Dual innervation of the mylohyoid muscle by the trigeminal and hypoglossal nerves: A case report

Preservation of the Nerve to the Mylohyoid Muscle During Submental Island Flaps: An Anatomic Feasibility Study for Facial Nerve Reanimation Procedures

“…There are various variations in the innervation of the mylohyoid muscles 35–37 . Iwanaga et al 35 reported a rare variant of branching from the lingual nerve to the nerve to the mylohyoid muscle.…”

“…Cooper et al 36 reported another rare case where the nerve to the mylohyoid muscle originated from both the inferior alveolar and lingual nerves. Shen et al 37 reported an extremely rare case in which the mylohyoid muscle was innervated by both the trigeminal and hypoglossal nerves. Such variations in the innervation and nerve course can lead to clinical consequences such as anesthetic failure and iatrogenic injury during surgical procedures in this region 37 …”

Mylohyoid Muscle: Current Understanding for Clinical Management—Part I: Anatomy and Embryology

“…The former is a motor nerve innervating the extrinsic muscles of the tongue (genioglossus, hyoglossus, and styloglossus), as well as the intrinsic muscles. Shen et al 48 and Madhyastha et al 49 reported cases in which the hypoglossal nerve gave branches to the ansa cervicalis and the thyrohyoid muscle, and then proceeded forward superficially to the hypoglossal muscle and gave branches to the mylohyoid muscle. Zhan and colleagues found communication between the lingual nerve and the nerve to the mylohyoid muscle through the mylohyoid muscle within the submandibular triangle.…”

“…Such communications between the lingual nerve and the nerve to the mylohyoid muscle are found in 1.45% to 12.5% of cases 50–54 . These dual innervations are thought to be embryological in origin; the density of the nerve cord about the pharyngeal arches changes during development, extending branches to areas different from the original pharyngeal arch and having different roles, for example, motor function and proprioception, as seen in the trapezius and sternocleidomastoid muscles 48,55 …”

Localizing the nerve to the mylohyoid using the mylohyoid triangle

“…Additionally, the lingual nerve often communicates with the nerve to the mylohyoid muscle [2]. Aberrant branching of the nerve and dual innervation of the mylohyoid muscle by the nerve to the mylohyoid muscle and hypoglossal nerve have been reported [16][17][18].…”