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Anatomic and histological study of great auricular nerve and its clinical implication

Authors
 Hun Mu Yang  ;  Hee Jin Kim  ;  Kyung Seok Hu 
Citation
 JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, Vol.68(2) : 230-236, 2015 
Journal Title
 JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 
ISSN
 1748-6815 
Issue Date
2015
MeSH
Cadaver ; Cervical Plexus/anatomy & histology* ; Ear, External/innervation* ; Facial Nerve/anatomy & histology ; Female ; Humans ; Male ; Mandibular Nerve/anatomy & histology ; Microscopy ; Middle Aged ; Parotid Gland/innervation*
Keywords
Great auricular nerve ; Nerve graft ; Nervous anastomosis ; Parotidectomy ; Rhytidectomy
Abstract
BACKGROUND: The great auricular nerve (GAN) is often sacrificed during parotidectomy, rhytidectomy, and platysma flap operation. Transection of the nerve results in a wooden numbness of preauricular region, pain, and neuroma. The aim of this study was to describe the branching patterns and distribution area of the GAN. METHODS: Twenty-five embalmed, adult hemifacial Korean cadavers (16 males, nine females; mean age 62.5 years) were used in this study. The branching of the GAN was determined through careful dissection. The histological structure of the GAN was also examined by harvesting and sectioning specimens, and then viewing them with the aid of a light microscope. RESULTS: The branching pattern of the anterior, posterior, deep, and superficial branches of the GAN could be classified into five types: type I (20%), where the deep branches arose from the anterior branch; type II (24%), where all branches originated at the same point; type III (28%), where the deep branch arose from the posterior branch; type IV (8%), where the superficial branches arose from the posterior branch; and type V (20%), where the anterior and posterior branches ran independently. A connection between the GAN and the facial nerve trunk was observed in all specimens, and a connection with the auriculotemporal nerve was observed in a few specimens. The total fascicular area of both regions decreased from proximal (1.42 mm2) to distal (0.60 mm2). There were 2.5 and 5 fascicles in the proximal and distal regions, respectively. CONCLUSION: The results reported herein will help toward preservation of the GAN during surgery in the region of the parotid gland. Furthermore, the histologic findings suggest that the GAN would be a good donor site for nerve grafting.
Full Text
http://www.sciencedirect.com/science/article/pii/S1748681514006238
DOI
10.1016/j.bjps.2014.10.030.
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
Hu, Kyung Seok(허경석) ORCID logo https://orcid.org/0000-0002-9048-3805
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139407
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