PAROTID ITF

• Capsule of Parotid Gland

  Formed by the investing later of deep cervical fascia, Fascia splits between the angle of mandible and mastoid process to enclose the gland into two layers: Superficial Layer - Thick, Adherent to the parotid gland, Attached to zygomatic arch; Deep Layer - Thin, Attached to styloid process, tympanic plate, angle and ramus of mandible, Has a thickened portion called the stylomandibular ligament, Stabilizes the TMJ to an extent, Separates the parotid gland from the submandibular gland
• Ramus of mandible - directly in front of p
• External Features of the Parotid Gland

  • Resembles a 3-sided pyramid with the apex directed downward, 4 Surfaces - flat parts: Superior base, Superficial, Anteromedial, Posteromedial; 3 Borders - sharper edges: Anterior, Posterior, Medial / Pharyngeal
• Parts of the Parotid Gland

  • External Features
  • Structures Within
• Parotid Gland

  1. "para," around + "otic," ear = around the ear

  2. Features: Largest salivary gland, Approximately 25g, Skin over the gland is supplied by the greater auricular nerve (C2-3)

  3. Location: Below the external acoustic meatus, Between the ramus of the mandible and sternocleidomastoid muscles, Anteriorly, overlaps with the masseter muscle
• Common Facial Vein

  Combination of facial vein + anterior branch of retromandibular vein, drains into the internal jugular vein
• External Jugular Vein

  Combination of posterior auricular vein + posterior branch of retromandibular vein
• Facial Nerve Pathway

  Exits the cranium through the stylomastoid foramen, enters the parotid gland through the posteromedial surface, divides into two branches, subdivides into terminal branches, leaves the gland at the anterior border
• Structures that run inside the parotid gland

  • External Carotid Artery (Brown)
  • Retromandibular Vein (Blue)
  • Facial Nerve (Yellow)
  • Lymph Nodes (Gray)
• Structures Around the Parotid Gland

  • Ramus of mandible - directly in front of parotid gland
  • Mastoid bone - directly behind the parotid gland
  • Wall of pharynx - right next to the medial border of the parotid gland
• Parotid Duct

  Emerges from the anterior border of the gland, runs forward past the masseter approximately 5 cm long, turns medially and pierces Buccal fat pad, Buccopharyngeal fascia, Buccinator, opens into the gingivobuccal vestibule opposite the crown of the upper 2nd molar as the parotid papilla
• Nerve Supply of the Parotid

  Parasympathetic nerves are secretomotor, making the gland secrete or empty
• Arteries and Veins within the Parotid

  1. External Carotid Artery enters through the posteromedial surface and terminates as internal maxillary artery & superficial temporal artery

  2. Retromandibular Vein is a combination of superficial temporal vein + internal maxillary vein, divides into anterior and posterior divisions which emerge at the apex of the parotid gland
• Facial Nerve

  Has two branches that further subdivide into terminal branches: Temporofacial (Temporal, Zygomatic) and Cervicofacial (Upper and lower buccal, Marginal mandibular, Cervical). These branches are collectively known as Pes Anserinus or Goose Foot. Parotid Lymph Nodes are found on the superficial surface
• Structures in the Parotid Duct

  • Buccal fat pad
  • Buccopharyngeal fascia
  • Buccinator
• Parasympathetic nerves


  Make the gland secrete or empty out secretions
• When the parotid gland swells

  The parotid fascia is stretched and pain is transmitted to CN V
• Foramen spinosum is where the middle meningeal artery exits
• The Temporal Fossa is above the zygomatic arch; the main structure found in the area is the temporalis muscle
• Sympathetic nerves

  Constrict blood vessels
• The Parotid Duct opens into the gingivobuccal vestibule opposite the crown of the upper 2nd molar as the parotid papilla
• Arterial supply of the Infratemporal Fossa

  • Facial artery
  • External carotid artery
  • Internal maxillary artery
  • Superficial temporal artery
  • Transverse facial artery
• Skin over the parotid gland

  Innervated by the greater auricular nerve (C2-3)
• The Infratemporal Fossa has various borders: Anterior Wall, Medial Wall, Posterior Wall, and Roof
• Nerve supply of the Parotid

  1. Parasympathetic nerves → secretomotor

  2. Sympathetic nerves → vasomotor

  3. Sensory nerves come from auriculotemporal nerve (CN V)
• The Infratemporal Fossa is an irregularly shaped space posterior to the maxilla
• Sensory nerves from auriculotemporal nerve (CN V)


  Innervate the fascia around the parotid gland
• Venous supply of the Infratemporal Fossa

  • Maxillary Vein
• Foramen ovale is where the mandibular branch of CN V exits
• Components of Maxillary Vein

  • Pterygoid plexus
  • Inferior alveolar vein
• Components of Retromandibular vein

  • Internal maxillary vein
  • Superficial temporal vein
• Nerve supply of the Infratemporal Fossa

  1. Mandibular branch (V3) of Trigeminal Nerve (CN V)

  2. Facial Nerve
• Arteries supplying mandibular teeth

  • Inferior alveolar artery
• Pterygopalatine ganglion is innervated by CN VII and is important for parasympathetic innervation
• Chorda tympani is a small branch of the facial nerve
• Anterior branch of Retromandibular vein


  • Forms Common facial vein with facial vein
  • Drains into Internal jugular vein
• Plexus is a network of small venules
• Arteries in the infratemporal fossa

  • Superficial temporal artery
  • Transverse facial artery
• Otic Ganglion is medial to CN V3
• Branches of Mandibular branch (V3)

  • Inferior Alveolar Nerve
  • Mental Nerve
  • Lingual Nerve
  • Auriculotemporal Nerve
  • Nerve to Mylohyoid