Sittitavornwong Somsak, Babston Michael, Denson Douglas, Zehren Steven, Friend Jonathan
Associate Professor, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
Resident, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
J Oral Maxillofac Surg. 2017 Jun;75(6):1104-1112. doi: 10.1016/j.joms.2017.01.018. Epub 2017 Jan 26.
Lingual nerve (LN) injury is quite prevalent despite its long-known anatomic course. The purpose of this study was to accurately predict the LN pathway by identifying and measuring close anatomic landmarks; these measurements should help lessen the incidence of LN injury.
LN dissection was carried out on 15 halved cadaver skulls (total, 28 specimens).
On average, the LN position was approximately 7 mm below the alveolar crest at the distal end of the mandibular second molar, 5.5 mm anterior to the lingula, and 14.6 mm distal to the alveolar crest at the mandibular second molar. From the base of the skull, the LN traveled 5 mm anteriorly to the inferior alveolar nerve and inferiorly to the posterior attachment of the mylohyoid muscle (approximately 1.5 cm distal to the mandibular second molar), where it turned anteromedially and traveled 7 mm inferiorly to the alveolar crest at the mandibular second molar.
Given the multiple procedures by dental practitioners and maxillofacial surgeons, the LN is at high risk for injury. This study validates the proximity of the LN to anatomic structures commonly encountered during head and neck procedures.
尽管舌神经（LN）的解剖路径早已为人所知，但其损伤却相当常见。本研究的目的是通过识别和测量紧密相邻的解剖标志来准确预测LN的走行；这些测量结果应有助于降低LN损伤的发生率。
对15个半侧尸体颅骨（共28个标本）进行LN解剖。
平均而言，LN在下颌第二磨牙远端牙槽嵴下方约7mm处、舌骨前5.5mm处以及下颌第二磨牙牙槽嵴远端14.6mm处。从颅底起，LN向前走行5mm至下牙槽神经，向下至下颌舌骨肌后附着点（在下颌第二磨牙远端约1.5cm处），在此处它转向内前方，向下走行7mm至下颌第二磨牙牙槽嵴。
鉴于牙科医生和颌面外科医生会进行多种手术操作，LN有很高的损伤风险。本研究证实了LN与头颈部手术中常见解剖结构的接近程度。
