ABSTRACT
It is well known that variations in the branching pattern of the mandibular nerve frequently account for the failure to obtain adequate local anesthesia in routine oral and dental procedures, and also for the unexpected injury to branches of the nerves during surgery. During our routine dissection, we found the presence of a communicating branch between the mylohyoid and lingual nerves in a middle aged male cadaver. We also discussed its clinical and surgical implications in this report.
Subject(s)
Lingual Nerve/abnormalities , Cadaver , Humans , India , Lingual Nerve/anatomy & histology , Male , Mandible/anatomy & histology , Mandibular Nerve/anatomy & histology , Middle AgedABSTRACT
The infratemporal fossa is one of the most difficult regions of skull base to access surgically. The presence of the ossified pterygospinous and pterygoalar ligaments makes it more critical and difficult to access, with an occasional entrapment of structures like the mandibular nerve (MN) and its branches. During a routine dissection of an adult male cadaver, an unusual course of the lingual nerve (LN) was found with an entrapment of the nerve between the ossified pterygospinous ligament and the medial pterygoid muscle. Furthermore, all the three branches of the posterior division of the mandibular nerve communicated with each other by two anastomosing branches. The clinical significance of the present variations has been discussed (Fig. 1, Ref. 23).
Subject(s)
Cranial Fossa, Middle , Lingual Nerve/abnormalities , Humans , Male , Middle AgedABSTRACT
The nerves commonly associated with accessory innervation of the mandible are identified and alternative techniques to gain their anesthesia are recommended, based on sound anesthetic principles and the current understanding of nerve anatomy.
Subject(s)
Anesthesia, Dental , Mandible/innervation , Nerve Block , Anesthesia, Dental/methods , Cheek/innervation , Chin/innervation , Facial Nerve/abnormalities , Humans , Hyoid Bone/innervation , Incisor/innervation , Lingual Nerve/abnormalities , Mandible/anatomy & histology , Mandibular Nerve/abnormalities , Mandibular Nerve/anatomy & histology , Mandibular Nerve/drug effects , Mouth Mucosa/innervation , Nerve Block/methods , Neurons, Afferent/classification , Neurons, Afferent/drug effects , Neurons, Afferent/ultrastructure , Periodontal Ligament/innervation , Tooth/innervationSubject(s)
Lingual Nerve/abnormalities , Mandibular Nerve/abnormalities , Aged , Cadaver , Female , HumansABSTRACT
In a Caucasian male, the maxillary artery (M) bilaterally arose with the facial artery anteromedially from the external carotid artery. On the right side, the M entered the infratemporal fossa between the neck of the mandible and the medial pterygoid muscle, whereas the left M pierced the medial pterygoid muscle, first being covered by the muscle and the angle of the mandible. On both sides, the M ran deep to the inferior head of the lateral pterygoid muscle and the buccal nerve. The right M lay deep to the inferior alveolar, but superficial to the lingual nerve, whereas the left inferior alveolar and lingual nerves had formed two roots, thus encircling the left M. The ascending palatine artery was replaced on both sides by palatine branches of the ascending pharyngeal artery. Since a bilaterial maxillofacial trunk with topographical relations as described herein has not been previously reported in man, the embryology and comparative anatomy of this variation are discussed.
Subject(s)
Carotid Arteries/abnormalities , Masseter Muscle/blood supply , Maxillary Artery/abnormalities , Pterygoid Muscles/blood supply , Aged , Autopsy , Cadaver , Humans , Lingual Nerve/abnormalities , Male , Maxillary Artery/embryologyABSTRACT
Brain-derived neurotrophic factor (BDNF) and Neurotrophin 3 (NT-3) are members of the neurotrophin family and are expressed in the developing and adult tongue papillae. BDNF null-mutated mice exhibit specific impairments related to innervation and development of the gustatory system while NT-3 null mice have deficits in their lingual somatosensory innervation. To further evaluate the functional specificity of these neurotrophins in the peripheral gustatory system, we generated double BDNF/NT-3 knockout mice and compared the phenotype to BDNF(-/-) and wild-type mice. Taste papillae morphology was severely distorted in BDNF(-/-) xNT-3(-/-) mice compared to single BDNF(-/-) and wild-type mice. The deficits were found throughout the tongue and all gustatory papillae. There was a significant loss of fungiform papillae and the papillae were smaller in size compared to BDNF(-/-) and wild-type mice. Circumvallate papillae in the double knockouts were smaller and did not contain any intraepithelial nerve fibers. BDNF(-/-) xNT-3(-/-) mice exhibited additive losses in both somatosensory and gustatory innervation indicating that BDNF and NT-3 exert specific roles in the innervation of the tongue. However, the additional loss of fungiform papillae and taste buds in BDNF(-/-) xNT-3(-/-) mice compared to single BDNF knockout mice indicate a synergistic functional role for both BDNF-dependent gustatory and NT-3-dependent somatosensory innervations in taste bud and taste papillae innervation and development.