American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which nerve is most commonly injured during a parotidectomy?

1. Lingual nerve

2. Glossopharyngeal nerve

3. Greater auricular nerve

4. Inferior alveolar nerve

The correct answer is: Greater auricular nerve

During a parotidectomy, the most commonly injured nerve is the greater auricular nerve. This nerve is responsible for providing sensation to the skin over a portion of the external ear and the area overlying the parotid gland. During surgical procedures involving the parotid gland, especially when removing tumors or managing other pathologies, the greater auricular nerve may inadvertently be cut or damaged due to its proximity to the surgical field. Surgeons often take care to identify and preserve this nerve; however, its position makes it at risk during dissection. Other nerves listed, such as the lingual nerve and the inferior alveolar nerve, while important in oral and facial sensation, are not as directly at risk during a parotidectomy due to their anatomical locations being more remote from the surgical site. The glossopharyngeal nerve, known for its function in taste and sensation in the oropharynx, is also less likely to be affected in this type of surgery. Understanding the anatomy and common complications associated with parotidectomy helps in improving surgical technique and minimizing nerve injuries during the procedure.