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Obata K, Kitagawa N, Ono K, Kanemoto H, Fukino K, Takeshita Y, Ibaragi S, Tubbs RS, Iwanaga J. Mylohyoid Muscle: Current Understanding for Clinical Management-Part I: Anatomy and Embryology. J Craniofac Surg 2024; 35:251-255. [PMID: 37948619 DOI: 10.1097/scs.0000000000009812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/26/2023] [Indexed: 11/12/2023] Open
Abstract
The mylohyoid is one of the suprahyoid muscles, along with the geniohyoid, digastric, and stylohyoid muscles. It lies between the anterior belly of the digastric muscle inferiorly and the geniohyoid superiorly. In Part I, the anatomy and embryology of the mylohyoid muscle will be reviewed in preparation for the clinical discussion in Part II.
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Affiliation(s)
- Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Norio Kitagawa
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Kisho Ono
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Hideka Kanemoto
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Keiko Fukino
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Richard S Tubbs
- Departments of Neurosurgery
- Neurology, Tulane Center for Clinical Neurosciences
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA
- University of Queensland, Brisbane, Australia
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
- Departments of Neurosurgery
- Neurology, Tulane Center for Clinical Neurosciences
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA
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Ono K, Ibaragi S, Obata K, Okui T, Kitagawa N, Tubbs RS, Iwanaga J. Preservation of the Nerve to the Mylohyoid Muscle During Submental Island Flaps: An Anatomic Feasibility Study for Facial Nerve Reanimation Procedures. J Craniofac Surg 2023; 34:2201-2205. [PMID: 37552139 DOI: 10.1097/scs.0000000000009589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/17/2023] [Indexed: 08/09/2023] Open
Abstract
The submental island flap is an axial pattern pedicle flap widely used in head and neck surgery because of its ease and success. Indications of the submental island flap range from reconstruction for the malignant tumor resection to loss of temporal bone and facial skin due to trauma. Whereas, intraoperative facial nerve injury is not uncommon. We verified whether it was possible to localize the nerve to the mylohyoid muscle and reanimate the facial nerve during submental island flap procedures by preserving the mylohyoid muscle using human fresh cadaveric specimens. Six cadaveric heads were dissected and the position of the nerve to the mylohyoid muscle identified to the mylohyoid triangle documented. We identified the nerve to the mylohyoid muscle on all sides within the mylohyoid triangle and were able to separate the nerve from the submental island flap completely. Our results suggest that facial nerve reanimation using the nerve to the mylohyoid muscle can be used while reconstructing with a submental island flap in cases of intraoperative facial nerve injury.
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Affiliation(s)
- Kisho Ono
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Tatsuo Okui
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane
| | - Norio Kitagawa
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Iwanaga J, Ibaragi S, Okui T, Divi V, Ohyama Y, Watanabe K, Kusukawa J, Tubbs RS. Cutaneous branch of the nerve to the mylohyoid muscle: potential cause of postoperative sensory alteration in the submental area. Ann Anat 2022; 243:151934. [PMID: 35307555 DOI: 10.1016/j.aanat.2022.151934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Previous studies suggest that the nerve to the mylohyoid muscle could have a cutaneous branch. However, its clinical relevance has rarely been discussed because there is insufficient evidence for it. Our aim in this study was to investigate the anatomy of the cutaneous branch of the nerve to the mylohyoid muscle and extend the discussion to surgical management. METHODS Twenty sides from ten embalmed cadaveric heads were dissected to identify the cutaneous branch of the nerve to the mylohyoid muscle. The cutaneous branch was traced up to its termination. RESULTS The cutaneous branch was observed in 90% and classified into types I and II. In type I, the terminal trunk reached the anterior belly of the digastric muscle. In type II there were two types of terminal trunks, superior and inferior branches, which were identified on all sides. The number of the terminal trunk was one in 23.1% (type I; 6/26) and two in 76.9% (type II; 20/26).The terminal points of the cutaneous branch were all located within a 3cm×2cm rectangular segment in the center of the submental area. CONCLUSIONS We propose a new dermatome including the nerve to the mylohyoid muscle in the center. Understanding the cutaneous branch of the nerve could help surgeons to prevent iatrogenic sensory loss of the submental area.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tatsuo Okui
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Vasu Divi
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan; Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichi Watanabe
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA; Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA; University of Queensland, Brisbane, Australia
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Iwanaga J, Kim HJ, Wysiadecki G, Obata K, Harazono Y, Ibaragi S, Tubbs RS. Localizing the nerve to the mylohyoid using the mylohyoid triangle. Anat Cell Biol 2021; 54:304-307. [PMID: 33941711 PMCID: PMC8493024 DOI: 10.5115/acb.21.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/18/2021] [Accepted: 04/05/2021] [Indexed: 11/27/2022] Open
Abstract
The nerve to the mylohyoid muscle has been well studied but there are no specific anatomical landmarks for identifying it. Therefore, we aimed to identify anatomical landmarks for localizing the nerve to the mylohyoid muscle in the submandibular region. Sixteen sides from eight embalmed Caucasian cadaveric heads were used in this study. The mean age at the time of death of the specimens was 80.3 years. The anterior and posterior bellies of the digastric muscle, submental artery, and mylohyoid muscle were dissected to verify their relationships with the nerve to the mylohyoid muscle. The nerve to the mylohyoid muscle was found medial to the submental artery, lateral to the anterior belly of the digastric muscle, and anterior to the posterior border of the mylohyoid muscle on all sides. Herein, we identified what we term the mylohyoid triangle. This anatomical region can help localize the nerve to the mylohyoid muscle.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Harazono
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
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Loureiro RM, Collin J, Sumi DV, Araújo LC, Murakoshi RW, Gomes RLE, Daniel MM. Postoperative CT findings of orthognathic surgery and its complications: A guide for radiologists. J Neuroradiol 2021; 49:17-32. [PMID: 33864896 DOI: 10.1016/j.neurad.2021.04.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/01/2022]
Abstract
Orthognathic surgery is the standard procedure to correct congenital, developmental, or acquired dentofacial deformities. The maxillomandibular relationship corrected by orthognathic surgery can improve facial esthetics, masticatory function, articulation, and breathing. The most common types of osteotomies include the combination of Le Fort I osteotomy, bilateral sagittal split mandibular ramus osteotomy, and genioplasty. High-resolution low-dose computed tomography is useful for evaluating the facial skeleton and soft tissues after surgery as well as for depicting a variety of possible complications. This article reviews the postoperative imaging findings of the most common orthognathic surgeries and their potential complications on multidetector-row computed tomography.
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Affiliation(s)
- Rafael Maffei Loureiro
- Hospital Israelita Albert Einstein, Department of Radiology, Av. Albert Einstein, 627/701, 05652-900 São Paulo, SP, Brazil.
| | - John Collin
- Bristol Royal Infirmary, Department of Oral and Maxillofacial Surgery, Marlborough Street, Bristol BS2 8HW, United Kingdom.
| | - Daniel Vaccaro Sumi
- Hospital Israelita Albert Einstein, Department of Radiology, Av. Albert Einstein, 627/701, 05652-900 São Paulo, SP, Brazil.
| | - Luziany Carvalho Araújo
- Hospital Israelita Albert Einstein, Department of Radiology, Av. Albert Einstein, 627/701, 05652-900 São Paulo, SP, Brazil.
| | - Rodrigo Watanabe Murakoshi
- Hospital Israelita Albert Einstein, Department of Radiology, Av. Albert Einstein, 627/701, 05652-900 São Paulo, SP, Brazil.
| | - Regina Lucia Elia Gomes
- Hospital Israelita Albert Einstein, Department of Radiology, Av. Albert Einstein, 627/701, 05652-900 São Paulo, SP, Brazil.
| | - Mauro Miguel Daniel
- Hospital Israelita Albert Einstein, Department of Radiology, Av. Albert Einstein, 627/701, 05652-900 São Paulo, SP, Brazil.
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Ryumon S, Hage D, Ibaragi S, Okui T, Tubbs RS, Iwanaga J. Dual innervation of the submandibular gland by nerve to mylohyoid and chorda tympani. Morphologie 2020; 105:316-318. [PMID: 33288421 DOI: 10.1016/j.morpho.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
The chorda tympani typically utilises the lingual nerve and submandibular ganglion to transmit parasympathetic fibres to the submandibular gland. During a routine anatomy dissection, the submandibular gland was found to be innervated by both the lingual nerve and the nerve to mylohyoid. The clinical implications of this variant dual innervation to the submandibular gland is not clear due to its rarity: however, recognising such a variation should be borne in mind during surgical intervention near the nerve to mylohyoid.
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Affiliation(s)
- S Ryumon
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - D Hage
- Department of Neurosurgery, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - S Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - T Okui
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - R S Tubbs
- Department of Neurosurgery, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurology, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
| | - J Iwanaga
- Department of Neurosurgery, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurology, Tulane Centre for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
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Kini S, Somayaji K, Acharya S, Sampath S. Anomalies and Clinical Significance of Mylohyoid Nerve: A Review. Clin Cosmet Investig Dent 2020; 12:429-436. [PMID: 33116912 PMCID: PMC7586056 DOI: 10.2147/ccide.s269882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background The mylohyoid nerve is a branch of the inferior alveolar nerve (IAN), which is a branch of the posterior division of the mandibular nerve (MN). It is the source of motor nerve supply to the mylohyoid and anterior belly of the digastric muscle. At times, it provides sensory innervation to the mandibular teeth and skin below the chin. Since the location, anatomical variation and communications of the mylohyoid nerve are varied, it becomes clinically important to have an in-depth knowledge when treating patients for dental and maxillofacial procedures. Such anatomical variations of the mylohyoid nerve innervations may account for failure of the nerve blocks and hence, knowledge is very important for the practitioner. Materials and Methods A thorough literature search was done using the key words mandibular nerve, communications of the mylohyoid nerve, inferior alveolar nerve, lingual nerve, failure of dental anaesthesia, mylohyoid nerve and dental implants "from the Databases - PubMed, Scopus Embase and Web of Science (years 1952-2020)". Results The mylohyoid nerve may contain motor and sensory fibres, it may pass through the mylohyoid groove or canal and communicate with other nerves, which is clinically significant. Such anatomical variations may be one of the reasons for the failure of the inferior alveolar nerve block. Conclusion Awareness of these variations is very significant in planning treatment and avoiding any unnecessary steps. The most frequently encountered anatomic variation of the mylohyoid nerve was innervation of the submental skin and the anterior teeth.
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Affiliation(s)
- Sandya Kini
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Krishnaraj Somayaji
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shashirashmi Acharya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shivakumar Sampath
- Department of Conservative Dentistry and Endodontics, Vivekananda Dental College for Women, Tiruchengod, Tamilnadu, India
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Ryu E, Kim D. Anatomical insights of the mylohyoid for clinical procedures in dentistry. Clin Anat 2020; 34:461-469. [DOI: 10.1002/ca.23675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/23/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Eun‐Jin Ryu
- Department of Dental Hygiene, Division of Health Science Dongseo University Busan South Korea
| | - Da‐Hye Kim
- Department of Dental Hygiene, Division of Health Science Dongseo University Busan South Korea
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Elsayed N, Shimo T, Tashiro M, Nakayama E, Nagayasu H. Disuse atrophy of masticatory muscles after intracranial trigeminal schwannoma resection: A case report and review of literature. Int J Surg Case Rep 2020; 75:23-28. [PMID: 32937220 PMCID: PMC7498842 DOI: 10.1016/j.ijscr.2020.08.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/04/2022] Open
Abstract
Temporomandibular disorders (TMD) are diseases of the temporomandibular joint and masticatory muscles, and are often difficult to be diagnosed. Determining the cause of facial asymmetry and jaw deviation are quite challenging. The morphologic and functional characteristics of masticatory muscles are maintained by sensory and motor innervation from the trigeminal nerve. Trigeminal schwannoma is a rare benign tumor originating from the Schwann cells. We experienced a case of masticatory muscle disuse atrophy during long-term follow-up after resection of intracranial trigeminal schwannoma.
Introduction Temporomandibular disorders (TMD) are diseases of the temporomandibular joint and masticatory muscles, and are often difficult to be diagnosed because they have various symptoms, pathological conditions and causes. Presentation of case Herein, we report a 78-year-old male referred to our hospital with a diagnosis of TMD and presenting with facial asymmetry, marked deviation to the right side on vertical mandibular movement and complaints of abnormal perception at the right oral and buccal region. Past medical history revealed that he had undergone a right intracranial trigeminal schwannoma resection 9 years prior. Computed tomography (CT) showed disuse atrophy of the right side of 4 masticatory muscles and 2 suprahyoid muscles controlled by the motor component of the mandibular division (V3) of the trigeminal nerve (TGN). Together with the neurosurgeon, we confirmed that there was no recurrence of the tumor and explained to the patient that the oral and maxillofacial symptoms are after-effects of the operation, and we provided oral hygiene instructions and coordinated cleaning of the inside of the oral cavity. Discussion Although it is difficult to compare treatment methods from case to case, we believe that in our case, the patient's understanding of the cause of his discomfort contributed significantly to the improvement of his quality of life. Conclusion We experienced a case of masticatory muscle disuse atrophy during long-term follow-up after resection of intracranial trigeminal schwannoma. Further studies are needed to develop the diagnostic and therapeutic protocols for disuse atrophy.
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Affiliation(s)
- Nagwan Elsayed
- Division of Oral and Maxillofacial Surgery, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Tsuyoshi Shimo
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan.
| | - Masayasu Tashiro
- Division of Oral and Maxillofacial Radiology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Eiji Nakayama
- Division of Oral and Maxillofacial Radiology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Hiroki Nagayasu
- Division of Oral and Maxillofacial Surgery, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
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Syomkin VA, Kuzin AV, Ordzhonikidze MZ, Sogacheva VV, Remizov GV. [Root dislocation into the mouth floor as a complication of lower impacted third molar extraction]. STOMATOLOGII︠A︡ 2020; 99:71-75. [PMID: 32692524 DOI: 10.17116/stomat20209904171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Root dislocation into soft tissues during lower jaw third molar extraction belongs to clinically rare complications. The thickness of the cortical plate on the third molar lingual side does not exceed 1.5 mm. Working with an elevator, or headpiece, it is possible to push the roots into the adjacent soft tissue. It is not possible to remove displaced tooth fragment through the socket, it requires additional surgical access from the lingual side. The authors described three clinical cases of root dislocation during third molar removing. Successful surgical treatment was done.
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Affiliation(s)
- V A Syomkin
- Federal State Institution Central Research Institute of Dental and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - A V Kuzin
- Federal State Institution Central Research Institute of Dental and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - M Z Ordzhonikidze
- Federal State Institution Central Research Institute of Dental and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - V V Sogacheva
- Federal State Institution Central Research Institute of Dental and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - G V Remizov
- Khimki Central Clinical Hospital, Khimki, Russia
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Nayak SB, Soumya KV. Mylohyoid foramen of mandible: a rare exit point of intra-mandibular origin of nerve to mylohyoid. Anat Cell Biol 2020; 53:114-116. [PMID: 32274257 PMCID: PMC7118266 DOI: 10.5115/acb.19.186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 12/02/2022] Open
Abstract
Nerve to mylohyoid is a branch of inferior alveolar nerve. It arises in the infratemporal fossa and runs in the mylohyoid groove of mandible to reach the submandibular region, where it supplies the anterior belly of digastric and mylohyoid muscles. Though sensory distribution of this nerve have been described, it is predominantly a motor nerve. Here, a rare intra-mandibular origin of nerve to mylohyoid has been presented. This nerve arose from the inferior alveolar nerve inside the mandible and came out to the submandibular region by passing through a small foramen present on the medial surface of the body of the mandible. It ended by supplying the anterior belly of digastric and mylohyoid muscles. The knowledge of this variation could be of importance to maxillofacial surgeons and radiologists.
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Affiliation(s)
- Satheesha B Nayak
- Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, India
| | - K V Soumya
- Department of Mathematics, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
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Velioglu O, Calis AS, Koca H, Velioglu E. Bupivacaine vs. lidocaine: a comparison of local anesthetic efficacy in impacted third molar surgery. Clin Oral Investig 2020; 24:3539-3546. [DOI: 10.1007/s00784-020-03224-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
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