Anatomy of the Skull Base and Infratemporal Fossa
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
The posterior division is sensory, except for the mylohyoid nerve. The auriculotemporal nerve springs from two roots, which pass either side of the MMA, and pass backwards between the sphenomandibular ligament and neck of the mandible. The inferior alveolar nerve swings downwards on the surface of the medial pterygoid muscle, passes between the sphenomandibular ligament and neck of the mandible, and gives off the mylohyoid nerve before entering the mandibular foramen. The lingual nerve is joined by the chorda tympani 2 cm below the base of the skull and passes downwards and forwards on the medial pterygoid, grooving the mandible before entering the mouth.
Head and Neck
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
The major vessels and nerves that supply the tongue include the lingual artery, which gives rise to the deep lingual artery; the lingual vein; the lingual nerve; and the hypoglossal nerve (Plate 3.41; described in detail in Section 3.3.2.1). The latter two structures pass between the hyoglossus muscle and the mylohyoid muscle, along with the submandibular duct. The lingual nerve gives rise to branches supplying the mucosa of the anterior two-thirds of the tongue with taste fibers and general sensation, as well as carrying postganglionic parasympathetic fibers from the submandibular ganglion.
The salivary glands
Neeraj Sethi, R. James A. England, Neil de Zoysa in 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
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.