Alteration of chin sensibility due to damage of the cutaneous branch of the mylohyoid nerve during genioplasty

Guyot, Laurent; Layoun, W.; Richard, Olivier; Cheynet, F; Gola, R

doi:10.1053/joms.2002.35753

Cited by 33 publications

(19 citation statements)

References 10 publications

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“…Moreover, accessory innervation of mandibular anterior and posterior teeth pulp by the mylohyoid nerve's sensory components is thought to be one reason for failure in the anesthesia of the inferior alveolar nerve. [4][5][6][7] Therefore, it is important for the clinician to be aware of variations in the mylohyoid groove and in the position and course of the mylohyoid nerve within this groove.…”

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A Mylohyoid Nerve Traveling Within The Mandibular Canal: A Case Report

Kılıç¹,

Kamburoğlu²,

Özen³

2008

TUTFD

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Nervus mylohyoideus n. trigeminus'un bir dalı olan n. mandibularis'in bir dalıdır ve mandibula iç yüzündeki sulcus mylohyoideus'ta seyreder. Bu sinir m. mylohyoideus ve m. digastricus'un ön karnını uyarır. Bu olgu raporu sinirin seyrindeki muhtemel bir varyasyona ışık tutar. Burada sunulan olguda, kırk dokuz yaşındaki bir erkek kadavranın rutin diseksiyonu sırasında, n. mylohyoideus mandibula'nın sağ tarafında mandibular kanal içerisinde seyrediyordu. Dental volumetrik tomografi ve görüntüleme sonrası diseksiyon ile mandibula içerisindeki kanalın ve sinirlerin pozisyonu değerlendirildi. Sağ yarım mandibula'ya sekiz seri halde kesit uygulandı ve sinirin beşinci, altıncı ve yedinci kesitlerde mandibular kanal içerisinde seyrettiği gözlendi. Sinir osteotomi ve tükürük bezi operasyonları gibi mandibula'nın cerrahi işlemleri esnasında hasar görebilir. Ek olarak, n. mylohyoideus'un duyu içeren dalları tarafından ön ve arka diş pulpalarının aksesuar sinir desteğinin n. alveolaris inferior'un anestezisinin yetersizliğinin sebeplerinden biri olabileceğini düşündürür. Klinisyenler mandibular kanal içeri-sinde seyreden bir n. mylohyoideus'un bulunmasından kaynaklanabilecek olan komplikasyonların farkında olmalıdırlar.Anahtar sözcükler: Mandibula; nervus mylohyoideus; nervus alveolaris inferior; varyasyon; mandibular yaralanmalar.The mylohyoid nerve is a branch of the mandibular division of the trigeminal nerve and travels through mylohyoid groove in the medial side of the mandible. This nerve innervates the mylohyoid muscle and the anterior belly of the digastric muscle. This case report highlights one possible variation in the course of the nerve. In the case presented here, mylohyoid nerve traveled within mandibular canal in the right side of a mandible on routine dissection of a 49-year-old male cadaver. The position of the canal and nerves within the mandible was assessed from dental cone-beam computed tomography images and by dissection after imaging. The right hemi-mandible was cut into eight serial, and the nerve was observed to travel within the mandibular canal in the 5th, 6th and 7th bony slices. The nerve can be damaged during surgical procedures of the mandible such as osteotomy and salivary gland operations. In addition, accessory innervation of anterior and posterior mandibular teeth pulp by sensory components of the mylohyoid nerve is thought to be one reason for the failure of anesthesia of the inferior alveolar nerve. Clinicians should be aware of complications that may arise from a mylohyoid nerve travelling within the mandibular canal.

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A Mylohyoid Nerve Traveling Within The Mandibular Canal: A Case Report

Kılıç¹,

Kamburoğlu²,

Özen³

2008

TUTFD

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“…This complication could be explained by selective local anesthetic infiltration of the mylohyoid nerve which causes submental analgesia 9 . The severity and clinical onset of the disturbance is determined by the grade of injury to the mylohyoid nerve 5 . The reported mylohyoid nerve injuries were attributed to: hyperextension of the neck during removal of an impacted lower third molar by lingual split technique 7 ; reduction of mylohyoid ridge 9 ; dissection of mylohyoid muscle prior to excision of submandibular gland 1,8 ; symphis/parasymphisial fractures; and sectioning of muscles in the floor of the mouth during genioplasty 4 .…”

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“…The major complication of genioplasty is a transient or permanent alteration in the neurosensorial function of the lower lip 3 . Neurosensorial disturbance, generally related to intraoperative stress to the mental nerve, is caused by retraction, stretching, axonotmesis with periostal elevators, retractors, saw, or osteotomes 3,5 .…”

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“…Injury to the mylohyoid nerve during genioplasties and digastric myotomies is likely to occur following aggressive stripping of the soft tissue pedicle attached to the inferior and medial aspect of the mandibular symphis 5 . Sensory innervation of the submental skin island is provided by the cutaneous branch of the mylohyoid nerve (CBMN), which can be injured by sectioning the anterior belly of the digastric muscles and the mylohyoid muscles 4,5 .…”

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“…Sensory innervation of the submental skin island is provided by the cutaneous branch of the mylohyoid nerve (CBMN), which can be injured by sectioning the anterior belly of the digastric muscles and the mylohyoid muscles 4,5 . Sensory disorders (hypoesthesia, anesthesia) of the submental skin region can occur in the case of a mylohyoid nerve injury without any damage to the mental nerves 1,3,4,8 .…”

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