Extraoral ligation of the lingual artery: an anatomic study.

OBJECTIVES

This article's purpose is to describe the variation in lingual artery position, review the anatomy and historical background of the smaller triangles of the anterior aspect of the neck, and discuss management of intraoral hemorrhage arising from the lingual artery.

STUDY DESIGN

Ninety-one extraoral dissections of the submandibular region were performed on 54 human cadavers.

RESULTS

Pirogoff's triangle was present in 58.2% of the cases. The lingual artery was inferior to the digastric tendon in 67% and 6.3 mm (+/-3.9 mm) superior to the hyoid bone. The lingual artery was inferior to the hypoglossal nerve in 84.6%, directly deep to the nerve in 11%, and superior to the nerve in 4.4%.

CONCLUSIONS

The lingual artery and hypoglossal nerve were more inferior than classically described. This finding suggests the need for a refinement of the extraoral ligation procedure, in which the facial artery is ligated first, and then, if necessary, the lingual artery is clamped and tied.