The lingual nerve carries sensory innervation from the anterior two-thirds of the tongue. It contains fibres from both the mandibular division of the trigeminal nerve (CN V3) and from the facial nerve (CN VII). The fibres from the trigeminal nerve are for touch, pain and temperature (general sensation), and the ones from the facial nerve are for taste (special sensation).
The nerve then comes to pass inferoanteriorly upon the medial pterygoid muscle towards the medial aspect of the ramus of mandible, eventually meeting the mandible at the junction of the ramus and body of mandible. Here, the lingual nerve is anterior and somewhat medial (deep) to the inferior alveolar nerve.[1]
It crosses obliquely to the side of the tongue beneath the constrictor pharyngis superior and styloglossus, and then between the hyoglossus and deep part of the submandibular gland; it finally runs from laterally to medially inferiorly crossing the duct of the submandibular gland, and along the tongue to its tip becoming the sublingual nerve, lying immediately beneath the mucous membrane.[citation needed]
The most common cause of lingual nerve injuries is third molar (wisdom tooth) surgery, less commonly the lingual nerve can be injured by local anaesthetic dental injections (particularly inferior dental block injections) and sublingual or submandibular surgery.[2]
Any injury to sensory nerves can result in pain, altered sensation and/or numbness, but usually a combination of all three symptoms arises. This can have a significant negative effect on the patient's quality of life affecting their daily function and psychological health.[3]
Patients should be routinely warned about lingual nerve injuries prior to wisdom tooth and floor of mouth surgery. The risk associated with wisdom tooth surgery is commonly accepted to be 2% temporary and 0.2% permanent.[4]
Warning patients of nerve injury prior to administration of deep dental injections has a risk of injury in approximately 1:14,000 with 25% of these remaining persistent.[citation needed] Preoperative warning about these injuries is routinely undertaken in the US and Germany. This reflects good practice recommended by the Royal College of Anaesthetists (prior warning of potential nerve injury in relation to spinal and epidural blocks 1 on 24–57,000 risk).[5][failed verification]
Infiltration dentistry is a technique that may reduce the possibility of lingual nerve injuries by avoiding deep injections.[6]
Avoiding lingual access when undertaking wisdom tooth surgery will also avoid unnecessary lingual nerve injury[7][8][9]
Mandible of human embryo 24 mm. long. Outer aspect.
Mandibular division of the trifacial nerve.
Mandibular division of trifacial nerve, seen from the middle line.
Plan of the facial and intermediate nerves and their communication with other nerves.
Hypoglossal nerve, cervical plexus, and their branches.
Sympathetic connections of the submaxillary and superior cervical ganglia.
Lingual nerve
Lingual nerve
Mandibular nerve and bone. Deep dissection. Anterior view.
Infratemporal fossa. Lingual and inferior alveolar nerve. Deep dissection. Anterolateral view
Referencesedit
This article incorporates text in the public domain from page 895 of the 20th edition ofGray's Anatomy(1918)
^ abcdMancall, Elliott L.; Brock, David G.; Gray, Henry, eds. (2011). Grays Clinical Neuroanatomy: The Anatomic Basis for Clinical Neuroscience. Philadelphia, PA: Elsevier Saunders. pp. 192–194. ISBN978-1-4160-4705-6.
^Br Dent J. 2013 Oct;215(8):393-9. doi: 10.1038/sj.bdj.2013.993.
^(PDF). www.quintpub.com. Archived from the original (PDF) on 15 February 2022. Retrieved 30 June 2022.{{cite web}}: CS1 maint: archived copy as title (link)
^sitecore\lewis.ashman@rcseng.ac.uk. "Recovering from Surgery — Royal College of Surgeons". Royal College of Surgeons. Retrieved 20 April 2018.
^(PDF). Archived from the original (PDF) on 2014-04-16. Retrieved 2014-04-15.
^J Am Dent Assoc. 2011 Sep;142 Suppl 3:19S-24S. The use of the mandibular infiltration anesthetic technique in adults. Meechan JG.
^J Oral Maxillofac Surg. 1995 Oct;53(10):1178-81. The relationship of the lingual nerve to the mandibular third molar region: an anatomic study. Pogrel MA1, Renaut A, Schmidt B, Ammar A.
^Br Dent J. 1996 Jun 22;180(12):456-61. Lingual nerve damage during lower third molar removal: a comparison of two surgical methods. Robinson PP1, Smith KG
^Eur J Dent Educ. 1999 May;3(2):52-5.The effect of surgical technique on lingual nerve damage during lower 3rd molar removal by dental students.Robinson PP, Loescher AR, Smith KG.
External linksedit
Anatomy figure: 27:03-05 at Human Anatomy Online, SUNY Downstate Medical Center
lingual, nerve, lingual, nerve, carries, sensory, innervation, from, anterior, thirds, tongue, contains, fibres, from, both, mandibular, division, trigeminal, nerve, from, facial, nerve, fibres, from, trigeminal, nerve, touch, pain, temperature, general, sensa. The lingual nerve carries sensory innervation from the anterior two thirds of the tongue It contains fibres from both the mandibular division of the trigeminal nerve CN V3 and from the facial nerve CN VII The fibres from the trigeminal nerve are for touch pain and temperature general sensation and the ones from the facial nerve are for taste special sensation Lingual nerveDistribution of the maxillary and mandibular nerves and the submaxillary ganglion The mouth cavity The apex of the tongue is turned upward and on the right side a superficial dissection of its under surface has been made DetailsFrommandibular nerveInnervatestongueIdentifiersLatinnervus lingualisMeSHD008036TA98A14 2 01 081TA26267FMA53218Anatomical terms of neuroanatomy edit on Wikidata Contents 1 Structure 1 1 Origin 1 2 Course 1 3 Distribution 1 3 1 General sensory 1 3 2 Special sensory and parasymathetic autonomic 2 Clinical significance 2 1 Lingual nerve injuries 3 See also 4 Additional images 5 References 6 External linksStructure editOrigin edit The lingual nerve arises from the posterior trunk of mandibular nerve CN V3 1 within the infratemporal fossa citation needed Course edit The lingual nerve first courses deep to the lateral pterygoid muscle and superior to the tensor veli palatini muscle while passing between these two muscles it is joined by the chorda tympani and often by a communicating branch from the inferior alveolar nerve 1 The nerve then comes to pass inferoanteriorly upon the medial pterygoid muscle towards the medial aspect of the ramus of mandible eventually meeting the mandible at the junction of the ramus and body of mandible Here the lingual nerve is anterior and somewhat medial deep to the inferior alveolar nerve 1 It crosses obliquely to the side of the tongue beneath the constrictor pharyngis superior and styloglossus and then between the hyoglossus and deep part of the submandibular gland it finally runs from laterally to medially inferiorly crossing the duct of the submandibular gland and along the tongue to its tip becoming the sublingual nerve lying immediately beneath the mucous membrane citation needed The submandibular ganglion is suspended by two nerve filaments from the lingual nerve citation needed Distribution edit General sensory edit The lingual nerve supplies general somatic afferent i e general sensory innervation to the mucous membrane of the anterior two thirds of the tongue i e body of tongue whereas the posterior one third i e root of tongue is innervated via the glossopharyngeal nerve CN IX citation needed the floor of the oral cavity and the mandibular inferior lingual gingiva 1 Special sensory and parasymathetic autonomic edit The lingual nerve also comes to convey fibres of the chorda tympani which are derived from the facial nerve CN VII which provide special sensation taste to the anterior two thirds of the tongue as well as parasympathetic and sympathetic innervation citation needed Clinical significance editLingual nerve injuries edit The most common cause of lingual nerve injuries is third molar wisdom tooth surgery less commonly the lingual nerve can be injured by local anaesthetic dental injections particularly inferior dental block injections and sublingual or submandibular surgery 2 Any injury to sensory nerves can result in pain altered sensation and or numbness but usually a combination of all three symptoms arises This can have a significant negative effect on the patient s quality of life affecting their daily function and psychological health 3 Patients should be routinely warned about lingual nerve injuries prior to wisdom tooth and floor of mouth surgery The risk associated with wisdom tooth surgery is commonly accepted to be 2 temporary and 0 2 permanent 4 Warning patients of nerve injury prior to administration of deep dental injections has a risk of injury in approximately 1 14 000 with 25 of these remaining persistent citation needed Preoperative warning about these injuries is routinely undertaken in the US and Germany This reflects good practice recommended by the Royal College of Anaesthetists prior warning of potential nerve injury in relation to spinal and epidural blocks 1 on 24 57 000 risk 5 failed verification Infiltration dentistry is a technique that may reduce the possibility of lingual nerve injuries by avoiding deep injections 6 Avoiding lingual access when undertaking wisdom tooth surgery will also avoid unnecessary lingual nerve injury 7 8 9 See also editLingual branches of hypoglossal nerveAdditional images edit nbsp Mandible of human embryo 24 mm long Outer aspect nbsp Mandibular division of the trifacial nerve nbsp Mandibular division of trifacial nerve seen from the middle line nbsp Plan of the facial and intermediate nerves and their communication with other nerves nbsp Hypoglossal nerve cervical plexus and their branches nbsp Sympathetic connections of the submaxillary and superior cervical ganglia nbsp Lingual nerve nbsp Lingual nerve nbsp Mandibular nerve and bone Deep dissection Anterior view nbsp Infratemporal fossa Lingual and inferior alveolar nerve Deep dissection Anterolateral viewReferences edit nbsp This article incorporates text in the public domain from page 895 of the 20th edition of Gray s Anatomy 1918 a b c d Mancall Elliott L Brock David G Gray Henry eds 2011 Grays Clinical Neuroanatomy The Anatomic Basis for Clinical Neuroscience Philadelphia PA Elsevier Saunders pp 192 194 ISBN 978 1 4160 4705 6 Br Dent J 2013 Oct 215 8 393 9 doi 10 1038 sj bdj 2013 993 Archived copy PDF www quintpub com Archived from the original PDF on 15 February 2022 Retrieved 30 June 2022 a href Template Cite web html title Template Cite web cite web a CS1 maint archived copy as title link sitecore lewis ashman rcseng ac uk Recovering from Surgery Royal College of Surgeons Royal College of Surgeons Retrieved 20 April 2018 Risks associated with your anaesthetic section 12 nerve damage associated with peripheral nerve block PDF Archived from the original PDF on 2014 04 16 Retrieved 2014 04 15 J Am Dent Assoc 2011 Sep 142 Suppl 3 19S 24S The use of the mandibular infiltration anesthetic technique in adults Meechan JG J Oral Maxillofac Surg 1995 Oct 53 10 1178 81 The relationship of the lingual nerve to the mandibular third molar region an anatomic study Pogrel MA1 Renaut A Schmidt B Ammar A Br Dent J 1996 Jun 22 180 12 456 61 Lingual nerve damage during lower third molar removal a comparison of two surgical methods Robinson PP1 Smith KG Eur J Dent Educ 1999 May 3 2 52 5 The effect of surgical technique on lingual nerve damage during lower 3rd molar removal by dental students Robinson PP Loescher AR Smith KG External links editAnatomy figure 27 03 05 at Human Anatomy Online SUNY Downstate Medical Center MedEd at Loyola GrossAnatomy h n cn cn1 cnb3 htm lesson4 at The Anatomy Lesson by Wesley Norman Georgetown University mandibularnerve cranialnerves at The Anatomy Lesson by Wesley Norman Georgetown University V Anatomy diagram 05287 011 1 Roche Lexicon illustrated navigator Elsevier Archived from the original on 2013 04 22 Portal nbsp Anatomy Retrieved from https en wikipedia org w index php title Lingual nerve amp oldid 1190664894, wikipedia, wiki, book, books, library,
