During submandibular gland excision through a standard skin crease incision, the structure most at risk of injury where it crosses the body of the mandible over the facial vessels is the:

• A Great auricular nerve
• B Hypoglossal nerve
• C Lingual nerve
• D Marginal mandibular branch of the facial nerve ✓

Explanation

The marginal mandibular branch of the facial nerve runs below the angle and body of the mandible before arching up over the facial vessels, so it is vulnerable during submandibular surgery. Injury causes paralysis of the depressor anguli oris with asymmetry of the lower lip on smiling. For this reason the skin incision is placed two finger breadths below the mandible. The lingual and hypoglossal nerves are encountered deeper within the surgical field, not at the mandibular border.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.