Intraglandular parotid nodes

At a glance

English

Intraglandular parotid nodes

Latin (TA2)

Nodi parotidei intraglandulares

System

Lymphatic

Region

Head

Side

Paired, left and right

About the intraglandular parotid nodes

The intraglandular parotid nodes lie inside the parotid gland itself rather than on its surface. They are scattered through the gland tissue, mostly in its superficial part and often close to the retromandibular vein and the branches of the facial nerve that run through the gland. Their number varies from person to person, and they are usually small. The parotid is unusual among salivary glands in having lymph nodes within it, because the gland capsule forms late in development, after nearby lymphoid tissue has already been enclosed.

Together with the nodes on the surface of the gland, in front of the ear and below it, they make up the parotid group of nodes of the head. The gland around them is enclosed in a tough parotid fascia, so swelling of these nodes can be painful and hard to feel through the tissue.

Lymph reaches them from the parotid gland, from the skin of the forehead, temple and lateral eyelids, from the front of the auricle, from the external ear canal and from the middle ear and auditory tube. Their outflow passes to the superior deep cervical nodes along the internal jugular vein, often through the other parotid nodes on the way.

These nodes are clinically important. Skin cancers of the scalp, temple, ear and face, including squamous cell carcinoma and melanoma, often spread first to the parotid nodes, and treatment may then need removal of part of the gland. Primary tumours of the gland can also spread to them. Because the facial nerve divides within the parotid, any surgery on these nodes carries a risk of weakness of the face, and the nerve is carefully identified and preserved.

Course and drainage

Begins at

Afferent vessels from the parotid gland, the skin of the forehead, temple and lateral eyelids, the front of the auricle, the external acoustic meatus and the middle ear.

Drains into

Efferent vessels pass to the superior deep cervical nodes, often by way of the other parotid nodes.

Drains

Filters lymph from the parotid gland and the side of the face and scalp. A common first site of spread for skin cancers of the face and scalp, so it often decides whether part of the parotid gland is removed.