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Martín-Cruces J, Cuendias P, García-Mesa Y, Cobo JL, García-Suárez O, Gaite JJ, Vega JA, Martín-Biedma B. Proprioceptive innervation of the human lips. Anat Rec (Hoboken) 2024; 307:669-676. [PMID: 37712912 DOI: 10.1002/ar.25324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
The objective of this study was to analyze the proprioceptive innervation of human lips, especially of the orbicularis oris muscle, since it is classically accepted that facial muscles lack typical proprioceptors, that is, muscle spindles, but recently this has been doubted. Upper and lower human lips (n = 5) from non-embalmed frozen cadavers were immunostained for detection of S100 protein (to identify nerves and sensory nerve formations), myosin heavy chain (to label muscle fibers within muscle spindles), and the mechano-gated ion channel PIEZO2. No muscle spindles were found, but there was a high density of sensory nerve formations, which were morphologically heterogeneous, and in some cases resemble Ruffini-like and Pacinian sensory corpuscles. The axons of these sensory formations displayed immunoreactivity for PIEZO2. Human lip muscles lack typical proprioceptors but possess a dense sensory innervation which can serve the lip proprioception.
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Affiliation(s)
- José Martín-Cruces
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
| | - Patricia Cuendias
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
| | - Yolanda García-Mesa
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
| | - Juan L Cobo
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
- Instituto Asturiano de Odontología, Oviedo, Spain
| | - Olivia García-Suárez
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
| | - Juan J Gaite
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
- Unidad Dental, Clínica Universitaria de Navarra, Pamplona, Spain
| | - José A Vega
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia-Santiago de Chile, Chile
| | - Benjamín Martín-Biedma
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Santiago de Compostela, Santiago, Spain
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2
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Wu Y, Lan Y, Mao J, Shen J, Kang T, Xie Z. The interaction between the nervous system and the stomatognathic system: from development to diseases. Int J Oral Sci 2023; 15:34. [PMID: 37580325 PMCID: PMC10425412 DOI: 10.1038/s41368-023-00241-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
The crosstalk between the nerve and stomatognathic systems plays a more important role in organismal health than previously appreciated with the presence of emerging concept of the "brain-oral axis". A deeper understanding of the intricate interaction between the nervous system and the stomatognathic system is warranted, considering their significant developmental homology and anatomical proximity, and the more complex innervation of the jawbone compared to other skeletons. In this review, we provide an in-depth look at studies concerning neurodevelopment, craniofacial development, and congenital anomalies that occur when the two systems develop abnormally. It summarizes the cross-regulation between nerves and jawbones and the effects of various states of the jawbone on intrabony nerve distribution. Diseases closely related to both the nervous system and the stomatognathic system are divided into craniofacial diseases caused by neurological illnesses, and neurological diseases caused by an aberrant stomatognathic system. The two-way relationships between common diseases, such as periodontitis and neurodegenerative disorders, and depression and oral diseases were also discussed. This review provides valuable insights into novel strategies for neuro-skeletal tissue engineering and early prevention and treatment of orofacial and neurological diseases.
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Affiliation(s)
- Yuzhu Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yanhua Lan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Jiajie Mao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Jiahui Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Ting Kang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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Ma P, Zhang G, Chen S, Miao C, Cao Y, Wang M, Liu W, Shen J, Tang PMK, Men Y, Ye L, Li C. Promotion effect of TGF-β-Zfp423-ApoD pathway on lip sensory recovery after nerve sacrifice caused by nerve collateral compensation. Int J Oral Sci 2023; 15:23. [PMID: 37286538 DOI: 10.1038/s41368-023-00230-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023] Open
Abstract
Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.
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Affiliation(s)
- Pingchuan Ma
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Gaowei Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Su Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Cheng Miao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yubin Cao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Meng Wang
- Department of Medical Record, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenwen Liu
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jiefei Shen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Patrick Ming-Kuen Tang
- Department of Medicine & Therapeutics, Li Ka Shing Institute of Health Sciences, and Lui Che Woo Institute of Innovative Medicine & Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Yi Men
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Nelke K, Janeczek M, Pasicka E, Żak K, Łukaszewski M, Jadach R, Dobrzyński M. The Temporary Mental Nerve Paresthesia as an Outcome of Dentigerous Cyst Removal during Preparation for Dental Implant Placement: A Case Report. Medicina (B Aires) 2023; 59:medicina59040711. [PMID: 37109669 PMCID: PMC10141477 DOI: 10.3390/medicina59040711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/19/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1–2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities.
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Affiliation(s)
- Kamil Nelke
- Privat Practice of Maxillo-Facial Surgery and Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland
- Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland
| | - Maciej Janeczek
- Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland
| | - Edyta Pasicka
- Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland
| | - Krzysztof Żak
- Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland
| | - Marceli Łukaszewski
- Department of Anaesthesiology and Intensive Care, Sokołowski Hospital, Sokołowskiego 4, 58-309 Wałbrzych, Poland
| | - Radosław Jadach
- Dental Salon Privat Dental Office, Horbaczewskiego 53a, 54-130 Wrocław, Poland
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
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Capon C, Crevant A, Pointin A, Sulukdjian A, Moreau N. Botulinum toxin A for management of refractory concurrent buccal and inferior alveolar nerve post-traumatic neuropathies: a case report. J Int Med Res 2022; 50:3000605211047704. [PMID: 36172992 PMCID: PMC9528003 DOI: 10.1177/03000605211047704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Painful post-traumatic trigeminal neuropathy (PPTTN) can result from iatrogenic injury to one or more branches of the trigeminal nerve during oral surgical procedures such as tooth extractions. Like other chronic neuropathic pain conditions, PPTTN can significantly alter the patient’s quality of life, especially when pharmacological treatment is ineffective or not tolerated. As such, new treatment options have been investigated, including local injections of botulinum toxin type A (BTX-A). A 29-year-old woman presented to our tertiary orofacial pain clinic for evaluation of chronic electric shock-like pain attacks and severe allodynia in the territory of the right inferior alveolar nerve and buccal nerve following right mandibular third molar extraction 3 years prior. Following several failed attempts at classic pharmacological management (including carbamazepine, venlafaxine, duloxetine, pregabalin, clonazepam, and amitriptyline), BTX-A injections were administered in the vicinity of the right mental nerve. This treatment provided significant improvement in the patient’s condition and overall quality of life with no significant adverse effects. Because both neuropathies were significantly improved by remote BTX-A injections, this case report provides preliminary clinical evidence supporting spinopetal transport of BTX-A, as shown in animal models, as an underlying pathophysiological mechanism of BTX-A-mediated analgesia.
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Affiliation(s)
- Chloé Capon
- Department of Dental Medicine, Bretonneau Hospital, AP-HP, Paris, France
| | - Aurélien Crevant
- Department of Dental Medicine, Bretonneau Hospital, AP-HP, Paris, France
| | - Armelle Pointin
- Department of Dental Medicine, Bretonneau Hospital, AP-HP, Paris, France
| | - Arek Sulukdjian
- Department of Dental Medicine, Bretonneau Hospital, AP-HP, Paris, France
| | - Nathan Moreau
- Department of Dental Medicine, Bretonneau Hospital, AP-HP, Paris, France.,Faculty of Dental Medicine, Université de Paris, F-75006.,Laboratory of Orofacial Neurobiology (EA 7543), Université de Paris, F-75006
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6
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Gibeili C, Sulukdjian A, Chanlon A, Moreau N. Unilateral glossodynia as a harbinger of an occult cerebellopontine angle tumour. BMJ Case Rep 2022; 15:e249408. [PMID: 35414584 PMCID: PMC9006837 DOI: 10.1136/bcr-2022-249408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/04/2022] Open
Abstract
A woman in her late 80s with severe bronchomalacia was referred to a tertiary orofacial pain clinic for unexplained right unilateral glossodynia of progressive and continuous evolution for the past 8 months, spreading to the ipsilateral labiomental region, associated with ipsilateral hypoacusia. Local and general clinical examinations were unremarkable and routine blood work could not reveal any underlying systemic disease explaining the glossodynia and burning/pricking labiomental pain. Suspecting a painful trigeminal neuropathy secondary to a space-occupying lesion, a cerebral MRI was prescribed, revealing an ipsilateral cerebellopontine angle lesion, compatible with either a schwannoma or meningioma. This lesion invaded the root entry zones of cranial nerves V and VIII explaining the patient's oral pain and hypoacusia. Following a neurosurgical consultation where surgical treatment was rejected, her pain was successfully managed by topical pregabalin mouthwashes, to prevent any risk of respiratory depression related to her underlying severe bronchomalacia.
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Affiliation(s)
- Chloé Gibeili
- Orofacial Pain Clinic, Department of Oral Medicine and Oral Surgery, Hopital Bretonneau, AP-HP, Paris, France
| | - Arek Sulukdjian
- Orofacial Pain Clinic, Department of Oral Medicine and Oral Surgery, Hopital Bretonneau, AP-HP, Paris, France
| | - Audrey Chanlon
- Orofacial Pain Clinic, Department of Oral Medicine and Oral Surgery, Hopital Bretonneau, AP-HP, Paris, France
| | - Nathan Moreau
- Orofacial Pain Clinic, Department of Oral Medicine and Oral Surgery, Hopital Bretonneau, AP-HP, Paris, France
- Oral Medicine and Oral Surgery, UFR d'Odontologie, Faculté de Santé, Université Paris Cité, Montrouge, France
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An anatomical and histological study of mental nerve branches to the inferior labial glands. Surg Radiol Anat 2021; 43:1801-1804. [PMID: 34232370 DOI: 10.1007/s00276-021-02795-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE In this study, we aimed to reveal the detailed anatomy of mental nerve branches to the inferior labial glands. METHODS Embalmed cadaveric heads were used in this study and the mental nerve branches to the inferior labial glands were dissected. Branches to the glands were then excised for histological observation. RESULTS On all sides, the inferior labial glands were innervated by small branches arising from mental nerve branches that innervated the lower lip. No nerve branches to the inferior labial gland crossed the midline. Histological observation found that the tissue to the inferior labial gland were composed primarily of nerve fibers with a small number of surrounding vessels. Histological findings in examined specimens were consistent. CONCLUSION The inferior labial glands were innervated by small branches of the mental nerve to the lower lip.
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Chen YH, Kim HY, Anuwong A, Huang TS, Duh QY. Transoral robotic thyroidectomy versus transoral endoscopic thyroidectomy: a propensity-score-matched analysis of surgical outcomes. Surg Endosc 2020; 35:6179-6189. [DOI: 10.1007/s00464-020-08114-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/16/2020] [Indexed: 12/14/2022]
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Mrożek K, Marchewka J, Leszczyński B, Wróbel A, Głąb H. Variability in the number of mental foramina in the African green monkey (Grivet) (Chlorocebus aethiops). ZOOMORPHOLOGY 2020. [DOI: 10.1007/s00435-020-00485-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractThis study aimed to determine the number of mental foramina (MFs) in vervet monkeys of the Cercopithecini tribe and perform a µCT analysis of mental foramina and mandibular canal morphology. A total of 19 simian skulls belonging to Chlorocebus aethiops species were used in the analyses. An average of three mental foramina was present in most individuals from the analyzed group. The Mann–Whitney test revealed no statistically significant difference between the number of foramina on the right- and left-hand side. Likewise, no statistically significant differences between the number of MFs across sexes were observed. Correlation coefficient values between mandibular length and the ipsilateral number of MF indicate a weak and statistically non-significant (p > 0.05) linear relationship. Volumetric reconstructions revealed the presence of a single periosteal sheathed mandibular canal terminated with four small mental foramina.
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Anatomical study of gasless transoral thyroidectomy and clinical application. Surg Endosc 2019; 34:3414-3423. [PMID: 31531736 DOI: 10.1007/s00464-019-07117-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 09/04/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Transoral thyroidectomy is becoming a preferred technique because it has the advantage of not leaving a scar after surgery. However, it is not yet standard because of the anatomic nerve complexity of this oral cavity and difficulty of approach. The aim of this study was to determine the safety zone of a gasless transoral thyroidectomy approach using an anatomical study and to evaluate the efficacy of this approach on clinical application. METHODS Phase 1, twenty unilateral specimens from fresh cadavers underwent staining by the modified Sihler's method to identify nerves around the oral vestibules. Then, the safety zone of the transoral thyroidectomy approach was proposed. Phase 2, a comparative analysis of the clinical outcomes of gasless transoral thyroidectomy through the safety zone versus transcutaneous thyroidectomy approach. RESULTS In phase 1, numerous inferior labial branches diverged from the mental nerve and were distributed across the lower lip. In most cases, the most lateral branch reached almost to the corner of the mouth, whereas a nerve-free area was present at the medial region of the lower lip. The suggested safety zone was presented as a trapezoid shape. In phase 2, there were no significant differences in age, mass size, or complications between the two groups. However, the operation time in the transoral thyroidectomy group was longer than in the transcutaneous group (p = 0.001). CONCLUSIONS Based on the anatomical study, we suggested a safety zone for the gasless transoral thyroidectomy. On application of this safety zone, gasless transoral thyroidectomy is a safe and feasible procedure.
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Martínez Pascual P, Maranillo E, Vázquez T, Simon de Blas C, Lasso JM, Sañudo JR. Extracranial Course of the Facial Nerve Revisited. Anat Rec (Hoboken) 2018; 302:599-608. [DOI: 10.1002/ar.23825] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/03/2017] [Accepted: 12/07/2017] [Indexed: 12/11/2022]
Affiliation(s)
| | - Eva Maranillo
- Department of Human Anatomy and Embryology, Facultad de MedicinaUniversidad Complutense de MadridMadrid Spain
| | - Teresa Vázquez
- Department of Human Anatomy and Embryology, Facultad de MedicinaUniversidad Complutense de MadridMadrid Spain
| | - Clara Simon de Blas
- Department of Computer Sciences and StatisticsUniversidad Rey Juan CarlosMadrid Spain
| | - Jose Maria Lasso
- Department of Plastic SurgeryHospital General Universitario Gregorio MarañónMadrid Spain
| | - José Ramón Sañudo
- Department of Human Anatomy and Embryology, Facultad de MedicinaUniversidad Complutense de MadridMadrid Spain
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12
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Anatomical landmarks of mandibular interforaminal region related to dental implant placement with 3D CBCT: comparison between edentulous and dental mandibles. Surg Radiol Anat 2017; 40:615-623. [PMID: 29124343 DOI: 10.1007/s00276-017-1934-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Anterior mandibular (interforaminal) region is important in implant applications as it serves a basis for neurovascular bedding and holds the prosthesis for patients. Treatment planning for dental implant patients is often complicated by the unknown extent of the anterior loop of the neurovascular bundle. Anatomical structures including mandibular incisive canal (MIC) and lingual foramen (LF) should also be examined as part of the detailed analysis for their neurovascular structures. This study aimed to detect the positions of LF and MIC as well as the prolongation of interforaminal region in Anatolian population to supply the reference data of the surgical safe zone in chin for the clinicians. MATERIALS AND METHODS Mandibles of 70 adult specimens (35 edentulous + 35 dentate) were retrieved from the Department of Anatomy, Ege University. Images of the dry mandibles were obtained using a cone beam computed tomography unit applying a standardized exposure protocol. Afterwards, mandibles were sawn into vertical sections according to the respective tomographic cross-sections. Images were evaluated for the absence/presence of the MIC, its dimensions and antero-posterior length for both edentulous and dentate groups. In addition; the presence, number, location, labial canal and LF diameter and height of the LF were determined for both groups. RESULTS The MIC was observed in 80 and 68.6% of the dentate and edentulous groups, consecutively (p > 0.05). The MIC continued towards the incisor region in a slightly downward direction. The LF was observed in all dentate mandibles (100%), while it was present in 94.3% of the edentulous mandibles (p > 0.05). For the dentate group, 62.9% of the specimens had two foramens and 20% had three foramens in the mandibular midline. Mean length of the MIC in dentate groups and edentulous groups was measured as 2.55 ± 0.809 and 3.08 ± 1.745 mm, respectively. Well-defined MIC mean diameter in dentate groups and edentulous groups were measured as 2.44 ± 0.702 and 2.35 ± 0.652 mm, respectively. Significant difference was found between dentate and edentulous group in most of the parameters except for the LF and the diameter of the MIC (p > 0.05). The correlation between observers' measurements ranged between 0.742 and 0.993 for all anatomical landmarks and mandible groups. CONCLUSION The MIC and LF are associated with neurovascular bundle variations in number, location and size. Therefore, clinicians should determine each of these anatomical structures on a case-by-case basis to recognize their presence and to take measures for the possible implications of various treatment options. These guidelines included leaving a 2 mm safety zone between an implant and the coronal aspect of the neurovascular bundle. To avoid neurovascular injury during surgery in the interforaminal area, guidelines were developed with respect to validating the presence of an anterior loop of the neurovascular bundle.
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13
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Takezawa K, Ghabriel M, Townsend G. The course and distribution of the buccal nerve: clinical relevance in dentistry. Aust Dent J 2017. [PMID: 28646596 DOI: 10.1111/adj.12543] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The buccal branch of the mandibular division of the trigeminal nerve is commonly anaesthetized for dental procedures and may be damaged during surgery. Descriptions of the distribution of the buccal nerve (BN) in anatomical texts are generally lacking in detail and do not provide information about the extent of its variation between individuals. There are also commonly-held clinical beliefs about the BN that lack support from anatomical dissections. METHODS Detailed dissections of the course and distribution of the BN were performed in a sample of 12 hemi-heads from 11 edentulous and partially dentate human adult cadavers. RESULTS A broader distribution of the BN was found than described previously, with innervation extending to the lips in all cases. Approximately half of the lateral sides of the lips were innervated by the BN in two cases and approximately one-third of their lateral sides in the other 10 cases. Distribution of the BN to the lower lips was wider than to the upper lips. CONCLUSIONS Our findings provide a stronger anatomical basis to underpin clinical procedures involving the BN and indicate that some commonly-held clinical views about this nerve are not supported by anatomical evidence.
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Affiliation(s)
- K Takezawa
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - M Ghabriel
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - G Townsend
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Iwanaga J, Watanabe K, Saga T, Tabira Y, Hirasaki E, Fisahn C, Tubbs RS, Kusukawa J, Yamaki KI. Radiological and Microsurgical Anatomy for Variation of the Mandible: Comparative Study of Human and Macaca fascicularis. Anat Rec (Hoboken) 2017; 300:1464-1471. [DOI: 10.1002/ar.23586] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/04/2016] [Accepted: 10/26/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Joe Iwanaga
- Department of Anatomy; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
- Dental and Oral Medical Center; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
- Seattle Science Foundation; 550 17th Ave, James Tower, Suite 600 Seattle Washington
| | - Koichi Watanabe
- Department of Anatomy; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
| | - Tsuyoshi Saga
- Department of Anatomy; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
| | - Yoko Tabira
- Department of Anatomy; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
| | - Eishi Hirasaki
- Evolutionary Morphology Section; Primate Research Institute, Kyoto University; Inuyama Aichi Japan
| | - Christian Fisahn
- Seattle Science Foundation; 550 17th Ave, James Tower, Suite 600 Seattle Washington
- Swedish Neuroscience Institute; Swedish Medical Center; 550 17th Avenue, Suite 500 Seattle Washington
| | - R. Shane Tubbs
- Seattle Science Foundation; 550 17th Ave, James Tower, Suite 600 Seattle Washington
| | - Jingo Kusukawa
- Dental and Oral Medical Center; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
| | - Koh-Ichi Yamaki
- Department of Anatomy; Kurume University School of Medicine; 67 Asahi-machi Kurume Fukuoka 830-0011 Japan
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15
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Communications Between the Trigeminal Nerve and the Facial Nerve in the Face: A Systematic Review. J Craniofac Surg 2016; 26:1643-6. [PMID: 26114519 DOI: 10.1097/scs.0000000000001810] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of the article is to elucidate the communications between the trigeminal nerve and facial nerve in the face. In a PubMed search, 328 studies were found using the terms 'trigeminal nerve, facial nerve, and communication.' The abstracts were read and 39 full-text articles were reviewed. Among them, 11 articles were analyzed. In the studies using dissection, the maxillary branch (V2) had the highest frequency (95.0% ± 8.0%) of communication with the facial nerve, followed by the mandibular branch (V3) (76.7% ± 38.5%). The ophthalmic branch (V1) had the lowest frequency of communication (33.8% ± 19.5%). In a Sihler stain, all of the maxillary branches and mandibular branches had communications with the facial nerve and 85.7% (12/14 hemifaces) of the ophthalmic branches had communications. The frequency of communications between the trigeminal nerve and facial nerve were significantly higher (P = 0.00, t-test) in the studies using a Sihler stain (94.7% ± 1.1%) than the studies using dissection (76.9 ± 35.8). The reason for the significantly higher frequency of trigeminal-facial communication in the studies using a Sihler stain is because of the limitation of the Sihler stain itself. This technique cannot differentiate the motor nerves from sensory nerves at the periphery, and a crossover can be misinterpreted as communication near to nerve terminal.
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16
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Iwanaga J, Watanabe K, Saga T, Tabira Y, Kitashima S, Kusukawa J, Yamaki KI. Accessory mental foramina and nerves: Application to periodontal, periapical, and implant surgery. Clin Anat 2015; 29:493-501. [DOI: 10.1002/ca.22635] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 09/14/2015] [Accepted: 09/18/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Joe Iwanaga
- Department of Anatomy; Kurume University School of Medicine; Kurume Fukuoka Japan
- Dental and Oral Medical Center; Kurume University School of Medicine; Kurume Fukuoka Japan
| | - Koichi Watanabe
- Department of Anatomy; Kurume University School of Medicine; Kurume Fukuoka Japan
| | - Tsuyoshi Saga
- Department of Anatomy; Kurume University School of Medicine; Kurume Fukuoka Japan
| | - Yoko Tabira
- Department of Anatomy; Kurume University School of Medicine; Kurume Fukuoka Japan
| | | | - Jingo Kusukawa
- Dental and Oral Medical Center; Kurume University School of Medicine; Kurume Fukuoka Japan
| | - Koh-Ichi Yamaki
- Department of Anatomy; Kurume University School of Medicine; Kurume Fukuoka Japan
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17
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Iwanaga J, Saga T, Tabira Y, Nakamura M, Kitashima S, Watanabe K, Kusukawa J, Yamaki KI. The clinical anatomy of accessory mental nerves and foramina. Clin Anat 2015. [DOI: 10.1002/ca.22597] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Joe Iwanaga
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
- Dental and Oral Medical Center; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Tsuyoshi Saga
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Yoko Tabira
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Moriyoshi Nakamura
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
- Dental and Oral Medical Center; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Sadaharu Kitashima
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
- Dental and Oral Medical Center; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Koichi Watanabe
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Jingo Kusukawa
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
- Dental and Oral Medical Center; Kurume University School of Medicine; Kurume, Fukuoka Japan
| | - Koh-Ichi Yamaki
- Department of Anatomy; Kurume University School of Medicine; Kurume, Fukuoka Japan
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18
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Yang HM, Won SY, Kim HJ, Hu KS. Neurovascular structures of the mandibular angle and condyle: a comprehensive anatomical review. Surg Radiol Anat 2015; 37:1109-18. [PMID: 25956586 DOI: 10.1007/s00276-015-1482-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/27/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Various surgical interventions including esthetic surgery, salivary gland excision, and open reduction of fracture have been performed in the area around the mandibular angle and condyle. This study aimed to comprehensively review the anatomy of the neurovascular structures on the angle and condyle with recent anatomic and clinical research. METHODS AND RESULTS We provide detailed information about the branching and distributing patterns of the neurovascular structures at the mandibular angle and condyle, with reported data of measurements and proportions from previous anatomical and clinical research. Our report should serve to help practitioners gain a better understanding of the area in order or reduce potential complications during local procedures. Reckless manipulation during mandibular angle reduction could mutilate arterial branches, not only from the facial artery, but also from the external carotid artery. The transverse facial artery and superficial temporal artery could be damaged during approach and incision in the condylar area. The marginal mandibular branch of the facial nerve can be easily damaged during submandibular gland excision or facial rejuvenation treatment. The main trunk of the facial nerve and its upper and lower distinct divisions have been damaged during parotidectomy, rhytidectomy, and open reductions of condylar fractures. CONCLUSION By revisiting the information in the present study, surgeons will be able to more accurately prevent procedure-related complications, such as iatrogenic vascular accidents on the mandibular angle and condyle, complete and partial facial palsy, gustatory sweating (Frey syndrome), and traumatic neuroma after parotidectomy.
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Affiliation(s)
- Hun-Mu Yang
- Department of Anatomy, Dankook University College of Medicine, Cheonan, South Korea
| | - Sung-Yoon Won
- Department of Occupational Therapy, Semyung University, Jecheon, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kyung-Seok Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, South Korea.
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