ĐẶC ĐIỂM GIẢI PHẪU DÂY THẦN KINH TAI LỚN TRONG PHẪU THUẬT CẮT TUYẾN MANG TAI TẠI KHOA TAI MŨI HỌNG - BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH TỪ 2022-2023

Abstract

Introduction: The great auricular nerve is part of the superficial cervical plexus, originating from the spinal nerve roots C2 - C3. Recently, many studies have emphasized the benefits of preserving the posterior branch of the great auricular nerve in parotidectomy, hoping to quickly restore sensation in the area dominated by the great auricular nerve after surgery. So what are the anatomical characteristics of the great auricular nerve in parotid surgery, how to preserve the posterior branch of the great auricular nerve, and is preservation easy?

Objectives: Describe the anatomical features of the great auricular nerve in parotidectomy.

Methods: Cross-sectional study describing 60 cases of parotidectomy with preservation of the posterior branch of the great auricular nerve from July 2022 - July 2023.

Results: The distance between the outer edge of the external jugular vein and the inner edge of the great auricular nerve (D1), the distance at the origin of the posterior border of the sternocleidomastoid muscle and at the bifurcation of the anterior and posterior branches are equivalent in length of the main trunk of the great auricular nerve (D2) and the distance from the location where the great auricular nerve branches into the anterior branch entering the glandular tissue and the posterior branch entering the skin of the earlobe area is equivalent to the length of the posterior branch (D3) with an average value of 8.45 ± 4.3 mm; 34.5 ± 8.4 mm; 31.2 ± 8.4 mm. The average time to find and preserve the posterior branch of the great auricular nerve is 12.4 ± 3.9 minutes.

Conclusions: The technique of finding and preserving the posterior branch of the great auricular nerve is not too difficult or complicated, and most of the time, the procedure takes no more than 15 minutes, which is an acceptable amount of time. Identify the great auricular nerve just below the SMAS layer, about 0.5 cm - 1 cm from the external jugular vein at the location where the nerve parallels this vein on the surface of the sternocleidomastoid muscle. Identifying and preserving the posterior branch of the great auricular nerve requires the surgeon's meticulousness during nerve dissection and identification of the posterior branch of the great auricular nerve.