Retromandibular vein: anatomy behind the jaw
- Vein
Quick facts
- Formation
- Union of the superficial temporal vein with the maxillary vein, inside the parotid gland, behind the neck of the mandible.
- Course
- Descends inside the parotid, behind the ramus of the mandible, to near the angle.
- Division
- Anterior branch, which joins the facial vein, and posterior branch, which forms the external jugular vein with the posterior auricular vein.
- Relationships
- Inside the parotid, it lies deep to the facial nerve and superficial to the external carotid artery.
- Relevance in HOF
- Large-caliber vessel at the angle and the parotid; a landmark in the anatomy of the lateral lower third.
The retromandibular vein is the vein formed by the union of the superficial temporal vein with the maxillary vein, inside the parotid gland, just behind the neck of the mandible. It descends behind the ramus of the mandible and, near the angle, divides into an anterior branch, which joins the facial vein, and a posterior branch, which takes part in forming the external jugular vein. In orofacial harmonization (HOF), it is a landmark in the anatomy of the region of the angle of the mandible and the parotid.
What is the course of the retromandibular vein?
| Segment | What happens |
|---|---|
| Origin | The superficial temporal vein (from the temple) and the maxillary vein (from the deep face) join behind the neck of the mandible |
| Inside the parotid | Descends through the gland, behind the ramus of the mandible |
| Near the angle | Divides into an anterior branch and a posterior branch |
| Anterior branch | Joins the facial vein and forms the common facial vein, which drains into the internal jugular vein |
| Posterior branch | Joins the posterior auricular vein and forms the external jugular vein |
The division pattern varies considerably between people, and in some cases the vein runs lateral to the facial nerve or has different divisions.
What is the relationship with the facial nerve and the carotid?
Inside the parotid, three structures cross the gland in layers. From the surface to the depth, the most commonly described order is: facial nerve, retromandibular vein and external carotid artery. That is why the vein is used as a landmark in parotid surgery to locate the nerve. The maxillary vein, which forms the retromandibular vein, comes from the pterygoid plexus, in the deep region of the face.
Why does it matter in HOF?
- Angle of the jaw: the area behind and below the angle concentrates the parotid, the retromandibular vein and branches of the facial nerve. Knowing this anatomy is part of planning jawline filler.
- Toxin in the masseter: the posterior border of the masseter borders the parotid. Injecting outside the muscle, toward the gland, is one of the cited causes of unwanted effects, a topic covered in botulinum toxin in the masseter.
- Bruising: large-caliber veins at the angle explain more extensive bruising when they are hit.
How does it show up in the assessment?
- Palpation of the angle and the parotid: a lump, pain or nodule in the area calls for investigation before any procedure.
- History of parotid surgery or disease: changes the local anatomy.
- Use of anticoagulants: raises the chance of bruising in areas with large-caliber veins.
Also called: posterior facial vein, vena retromandibularis.
Frequently asked questions
Where is the retromandibular vein?
Behind the ramus of the mandible, inside the parotid gland, between the ear and the angle of the jaw. It forms near the neck of the mandible and descends to the region of the angle, where it divides.