Clinical Anatomy - Parotid Gland

• A parotid abscess may be caused by spread of infection from the opening of the parotid duct in the mouth cavity
• It is best drained by horizontal incision / making many small holes - known as Hilton's method (below the angle of mandible)

• Parotidectomy = surgical removal of the parotid gland
• After parotidectomy, aberrant regeneration of secretomotor fibres may occur in the auriculotemporal nerve, which join the great auricular nerve
• This causes stimulation of sweat glands and hyperaemia in the area of distribution
• Results in redness and sweating in the skin area supplied by the nerve - called Frey's Syndrome (also known as auriculotemporal syndrome)
• Whenever the person chews, there is increased sweating in the region supplied by the auriculotemporal nerve

• During surgical removal, the facial nerve is preserved by removing the gland in two parts - superficial and deep separately
• The plane of cleavage is defined by tracing the nerve from behind forwards

• Slow growing, lobulated, painless tumour with no facial nerve involvement
• Signs of malignant change: pain, rapid growth, fixity with hardness, facial nerve involvement, and enlargement of cervical lymph nodes

• May form within the parotid gland or in Stenson's duct
• Located by injecting a radio-opaque dye through its opening in the vestibule of the mouth
• This procedure is called Sialogram
• The duct can be examined by a spatula or bidigital examination

• Parotid gland is ectodermal in origin
• Develops from buccal epithelium just lateral to the angle of mouth
• Outgrowth branches repeatedly to form the duct system and acini
• Mesoderm forms the intervening connective tissue