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The salivary glands
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Assess for signs of tumour involvement in closely related nerves: Lingual nerve: Numbness of tongueHypoglossal nerve: Weakness of tongueFacial nerve: Weakness of the lower lip
Oral Cavity Tumours Including Lip Reconstruction
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Motor innervation to muscles of the tongue is via the hypoglossal nerve, except palatoglossus which is supplied by the vagus nerve. Sensation of the tongue is supplied by the lingual nerve, a branch of the mandibular division of the trigeminal nerve. Taste sensation of the oral tongue is supplied by fibres of the facial nerve that run with the lingual nerve before passing to the chorda tympanic branch of the facial nerve.
Clinical Neuroanatomy
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
The posterior trunk is mainly sensory and divides into three main nerves: The auriculotemporal nerve, which passes behind the temporomandibular joint to join the facial nerve with which it is distributed to supply the skin over the tragus, helix, auditory meatus and tympanic membrane and, via superficial temporal branches, to the skin over temporalis. It also conveys the secretomotor fibres to the parotid gland and fibres derived from the tympanic branch of the glossopharyngeal nerve via the otic ganglion (see ‘The facial nerve (VII)’ below).The lingual nerve, which carries sensation from the presulcal tongue, the floor of the mouth and lower gums. It also carries the taste fibres of the chorda tympani from the mucous membranes of the anterior two-thirds of the tongue and conveys secretomotor fibres from the submandibular ganglion to the sublingual and anterior lingual glands. It communicates with the hypoglossal nerve.The inferior alveolar (dental) nerve enters the mandibular canal running forwards in the mandible to re-emerge on the chin at the mental foramen dividing into the incisive and mental branches, supplying sensory fibres to the skin and mucous membrane of the lower lip, jaw, incisor and canine teeth. The motor component of the posterior trunk leaves the inferior alveolar nerve, just before it enters the mandibular canal, as the mylohyoid nerve supplying mylohyoid and the anterior belly of digastric.
Is it possible to extract lower third molars with infiltration anaesthesia techniques using articaine? A double-blind randomized clinical trial
Published in Acta Odontologica Scandinavica, 2021
Rui Figueiredo, Stavros Sofos, Eduardo Soriano-Pons, Octavi Camps-Font, Gemma Sanmarti-García, Cosme Gay-Escoda, Eduard Valmaseda-Castellón
One of the most severe complications of IANB is injury to the inferior alveolar and/or lingual nerves [1,2]. Fortunately, these injuries are rarely associated with IANB and the estimated incidence is extremely low [25,26]. Nevertheless, clinicians should take into consideration the possible medicolegal repercussions of these complications [27]. Several authors have discussed whether such lesions are associated with mechanical (needle) or chemical (anaesthetic solution) injury of the nerve. Some papers have suggested that prilocaine and articaine are more likely to produce nerve impairment after nerve blocks [28,29]. Hillerup et al. [30] considered that this issue is probably related to the concentration of articaine (4%), which, according to these authors, might be neurotoxic. According to another paper by the same group [31], however, sensory impairment following the use of articaine is estimated at 1 case out of 4.8 million. Nonetheless, these complications can have important repercussions for the patient’s quality of life, particularly when neuropathic pain develops [32], and should therefore be avoided. The present results seem to support the literature concerning the higher vulnerability of the lingual nerve in comparison with the inferior alveolar nerve [1], since 7 of the IANB group patients experienced a sensation of electric discharge in the tongue, against 3 in the lower lip.
Is it possible that direct rigid laryngoscope-related ischemia–reperfusion injury occurs in the tongue during suspension laryngoscopy as detected by ultrasonography: a prospective controlled study
Published in Acta Oto-Laryngologica, 2020
Merih Onal, Bahar Colpan, Cagdas Elsurer, Mete Kaan Bozkurt, Ozkan Onal, Alparslan Turan
Suspension laryngoscopy (SL) is a surgical procedure and the main component of widespread laryngeal microsurgery performed for both diagnostic and therapeutic purposes. In this procedure, a rigid direct laryngoscope is inserted orally, and the tongue and the base of the tongue are compressed with a pressure exceeding 1000 mmHg [1]. The laryngoscope is suspended on a Mayo Trolley by using a suspender (SL), and it applies pressure on the tongue throughout the procedure [2]. The most common important complications of SL are difficulty in airway management, bleeding, and pneumothorax [3]. Given the upper airway manipulations due to the nature of the SL procedure, complications such as laryngospasm and edema may jeopardize airway management [3]. Minor injuries due to SL occur between 31% and 75% and most of this injuries involve the lips, tongue, and the oropharynx. The most reported tongue complication in the literature is taste and sensory impairment due to lingual nerve damage [2]. This pattern was observed because a lingual nerve can be directly damaged [2]. The presumed cause of lingual nerve injury is direct pressure or tension damage due to suspension of a laryngoscope or due to cricoid compression made by surgeons during the procedure [4]. Ultrasonography (USG) is an inexpensive method that can completely reveal soft tissues, and it does not have any radiation risk [5]. The tongue is an organ consisting of multiple muscle groups that are structurally similar to skeletal muscle [5]. Thus, the tongue is an ideal organ for evaluation with USG. Studies have shown that the tongue can be easily visualized by USG when the USG probe is placed on the skin; as a result, the base area and thickness of the tongue can be measured accurately [6].
Clinical application of a curved video suspension laryngoscope in laryngeal surgery
Published in Acta Oto-Laryngologica, 2022
Hangjin Li, Wei Zhang, Hui Qu, Jizhe Wang
Tessema et al. highlighted the importance of limiting the suspension time [18], and concluded that longer surgeries incurred a higher risk of tongue-related complications. In our study, two of 39 patients had temporary lingual nerve injury after conventional SL. Notably, we were able to reduce the surgical time to an average of 10 min when using the curved video SL system. A reduction in surgical time may allow the use of lower amounts of general anesthetics, induction agents, and neuromuscular blocking drugs, thus enabling a shorter recovery time.