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Great Auricular/Posterior Auricular Nerve Entrapment

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Peripheral Nerve Entrapments

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Abstract

The great auricular nerve (GAN) and the posterior auricular nerve (PAN) provide sensation to the mastoid and ear regions. These nerves have a variable origin, and there is much confusion regarding their anatomy. Because of their location, the GAN and PAN are very easily injured during surgery and trauma, and since their anatomy is not well understood, they are often missed as an etiology of parietal pain and headaches.

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References

  1. Brown JS, Ord RA. Preserving the great auricular nerve in parotid surgery. Br J Oral Maxillofac Surg. 1989;27(6):459–66.

    Article  CAS  PubMed  Google Scholar 

  2. Vieira MB, Maia AF, Ribeiro JC. Randomized prospective study of the validity of the great auricular nerve preservation in parotidectomy. Arch Otolaryngol Head Neck Surg. 2002;128(10):1191–5.

    Article  PubMed  Google Scholar 

  3. Hui Y, Wong DS, Wong LY, Ho WK, Wei WI. A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy. Am J Surg. 2003;185(6):574–9.

    Article  PubMed  Google Scholar 

  4. Hu J, Ye W, Zheng J, Zhu H, Zhang Z. The feasibility and significance of preservation of the lobular branch of the great auricular nerve in parotidectomy. Int J Oral Maxillofac Surg. 2010;39(7):684–9.

    Article  CAS  PubMed  Google Scholar 

  5. Lefkowitz T, Hazani R, Chowdhry S, Elston J, Yaremchuk MJ, Wilhelmi BJ. Anatomical landmarks to avoid injury to the great auricular nerve during rhytidectomy. Aesthet Surg J. 2013;33(1):19–23.

    Article  PubMed  Google Scholar 

  6. Ng AK, Page RS. Greater auricular nerve neuropraxia with beach chair positioning during shoulder surgery. Int J Should Surg. 2010;4(2):48–50.

    Article  Google Scholar 

  7. Park TS, Kim YS. Neuropraxia of the cutaneous nerve of the cervical plexus after shoulder arthroscopy. Arthroscopy. 2005;21(5):631.

    Article  PubMed  Google Scholar 

  8. de Gray LC, Matta BF. Acute and chronic pain following craniotomy: a review. Anaesthesia. 2005;60(7):693–704.

    Article  PubMed  Google Scholar 

  9. Vorobeichik L, Fallucco MA, Hagan RR. Chronic daily headaches secondary to greater auricular and lesser occipital neuromas following endolymphatic shunt surgery. BMJ Case Rep. 2012;2012.

    Google Scholar 

  10. Trescot AM. Headache management in an interventional pain practice. Pain Physician. 2000;3(2):197–200.

    CAS  PubMed  Google Scholar 

  11. Wyburn-Mason R. The nature of tic douloureux: treatment by alcohol block or section of the great auricular nerve. Brit Med J. 1953;2:119–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Patel N, Har-El G, Rosenfeld R. Quality of life after great auricular nerve sacrifice during parotidectomy. Arch Otolaryngol Head Neck Surg. 2001;127(7):884–8.

    CAS  PubMed  Google Scholar 

  13. Kemp WJ, Tubbs RS, Cohen-Gadol AA. The innervation of the scalp: a comprehensive review including anatomy, pathology, and neurosurgical correlates. Surg Neurol Int. 2011;2:178.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Di Francia R, Papon X, Mercier P. Anatomical study of the superficial cervical plexus: application to the prevention of the postoperative sensitive facial deficits. Morphologie. 2010;95(308):3–9.

    Article  PubMed  Google Scholar 

  15. Becser N, Bovim G, Sjaastad O. Extracranial nerves in the posterior part of the head. Anatomic variations and their possible clinical significance. Spine. 1998;23(13):1435–41.

    Article  CAS  PubMed  Google Scholar 

  16. Sand T, Becser N. Neurophysiological and anatomical variability of the greater auricular nerve. Acta Neurol Scand. 1998;98(5):333–9.

    Article  CAS  PubMed  Google Scholar 

  17. Smith OJ, Ross GL. Variations in the anatomy of the posterior auricular nerve and its potential as a landmark for identification of the facial nerve trunk: a cadaveric study. Anat Sci Int. 2012;87(2):101–5.

    Article  PubMed  Google Scholar 

  18. Colbert SD, Davies J, Aldridge T, Brennan PA. Posterior auricular nerve found anterior to the cartilage of the external auditory meatus – a previously unreported variant. Br J Oral Maxillofac Surg. 2012;51(5):448–9.

    Article  PubMed  Google Scholar 

  19. Tubbs RS, Salter EG, Wellons JC, Blount JP, Oakes WJ. Landmarks for the identification of the cutaneous nerves of the occiput and nuchal regions. Clin Anat. 2007;20(3):235–8.

    Article  PubMed  Google Scholar 

  20. Elahi F, Reddy C. Neuromodulation of the great auricular nerve for persistent post-traumatic headache. Pain Physician. 2014;17(4):E531–6.

    PubMed  Google Scholar 

  21. Izquierdo R, Parry SW, Boydell CL, Almand J. The great auricular nerve revisited: pertinent anatomy for SMAS-platysma rhytidectomy. Ann Plast Surg. 1991;27(1):44–8.

    Article  CAS  PubMed  Google Scholar 

  22. Peuker ET, Filler TJ. The nerve supply of the human auricle. Clin Anat. 2002;15(1):35–7.

    Article  PubMed  Google Scholar 

  23. Barry M, Bannister LH, Strandring SM. Nervous system. In: Bannister LH, Berry MM, Gray H, Williams PL, editors. Gray’s Anatomy. 38th ed. New York, NY: Churchill Livingstone; 1995. p. 901–1937.

    Google Scholar 

  24. Murphy R, Dziegielewski P, O’Connell D, Seikaly H, Ansari K. The great auricular nerve: an anatomic and surgical study. J Otolaryngol. 2012;41 Suppl 1:S75–7.

    Google Scholar 

  25. Liaqat S, Ehsan A, Bukhari SGA. Efficacy of greater auricular nerve infiltration anesthesia in patients having less than optimal analgesia after conventional inferior alveolar nerve block for surgical removal of mandibular third molar. Pakistan Oral Dental J. 2011;31(2):252–4.

    Google Scholar 

  26. Blau JN. Ear pain referred by the vagus. BMJ. 1989;299(6715):1569–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Monkhouse WS. The anatomy of the facial nerve. Ear Nose Throat J. 1990;69(10):677–83, 86–7.

    CAS  PubMed  Google Scholar 

  28. Ryan WR, Fee Jr WE. Great auricular nerve morbidity after nerve sacrifice during parotidectomy. Arch Otolaryngol Head Neck Surg. 2006;132(6):642–9.

    Article  PubMed  Google Scholar 

  29. Kessler LA, Abla A. Syndrome of the cervical plexus caused by high cervical nerve root compression. Neurosurgery. 1991;28(4):506–9.

    Article  CAS  PubMed  Google Scholar 

  30. Reiss M, Reiss G. Differential diagnosis of otalgia. Schmerz. 1999;13(6):392–7.

    Article  CAS  PubMed  Google Scholar 

  31. Trescot AM. Cryoanalgesia in interventional pain management. Pain Physician. 2003;6(3):345–60.

    PubMed  Google Scholar 

  32. Klein DS, Edwards LW, Klein PW. Treatment of cryptogenic earache with posterior auricular nerve block. Albuquerque: AAPM; 1992.

    Google Scholar 

  33. Thallaj A, Marhofer P, Moriggl B, Delvi BM, Kettner SC, Almajed M. Great auricular nerve blockade using high resolution ultrasound: a volunteer study. Anaesthesia. 2010;65(8):836–40.

    Article  CAS  PubMed  Google Scholar 

  34. Thallaj A. Ultrasound guidance of uncommon nerve blocks. Saudi J Anaesth. 2011;5(4):392–4.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Teixeira MJ, Siqueira SR, Almeida GM. Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain. Arq Neuropsiquiatr. 2006;64(4):983–9.

    Article  PubMed  Google Scholar 

  36. Navani A, Mahajan G, Kreis P, Fishman SM. A case of pulsed radiofrequency lesioning for occipital neuralgia. Pain Med. 2006;7(5):453–6.

    Article  PubMed  Google Scholar 

  37. Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients. Neurosurgery. 2001;48(3):524–32; discussion 32–4.

    Article  CAS  PubMed  Google Scholar 

  38. Shaheen OH. Benign salivary tumours. In: Shaheen OH, editor. Problems in head and neck surgery. London: Balliere Tindall; 1984. p. 70–91.

    Google Scholar 

  39. Lenchig S, Cohen J, Patin D. A minimally invasive surgical technique for the treatment of posttraumatic trigeminal neuropathic pain with peripheral nerve stimulation. Pain Physician. 2012;15(5):E725–32.

    PubMed  Google Scholar 

  40. Johnson MD, Burchiel KJ. Peripheral stimulation for treatment of trigeminal postherpetic neuralgia and trigeminal posttraumatic neuropathic pain: a pilot study. Neurosurgery. 2004;55(1):135–41; discussion 41–2.

    Article  PubMed  Google Scholar 

  41. Verrills P, Vivian D, Mitchell B, Barnard A. Peripheral nerve field stimulation for chronic pain: 100 cases and review of the literature. Pain Med. 2011;12(9):1395–405.

    Article  PubMed  Google Scholar 

  42. Mobbs RJ, Nair S, Blum P. Peripheral nerve stimulation for the treatment of chronic pain. J Clin Neurosci Off J Neurosurg Soc Aust. 2007;14(3):216–21; discussion 22–3.

    CAS  Google Scholar 

  43. Nashold Jr BS, Goldner JL, Mullen JB, Bright DS. Long-term pain control by direct peripheral-nerve stimulation. J Bone Joint Surg Am. 1982;64(1):1–10.

    Article  PubMed  Google Scholar 

  44. Huntoon MA, Burgher AH. Ultrasound-guided permanent implantation of peripheral nerve stimulation (PNS) system for neuropathic pain of the extremities: original cases and outcomes. Pain Med. 2009;10(8):1369–77.

    Article  PubMed  Google Scholar 

  45. Ulubil SA, Eshraghi AA, Telischi FF. Sectioning the sensory auricular branch of the facial nerve to treat recalcitrant otalgia. Otol Neurotol. 2009;30(4):522–4.

    Article  PubMed  Google Scholar 

  46. Ginsberg LE, Eicher SA. Great auricular nerve: anatomy and imaging in a case of perineural tumor spread. AJNR Am J Neuroradiol. 2000;21(3):568–71.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Private Practice, Ft. Myers, FL, USA

    Leonard Benton MD

  2. Pain and Headache Center, Anchorage, AK, USA

    Andrea M. Trescot MD, ABIPP, FIPP

Authors
  1. Leonard Benton MD
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  2. Andrea M. Trescot MD, ABIPP, FIPP
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Corresponding author

Correspondence to Leonard Benton MD .

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Editors and Affiliations

  1. Pain and Headache Center, Anchorage, AK, USA

    Andrea M. Trescot MD, ABIPP, FIPP (Medical Director) (Medical Director)

Electronic Supplementary Materials

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Physical exam of the posterior auricular nerve (MOV 45449 kb)

Landmark-guided injection of the posterior auricular nerve (MOV 43939 kb)

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Benton, L., Trescot, A.M. (2016). Great Auricular/Posterior Auricular Nerve Entrapment. In: Trescot, A.M. (eds) Peripheral Nerve Entrapments. Springer, Cham. https://doi.org/10.1007/978-3-319-27482-9_16

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  • DOI: https://doi.org/10.1007/978-3-319-27482-9_16

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27480-5

  • Online ISBN: 978-3-319-27482-9

  • eBook Packages: MedicineMedicine (R0)

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