Intraoperative localization of the marginal mandibular nerve: a landmark study

BACKGROUND: Identification and preservation of the marginal mandibular nerve (MMN) remains an important step in otolaryngology procedures. Current publications place the MMN at least 1 cm below the mandible. This study will evaluate the accuracy of the method of determining the surgical location of this branch of the facial nerve in vivo. METHODS: MMN were examined in 52 consecutive otolaryngology patients. Using a validated landmarking scheme, distances were measured from the inferior edge of the mandible and the lowest point of the nerve. A comparison of 33 nerves pairs was undertaken. Effect of patient’s age was analysed. RESULTS: Eighty five nerves were landmarked. The mean position of the nerve was 0.2–3.4 mm higher than the margin of the mandible. There were no significant difference in position with respect to age and left versus right comparisons. CONCLUSION: The marginal mandibular nerve (MMN) is significantly higher than previously published. The location of the nerve on the right does not correlate with the left. Location of the nerve does not correlate with patient’s age.