Supernumerary muscle bundles in the submental triangle: their positional relationships according to innervation

The positional relationships between the supernumerary muscle bundles within the submental triangle and their innervating branches from the mylohyoid nerve were investigated. Ten heads of Japanese cadavers that showed aberrant muscle bundles within the submental triangle were examined. Three additional heads without such aberrant bundles were used for comparison. All cadavers were fixed with 8% formalin and preserved in 30% ethanol. After the examination of the origin and insertion of the muscles, the bony elements were removed, and then their innervating branches from the mylohyoid nerve were examined in detail under a binocular microscope. In 11 head-halves of six cadavers unilateral supernumerary bundles were found. Right and left mylohyoid nerves gave off branches that crossed the inner surface of the bundles of each respective side. Supernumerary bundles ran across the median line in two heads. In one head, the twigs from the mylohyoid nerve of the same side as the mandibular origin entered the inner surface of the bundles. The other head received double innervation from right and left nerves. Three heads showed supernumerary bundles that attached to the mandible or the hyoid bone at one end and joined the mylohyoid muscle at the other end. The branches from the mylohyoid nerve of the digastric side entered the inner surface of the bundles, and those of the mylohyoid side entered their outer surface. After giving off branches to the muscles, the mylohyoid nerve continued as a cutaneous nerve of the submental region. Based on the innervation patterns of the aberrant bundles within the submental triangle, it was suggested that these bundles result from the combination of the remnants of the primordia of the mylohyoid muscle and the anterior belly of the digastric.