Abstract
BackgroundIdentification and preservation of the marginal mandibular nerve (MMN) remains an important step in otolaryngology procedures. Current publications place the MMN at least 1 cm below the mandible. This study will evaluate the accuracy of the method of determining the surgical location of this branch of the facial nerve in vivo.MethodsMMN were examined in 52 consecutive otolaryngology patients. Using a validated landmarking scheme, distances were measured from the inferior edge of the mandible and the lowest point of the nerve. A comparison of 33 nerves pairs was undertaken. Effect of patient’s age was analysed.ResultsEighty five nerves were landmarked. The mean position of the nerve was 0.2–3.4 mm higher than the margin of the mandible. There were no significant difference in position with respect to age and left versus right comparisons.ConclusionThe marginal mandibular nerve (MMN) is significantly higher than previously published. The location of the nerve on the right does not correlate with the left. Location of the nerve does not correlate with patient’s age.
Highlights
Identification and preservation of the marginal mandibular nerve (MMN) remains an important step in otolaryngology procedures
The temporal, zygomatic, buccal, marginal mandibular, and cervical are the five major branches of the facial nerve, with the marginal mandibular branch being at particular risk during surgical procedures in the submandibular region [2,3,4,5,6] and rhytidectomy/liposuction [7]
The marginal mandibular branch supplies the muscles of facial expression that pull and close the angle of the mouth and pulls the lower lip downward
Summary
Identification and preservation of the marginal mandibular nerve (MMN) remains an important step in otolaryngology procedures. Identification and preservation of the marginal mandibular nerve remains a critical step in otolaryngologic, The marginal mandibular branch supplies the muscles of facial expression that pull and close the angle of the mouth and pulls the lower lip downward (depressor labii inferioris and depressor anguli oris). The nerve passes along the inferior border of the mandible, often looping down into the neck, deep to the platysma and depressor anguli oris [10]. Touré et al [11] reports a case where the marginal mandibular branch was situated 17.5 mm from the inferior border of the mandible. This branch can occasionally be damaged during cervical surgeries, parotidectomies, open reductions of mandibular angle fractures, rhytidoplasties and other
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