Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach

Abdul Veli İsmailoğlu; Ömer Selim Al; Sevdenur Yazı; Pelin İsmailoğlu; Mustafa Aktekin; Ümit Süleyman Şehirli

Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach

Abstract

Aims: This study aimed to describe the topographic anatomy of the marginal mandibular nerve (MMN) and cervical branch of facial nerve (CBFN) and propose a surgical technique to reduce the risk of MMN-CBFN injuries during submandibular gland (SMG) resection. Methods: 12 hemifaces from 7 low-formalin-fixed, red-blue-latex-injected cadaveric heads were dissected under 2.5×magnification using a surgical microscope. After elevation of skin-SMAS-platysma flap, a meticulous dissection was performed to expose the MMN, CBFN, facial vessels, hypoglossal nerve, masseter muscle, and SMG. All structures were mapped using relevant surgical landmarks. Results: The MMN was predominantly located (91.6%) in the 10 mm area both superior and inferior to the mandibular edge. The MMN crossed the mandibular edge 4.2±0.8 cm anterior to the mandibular angle (at the masseter’s anterior border) alongside the facial artery. The most inferior branch of the CBFN was located 3.7±0.6 cm below the mandibular edge. The MMN-CBFN consistently coursed between the layers of the investing fascia deep to the platysma. Conclusion: A surgical approach involving a skin-platysma-deep fascia flap incision placed 4 cm below the mandibular edge ensures safe exposure of the SMG while preserving both the marginal mandibular and cervical branches of the facial nerve.

Keywords

Supporting Institution

anonymous colleague

Ethical Statement

This study was conducted in accordance with ethical standards and approved by the local Ethics Committee (09.2026.26-0147). This study was conducted on donated cadavers in line with the principles of the Declaration of Helsinki. All donor consent forms are archived in the Department of Anatomy within the faculty.

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Details

Primary Language

English

Subjects

Surgery (Other)

Journal Section

Research Article

Authors

Abdul Veli İsmailoğlu ^*
0000-0003-0904-8679
Türkiye

Ömer Selim Al
0000-0001-7303-5747
Türkiye

Sevdenur Yazı
0000-0003-1325-4205
Türkiye

Pelin İsmailoğlu
0000-0002-2631-496X
Türkiye

Mustafa Aktekin
0000-0003-4253-9963
Türkiye

Ümit Süleyman Şehirli
0000-0001-6261-4567
Türkiye

Publication Date

July 16, 2026

Submission Date

March 30, 2026

Acceptance Date

May 5, 2026

Published in Issue

Year 2026 Volume: 8 Number: 4

IZ

https://izlik.org/JA49MH65ES

Cite

RIS / Bibtex

APA

İsmailoğlu, A. V., Al, Ö. S., Yazı, S., İsmailoğlu, P., Aktekin, M., & Şehirli, Ü. S. (2026). Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach. Anatolian Current Medical Journal, 8(4), 599-604. https://izlik.org/JA49MH65ES

AMA

1.İsmailoğlu AV, Al ÖS, Yazı S, İsmailoğlu P, Aktekin M, Şehirli ÜS. Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach. Anatolian Curr Med J / ACMJ / acmj. 2026;8(4):599-604. https://izlik.org/JA49MH65ES

Chicago

İsmailoğlu, Abdul Veli, Ömer Selim Al, Sevdenur Yazı, Pelin İsmailoğlu, Mustafa Aktekin, and Ümit Süleyman Şehirli. 2026. “Minimizing Nerve Injury in Submandibular Gland Resection: Anatomical Landmarks and a Proposed Safe Approach”. Anatolian Current Medical Journal 8 (4): 599-604. https://izlik.org/JA49MH65ES.

EndNote

İsmailoğlu AV, Al ÖS, Yazı S, İsmailoğlu P, Aktekin M, Şehirli ÜS (July 1, 2026) Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach. Anatolian Current Medical Journal 8 4 599–604.

IEEE

[1]A. V. İsmailoğlu, Ö. S. Al, S. Yazı, P. İsmailoğlu, M. Aktekin, and Ü. S. Şehirli, “Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 4, pp. 599–604, July 2026, [Online]. Available: https://izlik.org/JA49MH65ES

ISNAD

İsmailoğlu, Abdul Veli - Al, Ömer Selim - Yazı, Sevdenur - İsmailoğlu, Pelin - Aktekin, Mustafa - Şehirli, Ümit Süleyman. “Minimizing Nerve Injury in Submandibular Gland Resection: Anatomical Landmarks and a Proposed Safe Approach”. Anatolian Current Medical Journal 8/4 (July 1, 2026): 599-604. https://izlik.org/JA49MH65ES.

JAMA

1.İsmailoğlu AV, Al ÖS, Yazı S, İsmailoğlu P, Aktekin M, Şehirli ÜS. Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach. Anatolian Curr Med J / ACMJ / acmj. 2026;8:599–604.

MLA

İsmailoğlu, Abdul Veli, et al. “Minimizing Nerve Injury in Submandibular Gland Resection: Anatomical Landmarks and a Proposed Safe Approach”. Anatolian Current Medical Journal, vol. 8, no. 4, July 2026, pp. 599-04, https://izlik.org/JA49MH65ES.

Vancouver

1.Abdul Veli İsmailoğlu, Ömer Selim Al, Sevdenur Yazı, Pelin İsmailoğlu, Mustafa Aktekin, Ümit Süleyman Şehirli. Minimizing nerve injury in submandibular gland resection: anatomical landmarks and a proposed safe approach. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Jul. 1;8(4):599-604. Available from: https://izlik.org/JA49MH65ES