Joe Iwanaga1,2,3, Koichi Watanabe4, Tsuyoshi Saga4, Yoko Tabira4, Moriyoshi Nakamura5, Christian Fisahn6,7, R Shane Tubbs6, Jingo Kusukawa5, Koh-Ichi Yamaki4. 1. Department of Anatomy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. iwanaga_jyou@med.kurume-u.ac.jp. 2. Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. iwanaga_jyou@med.kurume-u.ac.jp. 3. Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA. iwanaga_jyou@med.kurume-u.ac.jp. 4. Department of Anatomy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. 5. Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. 6. Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA. 7. Neuroscience Institute, Swedish Medical Center, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA.
Abstract
PURPOSE: Many dental procedures are at risk of injuring the lingual nerve. We performed this study to better elucidate the microanatomy that exists between the ipsilateral lingual and hypoglossal nerves so that iatrogenic injury can be avoided. METHODS: Adult human cadaveric tongues (ten sides) underwent Sihler's staining to identify the microanatomy between the lingual and hypoglossal nerves. RESULTS: The lingual nerve entered the middle part of the anterior two-thirds of the tongue from its lateral side and divided into two to four thick branches. These branches were then disseminated to the anterior, middle, and posterior parts of the anterior two-thirds of the tongue via 7-14 thin nerve bundles as terminal branches. The hypoglossal nerve entered the tongue at the posterior border of its anterior two-thirds and traveled forward to the apex of the tongue on all sides. All specimens were found to have communicating branches between the lingual and hypoglossal nerves at its anterior, middle, and posterior thirds. CONCLUSIONS: Our results indicate that the ipsilateral lingual and hypoglossal nerves constantly have three connections on each side between them. This knowledge might aid the dentist in minimizing iatrogenic nerve injury.
PURPOSE: Many dental procedures are at risk of injuring the lingual nerve. We performed this study to better elucidate the microanatomy that exists between the ipsilateral lingual and hypoglossal nerves so that iatrogenic injury can be avoided. METHODS: Adult human cadaveric tongues (ten sides) underwent Sihler's staining to identify the microanatomy between the lingual and hypoglossal nerves. RESULTS: The lingual nerve entered the middle part of the anterior two-thirds of the tongue from its lateral side and divided into two to four thick branches. These branches were then disseminated to the anterior, middle, and posterior parts of the anterior two-thirds of the tongue via 7-14 thin nerve bundles as terminal branches. The hypoglossal nerve entered the tongue at the posterior border of its anterior two-thirds and traveled forward to the apex of the tongue on all sides. All specimens were found to have communicating branches between the lingual and hypoglossal nerves at its anterior, middle, and posterior thirds. CONCLUSIONS: Our results indicate that the ipsilateral lingual and hypoglossal nerves constantly have three connections on each side between them. This knowledge might aid the dentist in minimizing iatrogenic nerve injury.