Lingual Nerve Course and Its Communication with Hypoglossal Nerve: Variations in Cadavers in Western India

Abstract

Background:Locationand variations in branching pattern of lingual nerve makes it vulnerable to injury in various oral and dental surgical procedures. Awareness of variations in distribution pattern will reduce the chances of injury to lingual nerve and post-operative complications in excision of ranulas, extraction of third molar tooth, sub mental endotracheal intubationand during difficult suspension laryngoscopy. Present study was undertaken to describe the course, morphology and variationsof lingual nerve in infra-temporal and submandibular regions and to find out communication(s) if any with hypoglossal nerve.Methods: Head and neck dissection was performed in fifteen formalin fixed cadavers after obtaining due permission from institutional ethics committee. Length and diameter of each lingual nerve was measured. Morphology of lingual nerve was studied to find its communicating branches with hypoglossal nerve.Results:Significant difference was noted in the length of second part of lingual nerve in males and females(p<0.05). Diameter of lingual nerve at the level of second molar tooth was found as 2.82mm in males and 2.79 mm in females.Communications between lingual nerve and hypoglossal nerve were found in 6 specimens. In five specimenssingle communication was found.Three communicating branches (proximal, middle and distal) were found in one specimen between lingual nerve and hypoglossal nerve. Lingual nerve either terminates as a single branch or as multiple branches.Conclusion:Present study reports variations in termination pattern of lingual nerve.Multiple extralingual communications with different morphological patternswere observed between lingual and hypoglossal nerve.