Lingual Nerve Taste Disturbance — ORE Part 1 MCQ

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ModerateOral SurgeryLingual Nerve Taste DisturbanceORE Part 1

Two weeks after removal of a mandibular third molar, a patient reports altered taste over the ipsilateral anterior two-thirds of the tongue. Which nerve was most likely injured?

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Correct answer: B — Lingual nerve

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · C = shown as D · B = shown as E

A is correct. The lingual nerve is vulnerable during mandibular third-molar surgery. It provides general sensation to the anterior two-thirds of the tongue and carries chorda tympani taste fibres to this region; consequently, lingual nerve injury may present with altered taste, with or without numbness. The inferior alveolar nerve would cause altered sensation of the lower lip and chin rather than tongue taste disturbance. The hypoglossal nerve is motor to the tongue and injury causes weakness or deviation. The glossopharyngeal nerve supplies taste to the posterior third of the tongue. Although taste fibres originate from the facial nerve through the chorda tympani, an extracranial facial-nerve injury is not the expected complication of lower third-molar removal.

Reference: Rusu MC, et al. Details of the intralingual topography and morphology of the lingual nerve. International Journal of Oral and Maxillofacial Surgery. 2008. https://pubmed.ncbi.nlm.nih.gov/9469723/