Tuesday, August 11, 2009

Lingual Foramen

Vascular channels are often found in the midline and lateral to the midline of the mandible. Although the lingual foramen was found in 99% of dissections it was seen in less than 49% of peripaical films . Here is patient I saw recently.One can see the lingual foramen clearly on the CT slice, as well as the periapical film and also if you look carefully at the OPG.
The lingual foramen harbors an artery that is an anastomosis of right and left sublingual arteries. This tiny vessel (0.4 to 1.5mm) has been implicated in serious hemorrhage and rarely fatalities. one should be aware of the presence of this vessel and avoid it when possible.
For the periapical and the opg image click on the title of this post


  1. dear doc..
    do u do a c.t. scan for all anterior mandible cases.
    if there is extensive bleeding thru the osteotomy do we have to doubt a ling arty perforn
    besides pressure pack any other tech to manage??/

  2. No I dont do a ctScan for every anterior mandible case. If there is bleeding through the osteotomy the best thing is to place an implant into the osteotomy. That will help control the bleeding. In theory finding the vessel and ligating it, or passing a suture around and deep to the vessel and tying it off are all options. In practice the mouth fills up with blood too fast to allow one to even find out where the bleeding is from. Pressure packs held in place until one can get the patient to a hospital are the most reliable. Even at the hospital often the pressure pack will continue !

  3. how does this affect harvest of block grafts from the chin?specially when we scrape till the lingual cortex?
    would it be better then to do a ct scan?
    if we do identify a vessel on the scan...any modifications required in our trt plan???????