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Anatomic variations of the marginal mandibular nerve
P G Balagopal1, Nebu Abraham George, P Sebastian
1Division of Surgical Oncology, Regional Cancer Centre, Trivandrum, 695011 India.
Indian Journal of Surgical Oncology
|March 2, 2013
Summary
The marginal mandibular nerve (MMN) often shows variations in its branching pattern, with most patients having a single division. Understanding these variations is crucial for preserving facial symmetry and function during surgery.
Area of Science:
- Anatomy
- Surgical Anatomy
- Head and Neck Surgery
Background:
- The marginal mandibular nerve (MMN), a branch of the facial nerve, innervates muscles vital for facial symmetry, expressions, and phonation.
- Variations in MMN anatomy can impact surgical outcomes and patient morbidity.
Purpose of the Study:
- To investigate the branching patterns and positional variations of the marginal mandibular nerve.
- To identify reliable landmarks for MMN identification during surgical procedures.
Main Methods:
- Retrospective analysis of 202 patients undergoing neck dissection.
- Identification and tracing of the MMN, noting its branching pattern and relationship to the lower border of the mandible and facial artery.
- Recording the number and position of MMN branches and any communication with the cervical branch of the facial nerve.
Main Results:
- A single MMN division was observed in 79.7% of patients.
- Multiple branches (two, three, or four) were noted in 20.3% of cases.
- The facial artery crossing the lower mandibular border served as a reliable landmark for MMN identification, with branches typically located 1.73 mm below the mandible.
Conclusions:
- Significant variations in MMN branching patterns are common.
- Preservation of all MMN branches is essential for maintaining facial cosmesis and reducing surgical morbidity.
- The facial artery crossing the mandibular border is a dependable anatomical landmark for locating the MMN.
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