Great auricular nerve injury, the "subauricular band" phenomenon, and the periauricular adipose compartments

Rod J. Rohrich, Nathan S. Taylor, Jamil Ahmad, An Lu, Joel E. Pessa

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Experience with anatomical dissection has suggested that two potential complications of rhytidectomy are related to the anatomy of the periauricular adipose compartments: great auricular nerve injury and the "subauricular band" phenomenon. This study describes this anatomy and its relationship to these potential complications. Methods: The results of 24 fresh hemifacial cadaver dissections were included in this study. Injections included the use of methylene blue and fixable dye injected into specific regions around the ear. The study incorporated digital macro photography, time-lapse photography, and three-dimensional cross-sections in multiple planes (coronal, sagittal, and axial planes) to identify structural relationships. Results: This study defined five periauricular adipose compartments. The main branch of the great auricular nerve always ran within the subauricular membrane. The subauricular membrane was located between the subauricular and inferior adipose compartments. Inadequate dissection of the lateral neck and postauricular area along with failure to release this membrane completely results in banding of the lateral neck, a stigma of face lift surgery. McKinney's point was consistently found to lie where the great auricular nerve travels deep to the inferior border of Lore's fascia and the tail of the parotid. Below this point, the great auricular nerve is closer to the skin surface and more susceptible to potential injury. Conclusion: Two possible complications of rhytidectomy, great auricular nerve injury and the "subauricular band" phenomenon, are avoidable by understanding the anatomy of the periauricular adipose compartments.

Original languageEnglish (US)
Pages (from-to)835-843
Number of pages9
JournalPlastic and Reconstructive Surgery
Volume127
Issue number2
DOIs
StatePublished - Feb 2011

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Rhytidoplasty
Anatomy
Photography
Membranes
Dissection
Wounds and Injuries
Neck Dissection
Methylene Blue
Fascia
Cadaver
Ear
Coloring Agents
Neck
Skin
Injections

ASJC Scopus subject areas

  • Surgery

Cite this

Great auricular nerve injury, the "subauricular band" phenomenon, and the periauricular adipose compartments. / Rohrich, Rod J.; Taylor, Nathan S.; Ahmad, Jamil; Lu, An; Pessa, Joel E.

In: Plastic and Reconstructive Surgery, Vol. 127, No. 2, 02.2011, p. 835-843.

Research output: Contribution to journalArticle

Rohrich, Rod J. ; Taylor, Nathan S. ; Ahmad, Jamil ; Lu, An ; Pessa, Joel E. / Great auricular nerve injury, the "subauricular band" phenomenon, and the periauricular adipose compartments. In: Plastic and Reconstructive Surgery. 2011 ; Vol. 127, No. 2. pp. 835-843.
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