Anatomic Location of the Tongue Base Neurovascular Bundle

Abstract

Knowledge of the location of the hypoglossal/lingual artery neurovascular bundle (HLNVB) is essential in performing tongue base resections for neoplasm and for obstructive sleep apnea. Transoral and transcervical resections of the tongue base may be performed with greater exposure and certainty when the relationship of the HLNVB to local landmarks is understood; knowledge of the HLNVB allows resection of a larger amount of contralateral tongue base during partial glossectomy without violating the contralateral remnant tongue's blood supply. Ten cadaver heads were dissected to determine the position of the HLNVB with respect to soft tissue and bony landmarks at the tongue base. Our results indicate the position of the tongue base HLNVB is significantly inferior and lateral, that is, 2.7 cm inferior and 1.6 cm lateral to the foramen cecum, 0.9 cm superior to the hyoid bone, and 2.2 cm medial to the mandible. This inferolateral location allows the potential for aggressive tongue base resection without neurovascular compromise.

Surgical treatment of macroglossia in patients with Beckwith–Wiedemann syndrome: a 20-year experience and review of the literature

“…Knowledge of the anatomy of the tongue and the position of the lingual nerve is essential to allow safe performance of surgical tongue reduction for the treatment of macroglossia 48 . Whilst reducing the tongue, it is important to preserve the inferolateral neurovascular bundles and at the same time maintain the tongue shape 2,15,23,31,48 .…”

Distribution of the hypoglossal nerve at the base of the tongue and its clinical importance in radiofrequency ablation therapy

“…The hypoglossal nerve enters the tongue inferolaterally (2,10,17). According to Touré et al 's (16) study on 6 human tongues with Sihler coloration technique, the hypoglossal nerve penetrated into the tongue at the junction between the posterior quarter and anterior three-quarters, with an obliquely ventral and medial course, and from its entry into the tongue it divided into a bunch of 8 first-order branches.…”

“…There were some measurements of the neurovascular structures of the tongue base in previous studies (10,18). Lauretano et al (10) dissected 10 cadaver heads to determine the position of the neurovascular bundle of the hypoglossal nerve and lingual artery with respect to soft tissue and bony landmarks at the tongue base.…”

Our experiences with tongue base radiofrequency, for treatment of obstructive sleep apnea

“…Bu noktada dikkat edilmesi ve bilinmesi gereken nokta lingual arter ve hipoglossal sinirin bu bölge ile olan yakın komşuluk özellikleridir. 15 Uygulama sırasında bu iki önemli yapıda gelişebilecek hasarlar ciddi komplikasyonlar ile sonuçlanabilir. Bu nedenle son zamanlarda bu tür komplikasyon risklerini azaltmak iddiası ile transservikal yol ile skopi eşliğinde uygulamalar yapıl-maya başlanılmıştır.…”