Distribution pattern of the human lingual nerve.

Abstract

The tongue is an intricate organ with many functions. Despite the knowledge of the presence of muscular and neural connections in the tongue, a detailed neuroanatomical depiction of the nerves' topography in the tongue has not been demonstrated. The topography, branching patterns and neuronal interconnections of the lingual nerve were studied in five postmortem human tongues. They were stained with Sihler's stain, a technique that renders most of the tongue tissue translucent while counterstaining nerves. The lingual nerve reaches the tongue posterolaterally. There are two main branches off of the main trunk: the medial branch sends 2-4 small branches to the medial part of the ventrolateral tongue and the lateral branch runs along the lateral tongue border and sends 3-4 large branches to the anterior tip of tongue. Each subdivision gives off 2-5 distal branches. Both medial and lateral branches have interconnections with the proximal part of the hypoglossal nerve. One of the unexpected discoveries in this study was the high density of nervous fibers in the lateral aspect of the tongue as compared to the midline region. The average diameter of the main trunk of the lingual nerve is 3.5 mm. The medial and lateral branches average 1 mm in diameter, the more distal subdivisions measure 0.5-0.75 mm, and the lingual-hypoglossal interconnections measure 0.125-0.250 mm. In summary, this study provides the first detailed depiction of the topography of the human lingual nerve and its branches in situ, confirmation of lingual-hypoglossal nerve connection, and the first depiction of the high density of lingual nerve innervation in the lateral tongue.