kemidi F, et al. Great auricular communication with the marginal mandibular nerve - a previously unreported anatomical variant. Br J Oral Maxillofac Surg. 2008; 46(6): 492–493.
- Diamond M, Wartmann CT, Tubbs RS, et al. Peripheral facial nerve communications and their clinical implications. Clin Anat. 2011; 24(1): 10–18.
- Gasser RF. The development of the facial nerve in man. Ann Otol Rhinol Laryngol. 1967; 76(1): 37–56.
- George M, Karkos PD, Dwivedi RC, et al. Preservation of greater auricular nerve during parotidectomy: sensation, quality of life, and morbidity issues. A systematic review. Head Neck. 2014; 36(4): 603–608.
- Lefkowitz T, Hazani R, Chowdhry S, et al. Anatomical landmarks to avoid injury to the great auricular nerve during rhytidectomy. Aesthet Surg J. 2013; 33(1): 19–23.
- Pillay P, Partab P, Lazarus L, et al. The great auricular nerve in fetuses. Int J Morphol. 2012; 30(1): 40–44.
- Toure G. Intraparotid location of the great auricular nerve: a new anatomical basis for gustatory sweating syndrome. Plast Reconstr Surg. 2015; 136(5): 1069–1081.
- Yang HM, Kim HJ, Hu KS. Anatomic and histological study of great auricular nerve and its clinical implication. J Plast Reconstr Aesthet Surg. 2015; 68(2): 230–236.
- Zohar Y, Siegal A, Siegal G, et al. The great auricular nerve; does it penetrate the parotid gland? An anatomical and microscopical study. J Craniomaxillofac Surg. 2002; 30(5): 318–321.
