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Decoding the Anatomy of Preauricular Lymph Nodes: A Cadaveric Exploration
Erica Tedone Clemente, MD, FEBOPRAS, Shih-Lun Lo, MD, Sonia Kukreja Pandey, MD, Melis Salman, MD, Wei F. Chen, MD, FACS
Cleveland Clinic
2025-01-10
Presenter: Erica Tedone Clemente
Affidavit:
Chen, Wei F.
Director Name: Chen, Wei F.
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Purpose: Primary lymphedema often causes swelling in various body regions, including the face and orbits, due to impaired lymphatic drainage. The preauricular lymph nodes (LNs) are critical in addressing such issues, making their precise localization essential for effective surgical interventions to relieve orbital edema. This study aims to pinpoint the exact anatomical position of preauricular LNs.
Methods: Dissections were performed on 12 cadavers to identify preauricular LNs, focusing on their placement at the sub-SMAS (Superficial Musculoaponeurotic System) level. The relationship of the LNs to the superficial temporal artery (STA), superficial temporal vein (STV), and tragus was documented. Measurements included LN size, distance from the tragus, and presence of lymphatic vessels.
Results: Preauricular LNs were identified in 16 of the 22 regions examined. Nodes averaged 4.56 mm in size and were located approximately 11.75 mm anterior to the tragus. They consistently resided at the sub-SMAS level, superficial and posterior to the STV. Afferent and efferent lymphatic vessels were also observed. Initial dissections required 2 hours to locate the LNs, but refined techniques reduced this to 30 minutes.
Conclusion: Preauricular LNs are reliably found at the sub-SMAS level, 10-15 mm anterior to the tragus, with an average size of 4.56 mm. Familiarity with these anatomical landmarks and optimized dissection techniques significantly reduces identification time, improving surgical outcomes for managing preauricular and orbital swelling.
