Schwannomas are neurogenic tumors that arise from Schwann cells of the neural sheath. They are most often benign and solitary. Ancient schwannoma is a rare variant of schwannoma with a typical characteristics of a slow growing benign tumor. A case of ancient schwannoma which originated from the lingual nerve has not been reported in the literature yet. The clinical and histological aspects of this tumor are discussed and the literature regarding this rare entity is reviewed.
Lingual Nerve* ; Neurilemmoma* ; Schwann Cells

Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.
Anesthesia, General ; Dexamethasone ; Female ; Humans ; Intubation ; Laryngoscopy ; Lingual Nerve Injuries ; Lingual Nerve ; Macroglossia ; Middle Aged ; Radius Fractures ; Tongue

The lingual nerve (LN) is a branch of the mandibular division of the trigeminal nerve, and its injury is one of the major complications during oral surgery. This study aims to investigate the anatomy of the LN in the lower third molar area. Twenty sides from ten fresh-frozen adult cadaveric Caucasian heads were examined to measure the diameter of the LN. The mean diameter of the LN was 2.20±0.37 mm (range, 1.61–2.95 mm). There were no statistically significant differences in the measurements between sexes, sides, or tooth status (dentulous or edentulous). Understanding the anatomical features of the LN is essential for performing any surgical procedure in the oral region.
Adult ; Cadaver ; Head ; Humans ; Lingual Nerve ; Mandibular Nerve ; Molar, Third ; Surgery, Oral ; Tooth ; Trigeminal Nerve

The purpose of this study was to investigate the courses of the maxillary artery and variations of the arteries and nerves in the infratemporal fossa from 36 Korean adult cadavers. The results were as follows; 1. In the majority of the cases (81.9%), course of the maxillary artery runs lateral to the lateral pterygoid muscle. 2. The variations of the arteries and nerves in the infratemporal fossa could be classified into six types. In the most common (type 2, 61.1%), the maxillary artery runs lateral to the lateral pterygoid muscle, and the inferior alveolar lingual and buccal nerves lie medial to the maxillary artery. In the next (type 1, 20.8%), the maxillary artery runs lateral to the lateral pterygoid muscle and the inferior alveolar and lingual nerves lie medial to the maxillary artery, and buccal nerve lies lateral to the maxillary artery. The remaining types were type 3 (7.0%), type 4 (4.2%), type 5 (5.6%) and type 6 (1.4%) in order.
Adult ; Arteries* ; Cadaver ; Humans ; Lingual Nerve ; Mandibular Nerve ; Maxillary Artery ; Pterygoid Muscles

INTRODUCTIONThe lingual, inferior alveolar and auriculotemporal nerves, being branches of the posterior division of the mandibular nerve, mainly innervate the mandibular teeth and all the major salivary glands. Anomalous communications among these branches are widely reported due to their significance to various treatment procedures undertaken in the region. This study was performed as detailed exploration of the functional perspectives of such communicating branches would further enhance the scope of these procedures.

METHODSA total of 36 specimens were dissected to examine the infratemporal region. The branches from the posterior division of the mandibular nerve--namely the lingual, inferior alveolar and auriculotemporal nerves--were carefully dissected, and their branches were studied and analysed for abnormal course.

RESULTSCommunication between branches of the posterior division of the mandibular nerve was observed in four specimens. In two of the four specimens, communication between the mylohyoid and lingual nerves was observed. A rare and seldom reported type of communication between the auriculotemporal and inferior alveolar nerves is described in this study. This communicating nerve split into two to form a buttonhole for the passage of the mylohyoid nerve.

CONCLUSIONSuch communicating branches between nerves found in this study are developmental in origin and thought to maintain functional integrity through an alternative route.

Cadaver ; Female ; Humans ; Lingual Nerve ; anatomy & histology ; Male ; Mandibular Nerve ; anatomy & histology ; Neck Muscles ; innervation ; Tongue

Schwannoma is a relatively slow-growing, encapsulated benign tumor that is derived from the Schwann cell of the nerve sheath. We report here on a case of schwannoma of the mouth floor with a review of the literature. A 67-year-old woman presented with a right mouth floor mass, which was first detected 5 years ago. The preoperative diagnosis was ranula on the basis of the physical findings and the computerized tomographic findings. However, the mass was found to be a true neoplastic lesion rather than a cystic lesion in the course of surgical dissection. The permanent pathologic report of the mass was schwannoma. Postoperatively, although the patient had no problem with taste, the pain-sense, speech and swallowing, she had mild deviation of the tongue towards the same side of the mass, which means that the function of the hypoglossal nerve was somewhat impaired. Her tongue deviation was spontaneously resolved within 6 weeks postoperatively.
Aged ; Deglutition ; Female ; Humans ; Hypoglossal Nerve ; Lingual Nerve ; Mouth ; Mouth Floor ; Neurilemmoma ; Ranula ; Tongue

BACKGROUND AND OBJECTIVES: Removal of the submandibular gland is often required for chronic inflammatory diseases and for benign tumors such as pleomorphic adenoma. The usual submandibular surgery can be performed through cervical approach, but this approach has disadvantages such as external scar and injury to the mandibular branch of the facial nerve. MATERIAL AND METHODS: Twenty-nine cases of submandibular gland disorders were analysed in view of surgical technique and complications. RESULTS: The submandibular gland was easily exposed intraorally by incision of the floor of the mouth extending posteriorly. Early postoperative complications were temporary paresis of lingual nerve, and temporary limitation of tongue movement. There were no late complications. CONCLUSIONS: The advantages of this technique are the avoidance of an external scar and nerve injury. We suggest this approach in the deliberate excision of chronically inflammed salivary gland and benign tumors as an alternative approach to the standard cervical approach.
Adenoma, Pleomorphic ; Cicatrix ; Facial Nerve ; Lingual Nerve ; Mouth ; Paresis ; Postoperative Complications ; Salivary Glands ; Submandibular Gland* ; Tongue

PURPOSE OF STUDY: Lingual nerve damage can be caused by surgery or trauma such as physical irriatation, radiation, chemotherapy, infection and viral infection. Once nerve damage occurred, patients sometimes complain taste change and loss of taste along with serious disturbance of tongue. The purpose of this study was to evaluate the effects of unilateral lingual nerve transection on taste as well as on the maintenance of taste buds. MATERIALS AND METHODS: Male Sprague-Dawley rats weighing 220-250g received unilateral transection of lingual nerve, subjected to the preference test for various taste solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) with two bottle test paradigm at 2, 4, 6, or 8 weeks after the operation. Tongue was fixed with 8% paraformaldehyde. After fixation, they were observed with scanning electron microscope(JSM-840A(R), JEOL, JAPAN) and counted the number of the dorsal surface of the fungiform papilla for changes of fungiform papilla. And, Fungiform papilla were obtained from coronal sections of the anterior tongue(cryosection). After cryosection, immunostaining with Galpha gust(I-20)(Santa Cruz Biotechnology, USA), PLCbeta2(Q-15)(Santa Cruz Biotechnology, USA), and T1R1(Alpha Diagnostic International, USA) were done. Immunofluorescence of labeled taste bud cells was examined by confocal microscopy(F92-300., Olympus, JAPAN). RESULTS: The preference score for salty and sweet tended to be higher in the operated rats with statistical significance, compared to the sham rats. Fungiform papilla counting were decreased after lingual nerve transaction. In 2 weeks, maximum differences occurred. Gustducin and T1R1 expressions of taste receptor in 2 and 4 weeks were decreased. PLCbeta2 were not expressed in both experimental and control group. CONCLUSION: This study demonstrated that the taste recognition for sweet and salty taste changed by week 2 and 4 after unilateral lingual nerve transection. However, regeneration related taste was occurred in the presence of preserving mesoneurial tissue and the time was 6 weeks. Our results demonstrated that unilateral lingual nerve damage caused morphological and numerical change of fungiform papilla. It should be noted in our study that lingual nerve transection resulted in not only morphological and numerical change but also functional change of fungiform papillae.
Animals ; Biotechnology ; Drug Therapy ; Fluorescent Antibody Technique ; Humans ; Lingual Nerve Injuries* ; Lingual Nerve* ; Male ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Sucrose ; Taste Buds* ; Tongue

Two major salivary glands, submandibular duct, lingual nerve, and vessels are situated beneath the mouth floor. Among these, passing through the pterygomandibular space, lingual nerve is innervated to the lingual gingiva and the mucosa of mouth floor, and is responsible for the general sensation of the anterior two thirds of the tongue. So, the injury of the lingual nerve during an anesthesia or surgery in the retromolar area may cause complications such as a numbness, a loss of taste of the tongue and the other dysfunctions. Therefore, to find out the morphology and the course of lingual nerve and to clarify the topographical relationships of lingual nerve at the infratemporal fossa and paralingual space area, 32 Korean hemi-sectioned heads were dissected macroscopically and microscopically with a viewpoint of clinical aspect in this study. This study demonstrated various anatomical characteristics with relation to the course and topography of the lingual nerve in Koreans. And clinical significances based on the anatomical variations through the topography of the courses and communications between the mandibular nerve branches were described in details.
Anesthesia ; Chorda Tympani Nerve ; Gingiva ; Head ; Hypesthesia ; Lingual Nerve* ; Mandibular Nerve ; Mouth Floor ; Mucous Membrane ; Salivary Glands ; Sensation ; Tongue

INTRODUCTION: This study evaluated nerve recovery through retrospective study of patients with lingual nerve damage. PATIENTS AND METHODS: The patients who visited Seoul National University Dental Hospital for an injury to the lingual nerve from April 1988 to August 2009 were enrolled in this study (n=41). The relevance of various factors including the causes of damage, age, etc. was analyzed by the subjective improvement based upon questionnaires and the clinical records. The evaluation variants were a subjective assessment and neurosensory examination composed of the direction, contact threshold, two-point discrimination, pin prick, thermal discrimination and current perception threshold. RESULTS: The causes of lingual nerve damage were an extraction of the lower third molar (75.6%), local anesthesia (9.7%), incision and drainage (4.88%), trauma (2.44%). The evaluation of subjective prognosis exhibited no difference in sensory improvement depending on the cause, age and gender. Based upon the subjective evaluation, 44.7% of patients showed sensory improvement. The first hospital visit from injury was shorter in the group showing subjective improvement (3.41 months) than those showing no improvement (5.24 months) (P=0.301). Thirty six out of 41 patients were treated with only conservative therapy and 5 patients were treated by surgical intervention. Neurosensory examinations revealed improvement, although not statistically significant, and the degree was higher in the subjectively improved group. The contact threshold discrimination showed the highest correlation with subjective improvement (P=0.069). Most of the sensory recovery was gained within 12 months and the degree of improvement at the tip of the tongue was higher than that of the dorsum (P<0.001). CONCLUSION: The damaged lingual nerve improved at a rate of 44.7% and mostly within 12 months after the incident. There was no difference between the subjective prognosis and neurosensory examination depending on the cause of damage, age and gender, whereas the contact threshold discrimination was the best variant that reflected the subjective prognosis statistically.
Anesthesia, Local ; Discrimination (Psychology) ; Drainage ; Humans ; Lingual Nerve ; Molar, Third ; Prognosis ; Surveys and Questionnaires ; Retrospective Studies ; Tongue