The marginal mandibular nerve in relation to the inferior border of the mandible
Research article published in Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (2014)
Abstract
PURPOSE: Injury to the marginal mandibular nerve (MMN) can occur in numerous surgeries involving incisions near the inferior border of the mandible. Injury to this nerve can cause considerable cosmetic and functional deformities. A thorough knowledge and understanding of the anatomic pathway of the MMN is important to avoid permanent nerve damage. The purpose of this study was to determine the position of the marginal mandibular nerve in relation to several key mandibular anatomic landmarks and to identify variations of the nerve as it approaches the inferior border of the mandible. MATERIALS AND METHODS: Human cadavers were dissected superficially from the parotid gland to the mental protuberance to expose the MMN. At complete exposure of the nerve, 5 anatomic landmarks on the inferior border of the mandible were identified and labeled. The distance between the MMN and these landmarks was recorded, and the average measurements were used to approximate the most common pathway of the MMN. RESULTS: It was found that the MMN runs, on average, 0.75 mm below the gonion, 0.08 mm superior to the posterior border of the antegonial notch, 0.06 mm superior to the arc of the antegonial notch, 1.29 mm superior to the anterior border of the antegonial notch, 3.6 mm superior to the point at which the facial artery reaches the inferior border of the mandible, and 10.9 mm superior to the vertical line that extends from the commissure of lip to the inferior border of the mandible. CONCLUSION: These data suggest 3 general pathways of the MMN in relation to the inferior border of the mandible.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Injury to the marginal mandibular nerve (MMN) can occur in numerous surgeries involving incisions near the inferior border of the mandible.
Why This Matters for Hirudotherapy
This cadaveric anatomic study dissected human cadavers to map the position of the marginal mandibular nerve (MMN) relative to five landmarks along the inferior border of the mandible, reporting average distances and concluding that the nerve follows roughly three general pathways in that region. Its relevance to hirudotherapy is indirect and practical: when leeches are applied near the lower face and jawline (for example in reconstructive or flap-salvage settings) or whenever procedures are planned in this area, knowing the variable course of the MMN supports safer placement and helps avoid the cosmetic and functional deficits nerve injury can cause. As a descriptive anatomy study in cadavers with no leech intervention, it provides anatomical context only and makes no clinical claims about hirudotherapy outcomes.
Citation
The marginal mandibular nerve in relation to the inferior border of the mandible
Baur DA et al. · Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2014
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