The Anatomy of the Retromandibular Vein

Table of Contents
View All
Table of Contents

The retromandibular vein is located in the facial area in front of the ear. This is a paired vein, with one on each side of the face. This deep vein of the face drains deoxygenated blood from various parts of the head and itself drains into the jugular veins to return the blood to the heart and lungs.

This article discusses the anatomy, variations, function, and clinical significance of the retromandibular vein.

Also Known As

The retromandibular vein is also called the posterior facial vein.

Human veins illustration, retromandibular vein

SCIEPRO/SCIENCE PHOTO LIBRARY / Getty Images

Anatomy 

The retromandibular vein is formed by the joining of the superficial temporal vein with the maxillary vein. It then passes through the parotid gland (the largest of the salivary glands) behind the mandible (jawbone).

After it emerges from the parotid gland, the retromandibular vein forms two branches: the anterior and the posterior. Venous blood from the retromandibular veins drains into the internal jugular vein and external jugular vein:

  • The anterior retromandibular vein joins with the anterior facial vein. It forms the common facial vein, which drains into the internal jugular vein.
  • The posterior retromandibular vein joins with the posterior auricular vein and forms the external jugular vein. The external jugular eventually drains into the subclavian vein.

The retromandibular vein is a deep vein, meaning it is far from the surface of the body. Unlike superficial veins, deep veins usually have a nearby artery with similar naming. Deep veins are larger and surrounded by muscle.

What Is a Vein?

Veins are part of your body’s circulatory system and help drain deoxygenated blood from the tissues and organs back to the heart to become oxygenated. Oxygenated blood then gets pumped from the heart through the arteries.

Anatomical Variations 

In some people, the retromandibular vein follows different paths on the different sides of the face.

One 2018 study outlines four different retromandibular vein variations that may increase the risk of damage during certain facial surgeries.

Even rarer is when the retromandibular vein is entirely absent. When it’s not present, it can make surgery more difficult. It also changes how blood drains from the head and neck.

Function 

The retromandibular vein drains venous blood from several areas around the head, including the:

  • Jaw
  • Parotid gland
  • Lateral skull
  • Masseter muscle (a large muscle on the side of the head used during chewing)

What Is the Masseter Muscle?

The masseter muscle is a large facial muscle that connects the lower jaw to the cheekbone. It's important for chewing foods. It's one of the strongest muscles in the body.

Deep veins like the retromandibular vein are larger than superficial veins because they transport large amounts of blood back to the heart.

Clinical Significance 

Potential anatomical variations of the retromandibular vein can make surgery in the facial area more difficult. By being aware of potential variations, surgeons can better prepare themselves for tricky facial surgeries.

In the rare case the retromandibular vein is absent, it poses a problem for surgeons who use the vein as a guidepost during certain facial surgeries such as a parotidectomy.

What Is a Parotidectomy?

A parotidectomy is surgery of the parotid gland. The surgery involves the removal of a tumor. A parotidectomy can be superficial or total, depending on the location of the tumor. The surgery requires a lot of skill and precision because of the many facial structures involved.

A study from 2018 outlines several case studies where anatomical variations of the vein were discovered during parotidectomies. Researchers explain that the variations may increase bleeding and nerve injury risk.

The location and variations of the retromandibular vein are also a concern during sagittal split ostomy surgery. This is one of the most common jaw surgeries. It is used to correct malformations of the lower jaw or improve overbite or underbite. Major bleeding or nerve damage can occur if the surgeon is not vigilant for variations.

Summary

The retromandibular vein is a deep facial vein that drains structures of the face, including the lateral (side) of the skull, jaw, parotid gland, and masseter muscle. It drains into the jugular veins. Its location and variation are essential to note when surgeons perform procedures on the parotid gland or jaw.

Was this page helpful?
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sugahara K, Matsunaga S, Yamamoto M, et al. Retromandibular vein position and course patterns in relation to mandible: anatomical morphologies requiring particular vigilance during sagittal split ramus osteotomyAnat Cell Biol. 2020;53(4):444-450. doi:10.5115/acb.20.236

  2. Cleveland Clinic. Blood vessels: Illustrations. Updated April 30, 2019.

  3. Mahore D, Mangalgiri AS, Namdev LN, Kapre M. Variations of retromandibular vein and its relation to facial nerve within parotid glandIndian J Otolaryngol Head Neck Surg. 2018;70(3):395-397. doi:10.1007/s12070-018-1389-1

  4. Patil J, Kumar N, Swamy RS, D'Souza MR, Guru A, Nayak SB. Absence of retromandibular vein associated with atypical formation of external jugular vein in the parotid regionAnat Cell Biol. 2014;47(2):135-137. doi:10.5115/acb.2014.47.2.135

  5. Library of Congress. What is the strongest muscle in the human body?

  6. Patil J, Kumar N, Swamy RS, D'Souza MR, Guru A, Nayak SB. Absence of retromandibular vein associated with atypical formation of external jugular vein in the parotid regionAnat Cell Biol. 2014;47(2):135-137. doi:10.5115/acb.2014.47.2.135

  7. Memorial Sloan Kettering Cancer Center. Parotidectomy (parotid gland tumor surgery).