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

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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.

Original languageEnglish
Pages (from-to)230-236
Number of pages7
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Issue number2
Publication statusPublished - 2015 Feb 1

Bibliographical note

Funding Information:
This study was supported by the Yonsei University College of Dentistry Fund ( 6-2014-0086 ).

Publisher Copyright:
© 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons.

All Science Journal Classification (ASJC) codes

  • Surgery


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