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CHAPTER 4 – PAROTIDECTOMY

Anna M. Pou,
Colin D. Pero

STEP 1: SURGICAL ANATOMY

      Identification and preservation of the facial nerve and its branches is key to successful parotid surgery.
      The anatomic landmarks that are used include the following (Figure 4-1):
      The mastoid process with the insertion of the sternocleidomastoid (SCM) muscle
      Posterior belly of the digastric muscle
      Tragal pointer
      Temporoparotid fascia
      Tympanomastoid fissure
      Styloid process

      The parotid gland is anatomically composed of one lobe with an accessory lobe along Stensen's duct. The plane of the facial nerve divides the gland into lateral and deep lobes for surgical purposes.
      The deep lobe is located along the posterior border of the ascending mandibular ramus or adjacent to the masseter muscle along the ramus.

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