Great auricular nerve
The great auricular nerve is a superficial nerve of the neck that arises from the cervical plexus. It arises from the ventral rami of spinal nerves C2 and C3, and is the largest ascending branch of the cervical plexus.
Along its course, the great auricular nerve emerges on the posterior border of the sternocleidomastoid muscle at the Erb’s point, which is the site where all cutaneous branches of the cervical plexus converge and become superficial. The great auricular nerve supplies the skin of the auricle, as well as the area overlying the parotid gland and mastoid process.
This article will discuss the anatomy and function of the great auricular nerve.
|Origin||Cervical plexus (C2, C3)|
|Branches||Anterior branch of great auricular nerve, posterior branch of great auricular nerve|
|Supply||Skin of the auricle, skin over the parotid gland and mastoid process|
Origin and course
The great auricular nerve is the largest ascending branch of cervical plexus, arising from the ventral rami of C2 and C3. The nerve arises just behind the middle portion of the sternocleidomastoid muscle and shortly thereafter curves around its posterior border and emerges on the muscle’s anterior surface. Here, the great auricular nerve perforates the deep cervical fascia and takes an ascending course, passing under the platysma muscle along the external jugular vein. As it reaches the parotid gland, the great auricular nerve divides into its terminal branches.
The Erb’s point, or punctum nervosum, is the site where all the cutaneous branches of the cervical plexus converge, pierce the deep cervical fascia and become superficial. Aside from the great auricular nerve, these branches also include lesser occipital, transverse cervical and supraclavicular.
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Branches and innervation
The great auricular nerve gives off two terminal branches:
- The anterior branch, also called the facial branch, which innervates the skin over the parotid gland. This branch immerses into the substance of the parotid gland, where it establishes a connection with the facial nerve.
- The posterior branch, also called the mastoid branch, which supplies the skin over the mastoid process and the posterior surface of the auricle. This branch gives off a small lateral filament, which supplies the lobule and concha. Along its course, the posterior branch communicates with the lesser occipital nerve, the auricular branch of vagus nerve (CN X) and the auricular branch of posterior auricular nerve.
Learn more about the great auricular nerve here.
Frey’s syndrome is a rare neurological disorder characterized by the occurrence of sweating and flushing on the cheek area adjacent to the ear in response to eating and salivation. The disorder can result due to several causes, often as a complication of surgeries that involve the parotid gland. It is believed that the connection established between the facial nerve (parasympathetic innervation) and the great auricular nerve (sensory innervation) via its anterior branch might be part of the anatomical basis of this disorder.