Surgical Localization of the Marginal Mandibular Nerve in Relation to the Inferior Border of the Mandible and the Submandibular Gland

Background: The marginal mandibular nerve (MMN) runs adjacent to the inferior border of the mandible (MIB) and is in a vulnerable location during surgical procedures. Identification and preservation of the MMN are critical in head and neck procedures. We aimed to evaluate the surgical localization of the MMN in relation to the MIB and the submandibular gland.

Methods: Marginal mandibular nerves were examined in 61 patients with 96 neck dissections. The maximum perpendicular distance was measured from the lowest point of the nerve in the neck to the inferior edge of the mandible and submandibular gland.

Results: Thirty-nine males and 22 females were enrolled in the study. A total of 96 neck dissections were performed. Bilateral neck dissection was performed in 35 patients, and unilateral neck dissection was performed in 26 patients. The mean nerve position on the right side was 2.57 mm below the MIB, while on the left side, the position was 3.53 mm below the MIB. The mean nerve positions for the right and left sides were 27.7 mm and 28.2 mm above the inferior border of the submandibular gland, respectively.

Conclusion: Accurate localization of the nerve is essential to avoid iatrogenic injury and potential complications. In this study, the MMN courses were below the MIB in 80% of the necks. In all the necks, except for three, the distance from the MMN to the MIB was 10 mm or less.

Cite this article as: Gündoğdu Y, Asya O, .zcan S, et al. Surgical localization of the marginal mandibular nerve in relation to the inferior border of the mandible and the submandibular gland. B-ENT. 2024;20(4):226-231.