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Posterior Auricular Vein

vena auricularis posterior

The posterior auricular vein drains the posterior auricle and the retroauricular scalp, descending posterior to the ear to join the posterior division of the retromandibular vein, forming the external jugular vein. It accompanies the posterior auricular artery and lies superficial to the mastoid process and sternocleidomastoid insertion. The posterior auricular vein is harvested as a reliable venous anastomosis target for free tissue transfer to the lateral face and parotid region.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The posterior auricular vein is relevant in retroauricular surgical approaches (mastoid surgery, parotidectomy posterior approach) where it is identified before incision to avoid inadvertent venous injury. It is also used as a recipient vein for microvascular anastomosis in free flap reconstruction of the lateral face, ear, and parotid region when the facial vessels or superficial temporal vessels are not accessible. The great auricular nerve accompanies the posterior auricular vein and both structures are encountered in retroauricular surgery.

Pathology

Common Injuries & Conditions

Posterior Auricular Vein as Recipient Vessel for Facial Free Flap

Free tissue transfer to the lateral face and periauricular region uses the posterior auricular vein as the venous outflow recipient when the facial or superficial temporal veins are unavailable due to previous surgery or radiation; its consistent position posterior to the ear and reliable diameter of 2-3 mm make it a reliable microsurgical recipient.