Parotid surgery requires an exceptionally high level of surgical skill for a very important reason. Embryology of the salivary glands and their associated structures. The parotid glands, ramus of the mandible, and the styloid process. These combined incisions can follow up with scars imperfect causing skin deformities locais2,12.
The abnormal growth typically presents as slowgrowing, solitary, unfixed neoplasm in the parotid area, although some are multinodular and fixed. Multiple minor glands important structure that run. Mr is the only imaging technique capable of direct imaging of the facial nerve in the parotid bed. These structures can be easily remembered by using the mnemonic fear f acial nerve, e xternal carotid artery, a uriculotemporal nerve, r etromandibular vein. Surgical anatomy of the thyroid and parathyroid glands. Important structure that run through the parotid gland. Surgical resection is the treatment of choice for the accessory. Surgical treatment of parotid gland tumors is sometimes difficult because of the anatomical relations of the facial nerve parotid lodge, as well as the increased potential for postoperative relapse. A duct, called stensens duct, drains saliva from the parotid gland into the mouth, at the area of the upper cheeks. Parotid gland is divided by the facial nerve into i. The first attempts to use the endoscope in sellar region surgery dates back to 1963 when the french neurosurgeon gerard. However, the parotid gland is the last to become encapsulated, after the lymphatics develop, resulting in its unique anatomy with entrapment of lymphatics in the parenchyma of the gland. Thus, detection of early stages of a parotid tumor is extremely important in terms of postoperative prognosis. Variations of parotidectomy indications and technique.
This is a quiz on the pituitary gland lectures in week 1 endocrine. The anatomy and physiology of salivary glands benefits of saliva is that it is easily available for noninvasive collection and analysis. Detailed anatomy of the parotid, submandibular, sublingual, and minor salivary glands, including nervous innervation, arterial supply, and venous and lymphatic drainage. Submandibular salivary gland vula university of cape town.
Masses in the parotid tail can be a source of consternation to radiologists and clinicians. Get a printable copy pdf file of the complete article 559k, or click on a page image below to browse page by page. Although the parotid parenchyma is not anatomically divided into lobes, the gland may theoretically be subdivided by the facial nerve into super. Terminal branch of external carotid artery that divided into. This website provides over 0 free medical books and more for all students and doctors this website the best choice for medical students during and after learning medicine. Jan 30, 2019 background the parotid gland is a primarily serous salivary gland that is located high in the neck in the preauricular area extending towards the cheek. Symptoms in most patients occur in a duration of less than a year up to several decades. Surgical excision of the submandibular gland smg is.
Part of an address delivered before the assembly of the international college of surgeons in rome on may 19, 1948. The procedure is most typically performed due to neoplasms tumors, which are growths of rapidly and abnormally dividing cells. The center provides patients with access to the leading facial nerve expert, dr. The most common reason to remove this gland is due to an abnormal mass contained within. Pleomorphic adenoma, which is the most common benign tumor in the salivary glands, occurs frequently in the parotid gland, but is relatively rare in the lower lip. The fine anatomical and histological details will be covered in. Background the parotid gland is a primarily serous salivary gland that is located high in the neck in the preauricular area extending towards the cheek. Anatomy of parotid gland free pdf epub medical books.
However, you should know the locations and characteristics of the salivary glands. The fine anatomical and histological details will be covered in other courses. The parotid glands are located in front and beneath the ear. It occupies the interval between the sternomastoid muscle and the mandible. Surgical anatomy of the parotid gland hamilton bailey part of an address delivered before the assembly of the international college of surgeons in rome on may 19, 1948. The project gutenberg ebook of surgical anatomy, by joseph. Download anatomy of parotid gland pdf free download free medical books pdf download microbiology pdf free parotid gland the parotid gland is the largest of the salivary glands. The external carotid artery forms its two terminal branches within the. Surgical anatomy of salivary glandssurgical anatomy of salivary glands dr. The parotid gland is a major salivary gland in many animals. The parotid gland being soft isnt confined only to the parotid bed but goes beyond it. The nerve traverses the parotid gland, with about 23 of the gland substance being superficial to the nerve. Its main duct stensen duct crosses the masseter muscle and opens in the buccal mucosa at the level of the second maxillary molar.
The parotid salivary glands, the largest of the three, are located between the ear and ascending branch of the lower jaw. Anatomy of the salivary glands, in ellis gl, auclair pl, gnepp dr eds. To understand the minimally invasive approach for parotid surgery, one must first understand the traditional surgical approach. Traditional parotidectomy is an open and invasive surgical procedure that carries several risks and potential complications. Each gland is enclosed in a tissue capsule and is composed of fat tissue and cells that secrete mainly serous fluids. Anatomy, function, and evaluation of the salivary glands. Lepore md, facs, in abernathys surgical secrets sixth edition, 2009. Get a printable copy pdf file of the complete article 1. Parotid gland may be removed if it gets on the way to a deep tumor orother structure in the brain, needed to be operated. Anatomy and surgery of the endoscopic endonasal approach pdf. The deep lobe of the parotid gland lies medial to the facial nerve branches and the mandible. This gland produces roughly 70% of the saliva in our mouth.
The largest, the parotid, drains by its duct into the mouth at the level of the second upper molar tooth. Neoplasms can be benign noncancerous or malignant cancerous. To access the accessory parotid gland, surgeons must dissect through the superficial layers of the cheek before reaching the tumor. It has superficial and deep lobes, separated by the facial nerve. The aim of this study was the results of surgical treatment of parotid diseases using only periauricular incision, which is more aesthetic, not to cause cervical. The paired parotid glands are the largest of the three major salivary glands arising as invagination of oral ectoderm into the surrounding mesenchymal tissue. Classically, accessory parotid gland tumors have been treated utilizing parotidectomy. Surgical anatomy of salivary glands linkedin slideshare. Kurth, surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial.
The distinguishing histologic feature of the parotid gland is that its acinar cells are. The extratemporal facial nerve and its branches pass through the parotid gland and supply motor innervation to the muscles of facial expression, as well as to the postauricular muscles, the p. The main goal in the surgical procedures that involve the parotid gland is to avoid injuring of the facial nerve, external carotid artery, auriculotemporal nerve and retromandibular vein. It passes in front of the posterior belly of the digastric muscle and lateral to the styloid. The parotid gland is the largest of the salivary glands. The gland produces some mucous secretion in the cat and dog. Review of literature corroborates this philosophy objectively by revealing low complication rates for neurovascular injury in complete gland resection. The major salivary glands are the parotid, submandibular, and sublingual glands. Full text full text is available as a scanned copy of the original print version. Earring lesions of the parotid tail american journal of. Deep lobe of the parotid gland largest portion between ramus of mandible and mastoid process small amount deep to facial nerve and over masseter muscle smaller extension retromandibular into the parapharyngeal space 26 deep lobe parotidectomy indications to understand the indications one must know. Chapter 1 anatomy, function, and evaluation of the salivary.
What are the structures within the parotid gland from lateral to medial. Anatomy of parotid gland pdf free download download. Adenomas of salivary glands one of the many difficulties of salivary gland surgery is the great variety of neoplasms that can form in the salivary gland tissues, and confusion has been caused by. Three cases of parotid tumors, with surgical confirmation of the relationship of the facial nerve to the tumor, are presented. The facial nerve and its branches pass through the parotid gland, as does the external carotid artery and retromandibular vein. This chapter will provide an overview of the functions of saliva, the anatomy and. Pdf salivary glands surgical anatomy and approaches. The submandibular glands are found on both sides, just under and deep to the jaw, towards the back of the mouth. The superficial temporal and maxillary veins unite in the gland to form the retromandibular vein, which contributes in a variable manner to the formation of the external jugular vein see fig. The mass itself can be found anywhere within the parotid gland. Anatomy and physiology of the salivary glands pdf ppt.
Babak azizzadeh, so they can rest assured that the preservation of their facial nerve, and therefore their. Parotidectomy is a major surgical procedure to remove the parotid gland shaded blue in the image which is one of 2 major salivary glands found in the human body. Results normal anatomy the facial nerve enters the parotid gland immediately upon leaving the stylomastoid foramen. Associate professor of surgery, university of oregon medical school associate professor of surgery, university of oregon medical school thomas k. Surgical anatomy of the parotid gland sciencedirect. Surgical anatomy parotid gland the paired parotid glands are the largest of the major salivary glands weigh, on average, 1530 g. Presentation on anatomy of parotid gland and surgical approaches. Sam jackson park road, portland 1, oregonsurgical anatomy of the parotid gland william w. Anatomy test 3 learn with flashcards, games, and more for free. Accessory parotid gland tumor surgery osborne head and. The parotid gland extends rostrally over the masseter muscle, ventrally to the angle of the jaw and caudally towards the atlantal fossa.
The majority of parotid gland tumors are benign, however 20% of parotid tumors are. Kurth, surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial halves. We believe the anatomy is straight forward and we have found the risks of surgical excision of the submandibular gland to be very low. The superficial layer of the deep cervical fascia invests the parotid gland and is contiguous with masseter fascia anteriorly and with sternocleidomastoid muscle scm and digastric muscle fascia posteriorly. Usually, the parotid gland is affected by a tumor, infectedor obstructing the saliva. Furthermore, salivary epithelial cells are often included within these lymph nodes. Surgical oncology lecturer of surgical oncology nci cairo universi slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Introduction to salivary glands university of michigan. The major salivary glands, three pairs in total, are found in and around your mouth and throat.
Surgery of the parotid gland authorstream presentation. The parotid gland is located in the space between the external auditory canal and the mandible. The parotid gland wraps around the angle of the mandible, with the majority of the gland lying super. Feb 19, 2015 surgical anatomy parotid gland the paired parotid glands are the largest of the major salivary glands weigh, on average, 1530 g. The parotid gland is wrapped around the mandibular ramus and extends to a position anterior and inferior to the ear. It can be used to monitor the presence and levels of hormones, drugs, antibodies, microorganisms and ions. Emil theodor kocher and theodor billroth pioneered the surgical management of thyroid disease in the late 1800s. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. Branching organs develop a complex arborization and morphology through a program of repetitive, selfsimilar branching forks to create new epithelial outgrowths.
Parotid gland applied anatomy and surgical considerations free download as powerpoint presentation. Histology and organization of the acini and duct systems within the salivary glands. An anatomic evaluation and surgical approach to submandibular. Jun 26, 2014 surgical anatomy of salivary glandssurgical anatomy of salivary glands dr. It is a larger gland with a higher flow rate in herbivores to lubricate and soften the food. The parotid, a serous compound tubuloalveolar gland, is yellowish, lobulated, and irregular in shape. Articles surgical anatomy of the parotid gland br med j 1948. Instructor in surgery, university of oregon medical school instructor in surgery, university of oregon medical school. A duct, called stensens duct, drains saliva from the parotid gland into the mouth, at the area of the. May 11, 2020 the main goal in the surgical procedures that involve the parotid gland is to avoid injuring of the facial nerve, external carotid artery, auriculotemporal nerve and retromandibular vein. Each gland is enclosed in a tissue capsule and is composed of fat tissue and cells that.
Bailey, the surgical anatomy of the parotid gland brit. Minimally invasive parotid surgery atlanta salivary. Surgical resection is the most commonly employed treatment modality for tumors of the salivary glands. Parotid gland tumor pictures, symptoms, surgery, causes. Parotidectomy, or surgical removal of the parotid gland, used to require a visible incision on the side of the neck below the ear. The pathology and surgery of the salivary glands r. The salivary glands comprise the parotid, the submandibular and the sublingual glands as well as small subsidiary glands scattered beneath the mucosa of the buccal cavity. From the department of surgery, university of oregon medical school, portland, oregon 3181 s. Some traumas to the head might also lead to parotidinjuries. Salivary gland anatomy n parotid gland n submandibular gland n sublingual gland n minor glands it is not our intent to cover anatomy during this course. Parotid gland applied anatomy and surgical considerations. Chapter 1 anatomy, function, and evaluation of the. The parotid, a serous compound tubuloalveolar gland, is yellowish, lo.
Safe and effective surgery of the salivary glands is dependent on a detailed knowledge of anatomical relationships in the head and neck and requires precise surgical technique. The parotid gland is a fascialcovered organ that is suspended from the zygomatic arch. A 65 year old male has a superficial parotidectomy and postoperatively is botheredby facial sweating when he eats. The first page of the pdf of this article appears above. We report a case of pleomorphic adenoma which developed from the lower lip in a 72yearold woman. Each parotid is wrapped around the mandibular ramus, and secretes serous saliva through the parotid duct into the mouth, to facilitate mastication and swallowing and to begin the digestion. As parotid dissecttion generally is directed along the facial es the parotid from a surgical perspective into superseparates the two lobes. A parotidectomy is the surgical excision removal of the parotid gland, the major and largest of the salivary glands. Parotid gland tumor is more common in the distal portion of the gland presenting as a discrete mass. However, the appearance of an accessory parotid tumor is rare, with a reported frequency of 17.
181 270 389 99 866 392 12 49 1504 99 359 1347 596 403 142 1093 1215 1043 65 1206 529 123 20 697 1558 1123 1145 6 56 749 476 1307 818 175