Vascular territories of the tongue: anatomical study and clinical applications

Abstract

The goal of this cadaver study has to propose the concept of angiosomes of the tongue (arterial cartography) from the notion of lingual artery segmentation, known in the literature since 1998. Fifteen fresh cadaver heads were used in this study. Four selective ink injections were made in specific location of the lingual artery like the segmentation concept. Three mucosal territories of the tongue were defined and they appear dependent on the precise segments of the lingual artery. The territory of the deep lingual artery is the dorsal side of the tongue, the territory of the sublingual artery is the ventral side and the territory depending of the dorsal artery is the root of tongue. No study was published yet about the vascular territories of the tongue. This study brings an additional knowledge and a review about the vascular risk of the tongue resections. The originality of this study consists of the description of vascular territories of tongue proceeding to different segment of lingual artery, which has not been described in the literature since now. The knowledge of these two notions is useful before every tongue resection, which can compromise the vascularity of the remaining tongue, and at the time of the lingual revascularization, once this vascularity is compromise.

Histopathologic Evaluations of the Lingual Artery in Healthy Tongue of Adult Cadaver

“…There were a few studies about anatomical distributions of the lingual artery using computed tomographic angiography, Doppler sonography and cadaveric tongue [2-5,8]. Hou et al [2] analyzed the lingual artery to define safety space for functional surgery of the tongue using computed tomographic angiography.…”

“…Kimura et al [4] used Doppler sonography to evaluate the lingual artery at the midpoint of tongue. Lopez et al [5] studied about vascular territory of the lingual artery using selective ink injections in 15 fresh cadaver heads. But none of these studies researched histologic features of the lingual artery on mobile tongue.…”

The definition of the V zone for the safety space of functional surgery of the tongue

“…One study of angiosomes confirmed the vascular abundance of the tongue and described the lingual territories as follows: the territory of the deep lingual artery is the dorsal side of the tongue, the sublingual artery is the ventral side, and the dorsal artery is the tongue base 14. In fact, the deep lingual arteries can be reflected indirectly on the dorsal tongue, and the lingual arteries, including the sublingual arteries, are below the level of the middle of the lingual frenulum.…”

Bilateral Asynchronous Renal Cell Carcinoma with Metastatic Involvement of the Tongue

“…Metastatic involvement of the anterior tongue, as seen in our case, whilst previously reported by others, occurs much less commonly [2, 3]. The predilection for the tongue may be related to its complex vascular anatomy [9]. Production of tumour-induced cytokines in RCC, including angiogenic factors, mediators of extracellular matrix remodelling, and those that promote escape from immune-surveillance, may underlie its propensity for haematogenous spread [5].…”