Anatomy help...

[AngkorWuT]

Doing submental dissection for unknown submental mass and attending asks what important nerve should be avoided. Now keep in mind we are superficial to the musculature in the midline, about halfway between the thyroid notch and hyoid bone. For the life of me I cannot think of what it is. We're too superficial to be worried about hypoglossal. Too midline to worry about the contents of the carotid sheath. I'm pretty sure the cervical facial nerve does not descent this inferior.

Superior laryngeal (not convinced anyways) - wrong
Vagus (definitely not convinced but worth a shot) - wrong
Facial (god how did I match) - wrong
Cervical sensory nerves (shot in the dark) - wrong
Hypoglossal (again, pretty sure it was not since it should be deeper and probably more lateral) - WRONG WRONG WRONG

I'm pretty sure ansa hypoglossi and phrenic are not correct either. I've stared at some stuf online and have come up with nothing. I'll go home and browse through my atlas.

So to the much smarter SDN ENT's...please help me

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[OtoHNS]

Sounds like a trick question, one of my attendings in residency loved to ask those...

There's really no important nerves or vessels in the submental area.

 

[Pir8DeacDoc]

Sounds like a trick question, one of my attendings in residency loved to ask those...

There's really no important nerves or vessels in the submental area.

Exactly..

Midline that superficial there's nothing. The only thing I ever hit in the midline lower is the Anterior Jugular vein. No matter how much I know it's there I used to hit it once a week or so during residency. Oh well, no biggie

 

[Fah-Q]

Sounds like a trick question, one of my attendings in residency loved to ask those...

There's really no important nerves or vessels in the submental area.

I agree that there are no nerves of importance there. However, I will argue that the submental artery is there and is of importance. The submental flap is a nice fasciocutaneous regional flap that I use a few times a year.

 

[resxn]

You're getting tricked. That's the beauty of the midline submentum--free of disaster. Well, except for our reconstruction guys who like to preserve every red vessel no matter how small. (sorry, Fah-Q)

 

[Fah-Q]

You're getting tricked. That's the beauty of the midline submentum--free of disaster. Well, except for our reconstruction guys who like to preserve every red vessel no matter how small. (sorry, Fah-Q)

You have angered the flap gods. Your blasphemy will not soon be forgotten.

 

[neutropeniaboy]

What's the submentum?

 

[Fah-Q]

What's the submentum?

It's between the ponticulus and subiculum.

 

[resxn]

What's the submentum?

I'll date myself here, but on a quirky tv show a ways back, one lawyer had a fascination with touching the submentum, but he called it the "waddle."

Anyone know the name? I can't be the oldest one here.

 

[kobugiman]

Isn't that from ally mcbeal?

 

[resxn]

yep, thanks for not leaving me out to dry

 

[neutropeniaboy]

Isn't that from ally mcbeal?

Yup...Peter MacNicol's character.

 

[neutropeniaboy]

It's between the ponticulus and subiculum.

Not the last time I blindly scraped in there...this submentum must be a head and neck term...

 

[resxn]

Yup...Peter MacNicol's character.

Actually, it was Greg Germann's character, Fish.

 

[neutropeniaboy]

Actually, it was Greg Germann's character, Fish.

I guess so, then.