Median accessory digastric muscle: radiological and surgical correlation

A median accessory digastric muscle was revealed during a dissection of the submental region. The muscle was located between the anterior bellies of the digastrics, external to the mylohyoid and deep to the platysma. It appeared as a flat quadrilateral sheet. Its base arose from the front of the body of the hyoid bone near its upper border. Lower portion of the fibers, at the right base of the muscle, initially traveled perpendicular to the lower fibers of the right mylohyoid. The rest of the muscle had a median course, with the cranial end inserting into the mandible between the digastric fossae. The muscle elevated the hyoid bone and depressed the mandible when appropriate stress was applied. No other morphologic abnormalities were found in this region. Aberrant anterior bellies of the digastric muscles are uncommon and occur bilaterally or unilaterally. This observation of a median accessory digastric muscle has not previously been reported. Knowledge of this variant will help to avoid confusion with pathological conditions of the floor of the mouth and the submental region. It is relevant both for the interpretation of radiological images and during surgical procedures such as dissection of the anterior belly of the digastric for a malignant disease and graft positioning.