Lingual Nerve Injury

Steven B. Graff-Radford, DDS, Randolph W. Evans, MD

Disclosures

Headache. 2003;43(9) 

In This Article

Anatomy

The lingual nerve branches from the third division of the trigeminal nerve after it exits the foramen ovale. It carries with it taste fibers from the chorda tympani that supply the anterior two thirds of the tongue. The lingual nerve may be round, oval, or flat and varies in size from 1.53 mm to 4.5 mm.[4] The nerve is either monofascicular or oligofascicular in structure at the pterygomandibular space, making it susceptible to injury by injection in this area.[73] It runs deep to the lateral pterygoid muscle parallel to the inferior alveolar nerve, lying anterior and medial to it. It then runs between the internal and medial pterygoid muscles and passes obliquely over the superior pharyngeal constrictor and styloglossus muscles 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. It 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.

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