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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
In the realms of cosmetics, arguably the most important branch of the mandibular nerve is the mental nerve, which branches from the inferior alveolar nerve (an inferior branch of the mandibular nerve) at the lower premolars. The mental nerve then runs anteriorly through the mandibular canal before exiting via the mental foramen allow for sensory innervation of the chin and lower lip. As previously discussed, the mental foramen is can be easily occluded during the augmentation of the chin with deeper fillers, resulting in potentially permanent damage to the distal mental nerve.
Facial Trauma
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
Palpate bilaterally and bimanually to pick up asymmetry.Sensation – Decreased sensation over maxilla can indicate infraorbital nerve damage from maxilla or zygoma fracture, numbness of lower lip (inferior alveolar nerve) or chin (mental nerve) suggests mandible fracture. Assess sensation and motor function BEFORE giving local anaesthetic.Palpate all bone and soft tissues systematically for tenderness, surface irregularities (foreign bodies), steps (fracture) and swelling (oedema, haematoma).Palpate intraorally noting step-offs, lacerations or loose/absent teeth.MovementTest facial nerve motor function (palsy warrants surgical exploration).
Remote Access Endoscopic and Robotic Thyroidectomy
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Unusual complications can also occur. For instance, a transient brachial plexus injury has been reported in the robotic transaxillary approach. Also, the marginal branch of the facial nerve can be injured in the postauricular facelift approach, possibly as a result of a robotic instrument compressing the nerve at the narrow postauricular port [18]. Mental nerve injuries can also occur in the transoral approach.
Does the mandibular lingual release approach impact post-operative swallowing in patients with oral cavity and/or oropharyngeal squamous cell carcinomas: a scoping review
Published in Speech, Language and Hearing, 2023
N. M. Hardingham, E. C. Ward, N. A. Clayton, R. A. Gallagher
In their 2014 paper, W. Li et al. (2014) explored the impact of impaired maxillofacial movement and sensation post-MLRA. They used a clinical rated numeric system rated 1–5 to assess tongue movement, and a similar tool rated 1–3 to assess lip function (based on the systems described by Devine et al. (2001) with a lower score representing better function). The authors showed little functional deficit in tongue movement and lip competence between those who had a MLRA (mean tongue score = 1.5, mean lip score = 1) versus the LSM (mean tongue score = 1.6, mean lip score = 1.04). The paper by H. Li et al. (2015) also examined tongue, lip and mental nerve function. The authors reported improved tongue and lip movement (all p = 0.05), better mental nerve function (lower lip sensation) and less numbness (p-0.05) in the MLRA group compared to the LSM cohort. No discussion was provided regarding the functional implications of this on swallowing. Finally, these researchers found that maxillofacial pain was reported less in the MLRA cohort (7.7%) compared to the LSM group, however, the authors stopped short of discussing the functional implications of this.
Blink reflex monitoring in microvascular decompression for trigeminal neuralgia
Published in Neurological Research, 2021
Tingting Ying, Bei Bao, Yan Yuan, Wenxiang Zhong, Jin Zhu, Yinda Tang, Shiting Li
In this study, 5 of 84 patients whose R1 of the BR did not disappear had complaints of facial numbness after surgery. It is surmised that the R1 evoked in this study was obtained by stimulating the supraorbital nerve (trigeminal V1 branch), so this method can only reflect sensations of the forehead and eyes. If sensations of the cheek, jaw, teeth, gums, and lips are to be monitored, the maxillary (V2) and mandibular (V3) branches of the trigeminal nerve must be stimulated to induce a BR. It was reported that nociception-specific BR can be used to assess nerve damage to the maxillary intraoral regions by using intraoral and extraoral stimulation when awake [13]. The mental nerve BR has been useful in diagnosing sensory loss in the distribution of the mental nerve [14]. However, there are no reports of applying these methods to monitor intraoperative trigeminal sensory function under general anesthesia. The combined application of these BRs may help in monitoring the sensory function of the entire face. We plan to study this in our upcoming research.
Oral mucosa grafting in periorbital reconstruction
Published in Orbit, 2018
Sensory innervation is delivered by the mental nerve, a terminal branch of the inferior alveolar nerve arising from the mandibular division of the trigeminal nerve (CNV3). The mental nerve leaves the mandible via the mental foramen located between the first and second premolar teeth.74,75 The harvesting surgeon must be aware of the risk of lower lip paraesthesia due to the close proximity of the labial mucosa graft harvest site to the mental foramen. The initial incision should be placed medial to the middle of the canines to avoid mental nerve injury. In addition, the surgeon should keep at least a 1–1.5 cm margin away from the lip vermillion to prevent lip contracture and inversion from post-operative scarring.79 Moreover, injury to the orbicularis oris muscle may limit mobility of the lips and impair smiling. Damage to the masticatory mucosa may predispose to periodontal defects if the labial mucosal graft is harvested outside the vestibule vertically near the teeth.74