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Updated: Jun 8, 2026
Modified Radical Neck Dissection for Cervical Metastasis
Published on: February 20, 2026
Anatomical variations and functional outcomes of the marginal mandibular nerve in neck dissection for head and neck
Shuchismita Chakraborty1, Abhishek Pathak2, Manoj Pandey3
1Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
Background:
The marginal mandibular nerve (MMN) is vulnerable during neck dissection for head and neck cancer. This study documents its anatomical variations and evaluates postoperative functional and quality-of-life outcomes.
Methods:
A prospective observational study was conducted with fifty-one patients undergoing neck dissection for primary head and neck malignancy. Preoperative and postoperative assessments carried out at 1 and 3 months after surgery included clinical evaluation of lip symmetry, electromyography (EMG) of the depressor anguli oris, and quality-of-life (QoL) using FACT-H&N and Distress Inventory for Cancer (DIC) version-2 questionnaire. Intraoperative MMN anatomy was systematically recorded.
Results:
MMN was identified in all the 51 neck dissections carried out. Mean number of branches was 1.05 ± 0.23, and mean distance from the mandibular border was 1.67 mm. Lip asymmetry was observed in over 50% of patients at 1 month, decreasing to 20% at 3 months. EMG showed complete denervation in 13 patients at 1 month, which continued till 3 months with no recovery, the branch was sacrificed in 11 of these for oncological clearance. FACT-H&N scores and DIC2 scores improved at 6 months follow-up.
Conclusion:
Meticulous identification and preservation of the MMN minimize transient dysfunction, with most patients achieving functional recovery and QOL improvement by 3 months.
