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.
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dear doc..
ReplyDeletedo 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??/
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 !
ReplyDeletehow does this affect harvest of block grafts from the chin?specially when we scrape till the lingual cortex?
ReplyDeletewould 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???????