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Great Auricular Nerve : Failsafe Method To Avoid Injury
Cemile Nurdan Ozturk, Can Ozturk, Franziska Huettner, James E Zins
Cleveland Clinic
2013-02-25
Presenter: Cemile Nurdan Ozturk
Affidavit:
the above work is an original work of the fellow.
Director Name: James Zins
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Aesthetics
Goals: Most anatomic descriptions of the great auricular nerve identify its course along the midbelly of the sternocleidomastoid muscle. From a practical point injury can also occur in closer proximity to the ear. The purpose of our study was to identify the distal course of the great auricular nerve as it approaches the lobule.
Methods: Dissections were performed in 26 hemi-necks. A vertical line through the mid-lobule was drawn perpendicular to the Frankfort`s horizontal acting as a reference point. Paper overlay tracings were then done to record each nerve`s course. The distance from the bony external auditory canal to the nerve was measured at its emergence from under sternocleidomastoid muscle, at midbelly of sternocleidomastoid muscle and at anterior muscle border. Branching patterns of the nerve and relation to external jugular vein were identified.
Results: In 100% of the dissections the distal course of the great auricular nerve fell within a 30 degree angle constructed using the vertical limb perpendicular to the Frankfurt`s horizontal and a second limb drawn posteriorly from the midlobule. The distance from the bony external auditory canal to the nerve was found to be 9.8±1.2cm at its emergence from under sternocleidomastoid muscle, 7.3±1.0cm at midbelly of sternocleidomastoid muscle and 4.9±1.1cm at anterior muscle border. Four types of branching patterns were identified and will be presented.
Conclusion: The 30 degree angle decribed above accurately identifies the nerve`s distal course in 100% of our dissections.
