Vascular Anatomy for the Prevention of Sublingual Hematomas: Life-Threatening Complication of Genioplasty

Choi, Bong-Kyoon; Lee, Sang-Soo; Yun, In Sik; Yang, Eun‐Jung

doi:10.1097/scs.0000000000009104

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Furthermore, Choi et al . reported that post-oral surgery sublingual hematoma leading to life-threatening airway obstruction requires immediate recognition and prompt management [ 23 ]. Most dental implant specialists are alert to the possibility of perforation of the lingual-side cortical bone by the implant as an accidental complication during oral implant insertion in the area from the mandibular incisal region to the premolar region [ 9 , 24 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

Structural analysis of the mylohyoid muscle as a septum dividing the floor of the oral cavity for the purposes of dental implant surgery: variety of muscle attachment positions and ranges of distribution

Noguchi,

Morita,

Suzuki

et al. 2023

Int J Implant Dent

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Objectives The objective was to investigate the details of the attachments of the mylohyoid muscle to the mandible anterior to the hyoid and mylohyoid lines to understand the positional relationship between the sublingual space and the mylohyoid, knowledge that is essential for dental implant surgery in the incisal region, as well as the routes of communication between the sublingual space and other spaces. Methods While evaluating the presence or absence of an anterior mylohyoid muscle fiber attachment to the mandible, sublingual gland herniation, spaces between muscle fascicles were also recorded as sites of penetration. The mean muscle thickness in each of these areas was also calculated. Results In all specimens, the mylohyoid originated not only from the mylohyoid line but also from the lingual surface of the center of the mandibular body (the mandibular symphysis) below the mental spines. The mylohyoid muscle fascicles were thickest in the posterior region, and further anterior to this, they tended to become thinner. Sublingual gland herniations passing through the mylohyoid were noted in the anterior and central regions, but not in the posterior region. Penetration between the muscle fascicles was most common in the central region, and no such penetration was evident in the posterior region. Conclusions These results suggest that the mylohyoid functions only incompletely as a septum, and that routes of communication from the sublingual space to the submandibular space may be present in both the anterior and central muscle fascicles of the mylohyoid. Therefore, bleeding complications during dental implant placement in the anterior mandible can be serious issues. There is a potential for sublingual hematoma that could compromise the airway by pressing the tongue against the soft palate into the pharynx.

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Section: Discussionmentioning

confidence: 99%

Structural analysis of the mylohyoid muscle as a septum dividing the floor of the oral cavity for the purposes of dental implant surgery: variety of muscle attachment positions and ranges of distribution

Noguchi,

Morita,

Suzuki

et al. 2023

Int J Implant Dent

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show abstract

“…The mylohyoid muscle still involves with many other surgical procedures such as genioplasty. 61,62 We hope this review would help dentists, oral and maxillofacial, and head and neck surgeons to understand clinical anatomy of the mylohyoid muscle.…”

Section: Discussionmentioning

confidence: 99%

Mylohyoid Muscle: Current Understanding for Clinical Management Part II: Clinical Anatomy, Radiology, and Surgical/Clinical Relevance

Obata,

Kitagawa,

Ono

et al. 2023

Journal of Craniofacial Surgery

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Augmentation genioplasty using discarded bone fragments following proximal segment osteotomy of the ramus in intraoral vertical ramus osteotomy (IVRO)

Kang,

Lee,

Jun

et al. 2024

Maxillofac Plast Reconstr Surg

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Background Based on a three-dimensional (3D) orthognathic simulation, this technical report introduces a method for augmentation genioplasty using a proximal bone fragment of the mandible, which is typically discarded in intraoral vertical ramus osteotomy (IVRO). Results A 43-year-old female patient diagnosed with Class III malocclusion, presenting with a protruding mandible and long facial height, underwent surgical treatment. The surgical plan involved mandibular setback position using IVRO and augmentation genioplasty. The 3D orthognathic surgery including augmentation genioplasty simulation was performed. An excessively elongated proximal segment was sectioned following IVRO. The inferior part of the sectioned proximal bone fragment of the mandible was positioned to align with the requirements of advancement genioplasty. After ensuring that the placement of the fragment matched that of the simulated surgery, each bone fragment was fixed. At 1.5 years post-surgery, the grafted bone on the augmentation genioplasty was well maintained, with slight bone resorption. Conclusions Augmentation genioplasty using the proximal bone fragment of the mandible, which is typically discarded in IVRO, reduces the surgical complications associated with chin osteotomy. When a secondary genioplasty is required, genioplasty with osteotomy, movement of the cut bone fragments, partial bone-shaving osteotomy, and additional bone grafting are viable options.

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Vascular Anatomy for the Prevention of Sublingual Hematomas: Life-Threatening Complication of Genioplasty

Cited by 3 publications

References 25 publications

Structural analysis of the mylohyoid muscle as a septum dividing the floor of the oral cavity for the purposes of dental implant surgery: variety of muscle attachment positions and ranges of distribution

Structural analysis of the mylohyoid muscle as a septum dividing the floor of the oral cavity for the purposes of dental implant surgery: variety of muscle attachment positions and ranges of distribution

Mylohyoid Muscle: Current Understanding for Clinical Management Part II: Clinical Anatomy, Radiology, and Surgical/Clinical Relevance

Augmentation genioplasty using discarded bone fragments following proximal segment osteotomy of the ramus in intraoral vertical ramus osteotomy (IVRO)

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