ANATOMY OF THE LINGUAL

NERVE
BASIC ANATOMY

 Branches from V3 of CN V
 Exists foramen ovale
 Carries taste fibres from chorda tympani – supplies anterior 2/3 of tongue
 The LN may be round, oval, or flat, and varies in size from 1.53mm-4.5mm
 The nerve may be monifascicular or oligofascicular at the pterygomandibular
space, making it suspectible to injury by injection at this area.
- Runs deep to the lateral pterygoid muscle,
parallel to the IAN
- Lies anterior and medial to IAN
- Then, it runs between internal and medial
pterygoid muscles, passing obliquely over
the superior pharyngeal constrictor and
styloglossus muscle, before approaching
the side of the tongue.
The nerve courses submucosally,
in contact with the periosteum,
covering the lingual or medial wall
of the third molar socket.
Crosses the Wharton duct, and
then loops back to cross it again.
It may run below and behind the
tooth before swerving superficially
across the surface of the
mylohyoid muscle.
WHAT PAPERS SAY

- Multiple research done on anatomy of

retromolar pad and LN
- Cadaver research
- Noted LN courses medial to the retromolar
pad, then enters sublingual space via
pterygomandibular space on all sides
Exit of the LN from the pterygomandibular space. Note that the
LN appears from the back of the retromolar pad (RMP) and goes
around medial to the RMP. a Without reflection of RMP; b with
reflection of RMP. LN lingual nerve, RMP retromolar
pad, T tongue
ADVICE TO AVOID LINGUAL NERVE INJURY

 Do not cut the retromolar pad

 Do not incise to superior pharyngeal constrictor muscle, which is located behind
the retromolar pad. If the scalpel goes into this muscle, it is in the
pterygomandibular space  LN can be cut.
 LN in 3rd molar touched lingual plate in, exist at the level of or above the alveolar
crest.
REFERENCES

 Graff‐Radford, S. B., & Evans, R. W. (2003). Lingual nerve

injury. Headache: The Journal of Head and Face Pain, 43(9), 975-983.
 Sittitavornwong, S., Babston, M., Denson, D., Zehren, S., & Friend, J.
(2017). Clinical anatomy of the lingual nerve: a review. Journal of Oral and
Maxillofacial Surgery, 75(5), 926-e1.