Purpose: Lingual nerve (LN) injury is quite prevalent despite its long-known anatomic course. The purpose of this study was to accurately predict the LN pathway by identifying and measuring close anatomic landmarks; these measurements should help lessen the incidence of LN injury.
Materials and methods: LN dissection was carried out on 15 halved cadaver skulls (total, 28 specimens).
Results: On average, the LN position was approximately 7 mm below the alveolar crest at the distal end of the mandibular second molar, 5.5 mm anterior to the lingula, and 14.6 mm distal to the alveolar crest at the mandibular second molar. From the base of the skull, the LN traveled 5 mm anteriorly to the inferior alveolar nerve and inferiorly to the posterior attachment of the mylohyoid muscle (approximately 1.5 cm distal to the mandibular second molar), where it turned anteromedially and traveled 7 mm inferiorly to the alveolar crest at the mandibular second molar.
Conclusion: Given the multiple procedures by dental practitioners and maxillofacial surgeons, the LN is at high risk for injury. This study validates the proximity of the LN to anatomic structures commonly encountered during head and neck procedures.
Published by Elsevier Inc.