She presently has no symptoms, except for slight hypoesthesia in the distribution of greater auricular nerve
and is under regular follow-up (Fig.
Does a preemptive block of great auricular nerve
improve postoperative analagesia in children undergoing tympanomastoid surgery.
The cervical plexus consists of the ventral primary divisions of the first four cervical spinal nerves and gives rise to (1) the muscular branches, including the phrenic nerve and nervus descendens cervicalis, as well as (2) the sensory branches, including the lesser occipital, transverse cutaneous, supraclavicular, and great auricular nerves
During parotidectomy, the great auricular nerve
, located near the posterior border of the sternocleidomastoid muscle and anterior to the mastoid tip, is often sacrificed at the parotid inferior pole.
the posterior auricular branch--which innervates the auricularis posterior, the cranially oriented muscles of the auricle, and the occipital muscles--communicates with the greater auricular nerve
, the auricular branch of the vagus nerve, and the lesser occipital nerve (3)
Sharma and co-workers reported a leprotic abscess formation in the great auricular nerve
created a free osteocutaneous fibula flap to reconstruct the mandible and grafted the great auricular nerve
to the facial nerve branches (figure 5).
2,3) The incidence of these abscesses is higher in males and the commonest nerve involved is the ulnar nerve, with the greater auricular nerve
being the most commonly affected sensory nerve.
The most frequently affected nerve trunks are the ulnar (in the medial fossae of the olecranon epicondyle), the radial nerve (in the radial fossae), the common peroneal (lateral popliteal) nerve, the median nerve (at the carpal tunnel), the auricular nerve
at the lateral side of the neck, and the posterior tibial behind the medial malleolus, all of them accessible to clinical examination.
The great auricular nerve
on the side of the neck, below the ear, is sometimes visibly enlarged: gently feel it to make sure it is the nerve (solid) and not one of the veins in the neck (full of fluid).
For all the patients, the same surgical approach was utilized as follows: firstly, local infiltration anaesthesia with lidocaine and 1:200,000 adrenaline and great auricular nerve
block was performed and, then, a very superficial skin ellipse excision was performed meticulously avoiding damage to the underlying fascial layer.
Trophic and vasomotor changes: Anhydrosis in 21 cases, thickened ulnar nerve found in 31 cases unilateral, 5 cases bilateral ulnar thickening, thickened and great auricular nerve
in 6 cases, thickened radial cutaneous nerve in 4 cases, thickened medial cutaneous nerve of forearm in 1 case, thickened cutaneous nerve of upper arm on right side, thickened common peroneal nerve in 17 cases.
Nerves that are predominantly involved include the ulnar nerve (UN), median nerve, lateral popliteal nerve, posterior tibial and greater auricular nerve
, with or without skin lesions.