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Clinical anatomy of the accessory mandibular foramen: application to mandibular ramus osteotomy

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Abstract

Purpose

An accessory foramen around the mandibular foramen is called an accessory mandibular foramen (AMF). The clinical anatomy of the AMF has not been well described. The aim of this study was to reveal the clinical anatomy of the AMF for a better understanding of its implication during ramus surgeries.

Methods

Twenty-two sides fresh-frozen cadaveric heads with a mean age of 76.2 ± 14.4 years at death underwent dissection. The neurovascular bundles passing through the AMF were observed. Additionally, a hemi-face of a latex injected embalmed cadaver was dissected medially to laterally and the neurovascular bundles of the AMF investigated.

Results

A unilateral foramen, bilateral foramina, and absence of foramina were found in 45.4%, 18.2%, and 36.4%, respectively. The origin of the neurovascular bundle entering the AMF was a branch of the maxillary artery in 20% and a tributary of the inferior alveolar vein in 80%. In the latex embalmed cadaver, the AMF was found to contain a branch from the maxillary artery and a tributary of the maxillary vein.

Conclusion

Given the practical meaning of the specific AMF located in the operative field of the ramus osteotomy, we suggest these be named “foramina for ramus osteotomy.”

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Acknowledgements

The authors would like to thank who donated their body for the advancement of medical education and research. All the authors have read the manuscript and have approved this submission.

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Authors and Affiliations

  1. Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA

    Joe Iwanaga & R. Shane Tubbs

  2. Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Joe Iwanaga, Shogo Kikuta & Jingo Kusukawa

  3. Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Joe Iwanaga & Koichi Watanabe

  4. Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Soichiro Ibaragi

  5. Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada

    R. Shane Tubbs

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  1. Joe Iwanaga
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Contributions

JI: Protocol/project development, Data collection, Data analysis, Manuscript writing. SK: Data collection, Manuscript writing. SI: Data analysis, Manuscript writing. KW: Data analysis, Manuscript editing. JK: Protocol/project development, Data analysis, Manuscript editing. RST: Protocol/project development, Data collection, Manuscript editing.

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Correspondence to Joe Iwanaga.

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The authors received no funding or grants for this work from any organization or foundation. The authors declare that they have no conflicts of interest.

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Iwanaga, J., Kikuta, S., Ibaragi, S. et al. Clinical anatomy of the accessory mandibular foramen: application to mandibular ramus osteotomy. Surg Radiol Anat 42, 41–47 (2020). https://doi.org/10.1007/s00276-019-02343-3

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  • DOI: https://doi.org/10.1007/s00276-019-02343-3

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