{{Short description|Cutaneous nerve of the head}} {{Infobox nerve | Name = Great auricular nerve | Latin = nervus auricularis magnus | Image = Gray805.png | Caption = The nerves of the scalp, face, and side of neck. (Great auricular visible below ear.) | Image2 = Gray804.png | Caption2 = Plan of the cervical plexus. (Great auricular labeled at top center.) | Innervates = Sensation of inferior part of auricle and parotid region of the face | BranchFrom = Cervical plexus (C2-C3) | BranchTo = }} The '''great auricular nerve''' is a cutaneous (sensory) nerve of the head. It originates from the second and third cervical (spinal) nerves (C2-C3) of the cervical plexus. It provides sensory innervation to the skin over the parotid gland and the mastoid process, parts of the outer ear, and to the parotid gland and its fascia.
Pain resulting from parotitis is caused by an impingement on the great auricular nerve.
== Structure == The great auricular nerve is the largest of the ascending branches of the cervical plexus.<ref name=":33">{{Cite book |last=Standring |first=Susan |title=Gray's Anatomy: The Anatomical Basis of Clinical Practice |year=2020 |isbn=978-0-7020-7707-4 |edition=42nd |location=[New York] |oclc=1201341621}}</ref>
=== Origin === It arises from the second and third cervical (spinal) nerves (C2-C3),<ref name=":33" /> with the predominant contribution coming from C2.'''<ref name=":0223">{{Cite book |last=Sinnatamby |first=Chummy S. |title=Last's Anatomy |publisher= Elsevier Australia|year=2011 |isbn=978-0-7295-3752-0 |edition=12th |pages=334–335}}</ref>'''
=== Course and relations === The great auricular nerve is a large trunk that ascends almost vertically over the sternocleidomastoid.'''<ref name=":0223"/>''' It winds around the posterior border of the sternocleidomastoid muscle, then perforates the deep fascia before ascending alongside the external jugular vein upon that sternocleidomastoid muscle beneath the platysma muscle to the parotid gland.<ref name=":33" /> Upon reaching the parotid gland, it divides into an anterior branch and a posterior branch.<ref name=":33" />
=== Branches === '''Anterior branch'''
The anterior branch (or facial branch{{Citation needed|date=December 2022}}) is distributed to the skin of the face over the parotid gland.<ref name=":33" />
It communicates with the facial nerve (CN VII) inside the parotid gland.<ref name=":33" />
'''Posterior branch'''
The posterior branch (or mastoid branch{{Citation needed|date=December 2022}}) innervates the skin over the mastoid process, on the back of the auricle (save for its upper part), of the lobule, and of the lower part of the concha.<ref name=":33" />
The posterior branch communicates with the lesser occipital nerve, the auricular branch of the vagus, and the posterior auricular branch of the facial.<ref name=":33" />
=== Distribution === The great auricular nerve is distributed to the skin of the face over the angle of the mandible'''<ref name=":0223"/>''' and parotid gland (via anterior branch<ref name=":33" />),<ref name=":33" />'''<ref name=":0223" />''' skin over of the mastoid region'''<ref name=":0223" />''' (i.e. skin over the mastoid process<ref name=":33" />) (via posterior branch<ref name=":33" />), parts of the auricle (posterior branch<ref name=":33" />),<ref name=":33" />'''<ref name=":0223" />''' and the parotid gland and parotid fascia.'''<ref name=":0223" />'''
== Clinical significance == The great auricular nerve may be damaged during surgery on the parotid gland, reducing sensation to the face.<ref>{{Cite journal|last1=Brown|first1=J. S.|last2=Ord|first2=R. A.|date=1 December 1989|title=Preserving the great auricular nerve in parotid surgery|url=https://www.sciencedirect.com/science/article/pii/S0266435689800038|journal=British Journal of Oral and Maxillofacial Surgery|language=en|volume=27|issue=6|pages=459–466|doi=10.1016/S0266-4356(89)80003-8|pmid=2597656 |issn=0266-4356|url-access=subscription}}</ref>
Pain resulting from parotitis is caused by an impingement on the great auricular nerve.<ref>{{Cite web |date=2024-02-10 |title=Understanding Great Auricular Nerve Pain: Causes, Symptoms, and Treatment – The Auricular Nerve |url=https://auricularnerve.com/understanding-great-auricular-nerve-pain-causes-symptoms-and-treatment/ |access-date=2025-06-04 |language=en-US}}</ref>
The intermingling of the great auricular nerve and the facial nerve (CN VII) is thought to be responsible for the pathogenesis of Frey's syndrome following parotidectomy.<ref name=":33" />
== Additional images == <gallery> File:Gray784.png|Dermatome distribution of the trigeminal nerve, also showing the sensory distribution of the great auricular, lesser occipital, and greater occipital nerves. File:Gray1210.png|Side of neck, showing chief surface markings. </gallery>
== References == <references />
== External links == * [http://www.aapmr.org/zimages/education/case65_b.jpg Diagram at aapmr.org] {{Webarchive|url=https://web.archive.org/web/20060213045424/http://www.aapmr.org/zimages/education/case65_b.jpg |date=2006-02-13 }} * {{SUNYAnatomyFigs|25|03|03}} - "Diagram of the cervical plexus."
{{Cervical plexus}} {{Portal bar|Anatomy}} {{Authority control}}
Category:Nerves of the head and neck