The parotid space is the compartment within the parotid fascia containing the parotid gland, the extratemporal portion of the facial nerve (CN VII) dividing the gland into superficial and deep lobes, the retromandibular vein, and the external carotid artery. The parotid fascia is derived from the investing layer of the deep cervical fascia. The deep lobe of the parotid extends through the stylomandibular tunnel into the parapharyngeal space.
| Location | Side of the face in front of and below the ear, wrapping around the ramus of the mandible |
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Encloses the parotid gland and the facial nerve branching within it. The tight capsule explains why parotid swelling (as in mumps) is painful.
The parotid space is the surgical domain of parotid surgery. Superficial parotidectomy removes the tissue superficial to the facial nerve plane; total parotidectomy removes all parotid tissue deep to the nerve as well. The facial nerve trunk exits the stylomastoid foramen and enters the parotid space where it divides into its pes anserinus pattern. Parotid neoplasms (80% benign: pleomorphic adenoma, Warthin tumour; 20% malignant: mucoepidermoid, acinic cell, adenoid cystic) require imaging to assess deep lobe involvement and relationship to the facial nerve.
The facial nerve trunk divides into its five main branches within the parotid space deep to the parotid parenchyma; superficial parotidectomy requires meticulous dissection along the facial nerve plane from its trunk distally to each branch, with injury rates of 1-3% for temporary and 0.5% for permanent paresis in experienced hands.
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