OBJECTIVES Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth. Thus, the purpose of this study was to analyze the trajectory of the mandibular canal (MC), the location of the mental foramen (MF) and the presence and extension of an anterior loop of the mental nerve (AL). STUDY DESIGN In this cross-sectional study, a total of 348 CBCTs were analyzed. Distances from MC to the surface of the basal, medial and lateral cortical of the mandible were measured at the level of the second molar, first molar and second premolar. Location of the MF relative to the apices of the premolars, as well as incidence and anterior extent of the AL were also determined. RESULTS Significant and clinically relevant correlations were found between the position of the MC in women, which was located more caudal (r=-0.219, p=0.007; r=-0.276, p<0.001; right and left, respectively) and lateral (r=-0.274, p=0.001; r=-0.285, p<0.001; right and left, respectively), particularly at the level of the premolars. Additionally, the presence (r=-0.181, p=0.001; r=-0.163, p=0.002; right and left, respectively) and anterior extension (r=-0.180, p=0.009; r=-0.285, p=0.05; right and left, respectively) of the AL was found to be inversely correlated with the age of the patient. CONCLUSIONS This analysis of a Caucasian population has found that the older the patient, the lower the incidence of the loop and the shorter its anterior extension.

/pdf/inferior-alveolar-nerve-trajectory-mental-foramen-location-vskrpv2o1c.pdf

Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop.

Background There are about 800 lymph nodes in the body of a healthy adult human being. Three hundred of them are in the head and neck area. The presence or absence of metastatic cancer in the head and neck lymph nodes is essential for the survival of patients. Materials and methods This article is an overview and is based on a thorough review of 25 other scientific works (24 foreign and 1 in Bulgarian)—articles, monographs, textbooks, anatomical and patho-anatomical atlases, and websites. Discussion Lymph nodes are a major part of the lymphatic system. They are small cluster formations located in strategic places in groups that play a key role in the lymphatic drainage of regional anatomical structures. The location of the lymph nodes in the head and neck region is associated with the different topographic anatomical lodges. There are different ways to group them. Topographically and anatomically, the groups of lymph nodes in the head are divided into superficial and deep. There are five types of superficial lymph nodes: facial, occipital, retroauricular, preauricular, and superficial parotid. The facial groups on their part are divided into suborbital or upper, buccal or middle, and supramandibular. Deep lymph nodes of the head include the repharyngeal and deep parotid lymph nodes. The neck lymph nodes can either be deep or superficial. Superficial lymph nodes include the submental, submandibular, and superficial lymph nodes located in front of and above the sternocleidomastoid muscle. The deep lymph nodes of the neck are classified into three groups based on their location: the upper, the middle (also called subdigastric lymph nodes), and the lower cervical third. For malignant processes in the head and neck area, nearby dissemination in the regional lymph basin (sentinel lymph nodes) is more characteristic. Depending on the initial diagnosis, the distant metastatic disease most commonly affects the lung, bones, and brain. Conclusion Knowledge of the structure, function, exact location, and lymphatic drainage of the lymph nodes of the head and neck, as well as the areas of lymphatic drainage in the same parts of the human body, is essential for making the correct diagnosis and determining the treatment plan for patients with lymphadenomegaly. 

Lymph nodes of the head and neck: in normal and pathological conditions

The lymphatic system consists of a collection of lymphatic vessels connected to lymph nodes which filter lymph fluid that gets collected throughout the body. Lymph nodes filter lymph via specialized white blood cells that destroy and remove microorganisms, malignant cells, damaged cells, and foreign particles. The lymphatic vessels and lymph nodes, along with the thymus, tonsils, and spleen, serve a vital function for the removal of interstitial fluid from tissue and development and maintenance of the immune response. Lymph fluid ultimately returns to the venous circulation. Lymph nodes are present throughout the body. The head and neck region contains over 300 lymph nodes, of which include the supraclavicular lymph nodes. This paper will focus on the supraclavicular lymph nodes and their anatomical relations, drainage, physiological variations, surgical considerations, and clinical significance in the context of malignancy and other pathology.

Anatomy, Head and Neck, Supraclavicular Lymph Node

Lymphatic system of the head and neck

A Head and Neck Lymph Node Classification Using an Anatomical Grid System While Maintaining Clinical Relevance

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A Head and Neck Lymph Node Classification Using an Anatomical Grid System While Maintaining Clinical Relevance