Anterior extensions of parotid gland and its relationship with the buccal branch of facial nerve: a case study

Abstract

Variant anterior extensions (AEx) of the parotid gland (PG) is observed such as accessory parotid gland (APG) and facial process (FP), which are in close proximity with the parotid duct over the lateral side of the masseter muscle. APG is a collection of salivary tissue separated from the main PG, whereas FP maintains the continuity. All pathologies occur in main PG including cancer can affects AEx as well. Single or multiple buccal branches (BB) of facial nerve (FN) also runs parallel to parotid duct. However the relationship of the BB with AEx of PG is not well reported in literature. During dissection classes carried out for first year Dental undergraduates, AEx of PG were observed and bilateral dissection of the lateral face of ten cadavers were done. There were four males and six female cadavers with a mean age of 75 years. Nine FP (45%) and 3 APG (15%) were observed out of the 20 sides examined making the incidence of AEx as 60%. Emergence of a single BB (15%) as well as double branches (45%) were observed. The double branches were running separately as well as making connections across the duct. The superior branch was deeply located and the inferior branch was emerging more superficially from PG. In all APG, BB was passing through the glandular mass. In relation to FP, double BB were running in the inferior and superior borders of the mass. In literature, occurrence of the FP was reported increasing with age where as APG was reducing, supporting our observations. However the relationship of FN branches with APG is not well reported in literature. Occurrence of AEx of PG should be considered in clinical practice as well as the BB relationship. Therefore further studies are recommended on the region.