Morphometrics of the Anterior Belly and Intermediate Tendon of the Digastric Muscle

Zdilla, Matthew J.; Pancake, Alex R.; Lambert, H. Wayne

doi:10.1097/scs.0000000000002708

Cited by 11 publications

(10 citation statements)

References 40 publications

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“…The arrowhead musculature is morphologically more akin to the mylohyoid, as opposed to the ABDM, in its sheet-like structure and the parallel orientation of its fibers (with the contralateral mylohyoid). Further, with regard to the size of typical, non-variant ABDM musculature, a recent report documented the average adult ABDM muscle belly length and area to be 38.7 ± 7.4 mm and 484.5 ± 101.2 mm 2 , respectively [41]. When comparing the size of the ABDMs reported in the present study to the aforementioned averages, the ABDMs reported here were larger than average with respect to both length and area, but remained within two standard deviations of the mean.…”

Section: Discussionmentioning

confidence: 99%

The submental arrowhead variation of the mylohyoid and anterior belly of the digastric muscles

et al. 2018

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Purpose-Submental anatomical variation is of clinical importance with regard to head and neck surgeries. One such anatomical variation is that of additional musculature joining the intermediate tendon of the digastric muscle to the midline of the mylohyoid musculature-a variation which this report refers to, accordingly, as an arrowhead variation. Though the arrowhead variation has been described in several case reports, it has not been subject to cross-sectional study. The purpose of this study is to determine the prevalence of the arrowhead variation. Methods-Prevalence of the arrowhead variation was assessed in 19 cadavers via gross dissection. Results-Two of the 19 cadavers (10.5%) were found to have arrowhead variations. The arrowhead variation was found in one male (1:11; 9.1%) and one female (1:8; 12.5%), respectively. Conclusions-This report demonstrates that the submental arrowhead variation of the anterior digastric and mylohyoid musculature has been reported in isolated case reports since the nineteenth century. This report is the first cross-sectional study of the arrowhead variant, identifying it in approximately one in ten individuals and in both sexes. Therefore, the presence of an arrowhead variation should be regularly considered with regard to diagnosis of submental masses. Likewise, the arrowhead variation should be considered in the preoperative planning of the myriad operations performed in the submental region.

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Section: Discussionmentioning

confidence: 99%

The submental arrowhead variation of the mylohyoid and anterior belly of the digastric muscles

et al. 2018

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“…Clinically, structural variations of the ABDM have implications in surgeries involving the muscles of the submental region such as correction of facial paralysis and an array of cosmetic surgeries for improving the frontal neck contour [5,9,10,23,26]. The ABDM variations, especially those with atavistic type variation and robust AB accessory muscles, could cause misidentification of the suprahyoid muscle groups which affects diagnosis involving the submandibular region [1,26,27]. Therefore, attracting attention to the frequent occurrence and morphological complexity of ABDM variations in the general population has significant clinical importance.…”

Section: Discussionmentioning

confidence: 99%

A cadaveric analysis of anatomical variations of the anterior belly of the digastric muscle

Anderson

Tucker

2021

Folia Morphol

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Background: The anterior belly of the digastric muscle (ABDM) presents highly variable and frequent anatomical variations. Since the ABDM functions as a landmark for clinical procedures involving the submental region, it is important to have a comprehensive understanding of its variations. In this study, we sought to improve our knowledge of ABDM variations in the ethnically diverse whole-body donor population in Northern California. Specific aims were: (1) to determine the frequency of ABDM and AB accessory muscle variations in cadavers donated to the UC Davis Body Donation Program, (2) to classify these variations identified in this population using the previously proposed nomenclatures by Yamada (1935) and Zlabek (1933), and (3) to investigate the innervation and arterial supply to the representative ABDM and AB accessory muscle variations. Materials and methods: During the 2018 and 2019 gross anatomy dissection laboratories at the UC Davis School of Medicine, the submental regions of 48 cadavers were examined and classified. Results: Fifteen cadavers (31.2%) presented ABDM and AB accessory muscle variations. These variations were clearly categorized using the morphology of the ABDMs and attachments of the AB accessory muscles. We also identified three previously unreported types of variations, two of which presented the fusion of right and left ABDMs and one presenting an ectopic tubercle beneath the mandibular symphysis to which a pair of AB accessory muscles were attached. Conclusions: ABDM variations were found in 1 in 3 individuals in the local Northern California population. Knowledge of the prevalence and common patterns of ABDM variations in the general population would be valuable information when an operation or examination is performed in the submental region.

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Additionally, the ABDM may be transferred in order to reanimate the mouth after palsy of the marginal mandibular branch of the facial nerve, and, likewise, variant ABDM musculature has been proposed for muscle transfer. [23][24][25][26][27][28][29] Because the ABDM is important in a variety of plastic surgical procedures, detailed knowledge of its association with nearby anatomy is important. This report is the first to demonstrate directly the existence of the retaining ligament of the anterior digastric muscle and document variation in its attachment sites, its composition, and its behavior when traction forces are applied.…”

Section: Discussionmentioning

confidence: 99%

The Retaining Ligament of the Anterior Digastric Muscle

Zdilla

Swearingen

Miller

et al. 2017

Journal of Craniofacial Surgery

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The anterior belly of the digastric muscle (ABDM) is important in numerous esthetic surgeries including rhytidectomy, alteration of the cervicomental angle via partial resection of the ABDM muscle belly, and suprahyoid muscular medialization and suspension. Recently, the connection between the ABDM and the mylohyoid muscle (MH) has been proposed as important for the mechanism of the digastric corset procedure. This report refers to the connection between the ABDM and the MH as a type of retaining ligament of the anterior digastric muscle (RLAD). This report is the first to directly demonstrate the existence of the RLAD, via photograph and video, and document variation in its attachment sites, its composition, and its behavior when traction forces are applied. In addition to the importance of the RLAD in plastic surgery, the RLAD may affect neurovascular structures between the ABDM and MH and serve as a physical barrier separating the submental fascial space from the submandibular fascial space and, therefore, influence the spread of infection.

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Morphometrics of the Anterior Belly and Intermediate Tendon of the Digastric Muscle

Cited by 11 publications

References 40 publications

The submental arrowhead variation of the mylohyoid and anterior belly of the digastric muscles

The submental arrowhead variation of the mylohyoid and anterior belly of the digastric muscles

A cadaveric analysis of anatomical variations of the anterior belly of the digastric muscle

The Retaining Ligament of the Anterior Digastric Muscle

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