Zdilla Matthew J, Mangus Kelsey R, Swearingen Jordan V, Miller Kyle D, Lambert H Wayne
Department of Natural Sciences and Mathematics, West Liberty University, CSC 139, P.O. Box 295, West Liberty, WV, 26074, USA.
Department of Graduate Health Sciences, West Liberty University, West Liberty, WV, USA.
Surg Radiol Anat. 2018 Dec;40(12):1429-1436. doi: 10.1007/s00276-018-2110-5. Epub 2018 Oct 10.
Submental anatomical variation is of clinical importance with regard to head and neck surgeries. One such anatomical variation is that of additional musculature joining the intermediate tendon of the digastric muscle to the midline of the mylohyoid musculature-a variation which this report refers to, accordingly, as an arrowhead variation. Though the arrowhead variation has been described in several case reports, it has not been subject to cross-sectional study. The purpose of this study is to determine the prevalence of the arrowhead variation.
Prevalence of the arrowhead variation was assessed in 19 cadavers via gross dissection.
Two of the 19 cadavers (10.5%) were found to have arrowhead variations. The arrowhead variation was found in one male (1:11; 9.1%) and one female (1:8; 12.5%), respectively.
This report demonstrates that the submental arrowhead variation of the anterior digastric and mylohyoid musculature has been reported in isolated case reports since the nineteenth century. This report is the first cross-sectional study of the arrowhead variant, identifying it in approximately one in ten individuals and in both sexes. Therefore, the presence of an arrowhead variation should be regularly considered with regard to diagnosis of submental masses. Likewise, the arrowhead variation should be considered in the preoperative planning of the myriad operations performed in the submental region.
颏下解剖变异在头颈外科手术中具有临床重要性。其中一种解剖变异是额外的肌肉组织将二腹肌中间腱与下颌舌骨肌的中线相连——本报告相应地将这种变异称为箭头样变异。尽管箭头样变异已在多篇病例报告中有所描述,但尚未进行横断面研究。本研究的目的是确定箭头样变异的发生率。
通过大体解剖对19具尸体评估箭头样变异的发生率。
19具尸体中有2具(10.5%)发现有箭头样变异。箭头样变异分别在1名男性(1:11;9.1%)和1名女性(1:8;12.5%)中发现。
本报告表明,自19世纪以来,孤立的病例报告中就已报道过二腹肌前肌和下颌舌骨肌的颏下箭头样变异。本报告是对箭头样变异的首次横断面研究,发现约十分之一的个体以及男女两性中均存在该变异。因此,在诊断颏下肿物时应经常考虑箭头样变异的存在。同样,在颏下区域进行的众多手术的术前规划中也应考虑箭头样变异。