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The auriculotemporal nerve is a sensory branch of the mandibular nerve (CN V 3) that runs with the superficial temporal artery and vein, and provides sensory innervation to parts of the external ear, scalp, and temporomandibular joint. The nerve also conveys post-ganglionic parasympathetic fibres from the otic ganglion to the parotid gland. [1]
Frey's syndrome (also known as Baillarger's syndrome, Dupuy's syndrome, auriculotemporal syndrome, [1] or Frey-Baillarger syndrome) is a rare neurological disorder resulting from damage to or near the parotid glands responsible for making saliva, and from damage to the auriculotemporal nerve often from surgery. [1] [2]
The temporal branches of the facial nerve (frontal branch of the facial nerve) crosses the zygomatic arch to the temporal region, supplying the auriculares anterior and superior, and joining with the zygomaticotemporal branch of the maxillary nerve, and with the auriculotemporal branch of the mandibular nerve.
The great auricular nerve is a large trunk that ascends almost vertically over the sternocleidomastoid. [2] It winds around the posterior border of the sternocleidomastoid muscle, then perforates the deep fascia before ascending alongside the external jugular vein upon that sternocleidomastoid muscle beneath the platysma muscle to the parotid gland. [1]
It ascends between the sphenomandibular ligament and the lateral pterygoid muscle, and between the two roots of the auriculotemporal nerve to the foramen spinosum of the sphenoid bone, through which it enters the cranium; it then runs forward in a groove on the great wing of the sphenoid bone, and divides into two branches, anterior and posterior.
Frey's syndrome is caused by re-routing of parasympathetic and sympathetic fibres of the auriculotemporal nerve (V3) within the otic ganglion. It is a complication of surgery involving the parotid gland whereby injury to these branches, which innervate the parotid gland and sweat glands of the face respectively, form abnormal connections.
Abducens nerve; Accessory nerve; Accessory obturator nerve; Alderman's nerve; Anococcygeal nerve; Ansa cervicalis; Anterior interosseous nerve; Anterior superior alveolar nerve; Auerbach's plexus; Auriculotemporal nerve; Axillary nerve; Brachial plexus; Buccal branch of the facial nerve; Buccal nerve; Cardiac plexus; Cavernous nerves; Cavernous ...
Surgical techniques in parotid surgery have evolved in the last years with the use of neuromonitoring of the facial nerve and have become safer and less invasive. [19] After surgical removal of the parotid gland (parotidectomy), the auriculotemporal nerve is liable to damage and upon recovery it fuses with sweat glands. This can cause sweating ...