The greater auricular nerve is the largest cutaneous branch of the cervical plexus, providing sensation to the ear and parotid region. Its prominent course across the SCM surface makes it the most commonly injured nerve in neck dissection, parotidectomy, and facelift surgery. Greater auricular nerve sacrifice during parotidectomy produces permanent inferior ear and lobe numbness — the most common permanent complication of parotid surgery.
| Origin | Cervical plexus (C2, C3) |
|---|
During superficial parotidectomy, the greater auricular nerve crosses the SCM at Erb's point and enters the parotid — the posterior branch to the earlobe is sacrificed in most parotidectomies, producing lower earlobe numbness. The anterior branch can often be preserved. Frey syndrome (gustatory sweating after parotidectomy) results from misdirected parasympathetic reinnervation of the greater auricular territory.
Earlobe numbness from posterior branch sacrifice during parotidectomy — partial preservation of the anterior branch minimises the sensory deficit.
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