How to avoid injury to the lingual nerve

The lingual nerve Lingual nerve is a branch of the trigeminal nerve's mandibular division (V3). It carries general sensation to the anterior two-thirds of the tongue, lingual gingiva, and ipsilateral floor of the mouth. It also carries a special visceral sensation (taste) via the chorda tympani nerve Chorda tympani nerve Visceral sensation (taste), chorda tympani nerve . In addition, it carries the parasympathetic innervation to the submandibular ganglion. Injury to the nerve will result in significant morbidity for the patient. The patient will suffer from paresthesia of half of the tongue, resulting in difficulty talking, eating with drooling, and tongue biting. Moreover, the taste is usually impaired with a possibility of persistent metallic taste. Finally, xerostomia and reduction of saliva production are other morbidity if the nerve is injured. After the lingual nerve branches from the mandibular nerve, it receives the chorda tympani nerve Chorda tympani nerve that transmits taste sensation to the anterior two-thirds of the tongue. At this level, it is usually located about 1 cm anterior to the mandibular foramen between the medial pterygoid muscle and the medial surface of the mandibular ramus (Fig. 2.1). At the level of the third molar, it runs superior to the mylohyoid muscle, and it can be at the level of the alveolar crest or higher in about 17% of the cases. Furthermore, the distance from the alveolar crest to the nerve at the level of the third molar is found to range between 2.28 and 3.01 mm. The surgeon should be careful with the atrophic mandible since the nerve will be near the ridge following bone resorption Bone resorption . Subsequently, the nerve will move anteromedially and run beneath the submandibular duct before it terminates at the ventral surface of the tongue. The purpose of this chapter is to explain how to avoid injury to the lingual nerve Lingual nerve during routine dentoalveoloar procedures Dentoalveoloar procedures .