The parotid gland, submandibular gland, and facial nerve in 3 dimensions: A digital anatomical model derived from radiology, peer-reviewed literature, and medical illustration

Abstract

Using published literature and radiographic imaging, this study aims to develop an anatomically accurate 3-dimensional (3D) digital model of the human parotid gland, submandibular gland, facial nerve, and adjacent anatomy. The model is available for viewing at https://shorturl.at/uzADZ. The left parotid and submandibular glands, parotid ducts, retromandibular vein, external carotid artery, and its relevant branches were segmented from a computed tomography (CT) angiography study of a healthy female. The object segmentations were exported and refined based on a literature review of relevant anatomical structures. These structures were incorporated into the head and neck model to ensure compatibility with other anatomical structures, such as the mandible and skull base. Following the segmentation of the parotid and submandibular glands, the parotid gland was divided into superficial and deep lobes based on the course of the retromandibular vein. The facial nerve and its branches were added according to the most common anatomical variants. The internal maxillary artery and its first-order branches were identified; when below the resolution of the patient's imaging study, these branches were added according to the most commonly described anatomical variants. This applies to all other neurovascular structures depicted in the final renders. This study demonstrates the critical anatomic landmarks related to surgery of the parotid and submandibular glands, with particular emphasis on vascular structures including the maxillary and facial arteries, the common facial vein, external jugular vein, and retromandibular vein, as well as the facial nerve (CN VII), great auricular nerve, auriculotemporal nerve, lingual nerve, and hypoglossal nerve. The associated 3D model can serve as a helpful tool for improving the understanding of anatomical relationships, particularly in the parotid space.