Lingual Nerve Anatomy — MFDS Part 1 MCQ

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ModerateAnatomy (Head & Neck)Lingual Nerve AnatomyMFDS Part 1

During surgical extraction of a mandibular third molar, in which anatomical region is the lingual nerve closest to the operative field and therefore most at risk of injury?

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Correct answer: D — Lingual aspect of the third-molar/retromolar region near the alveolar crest

The correct answer is D. The lingual nerve passes immediately medial to the mandibular third-molar and retromolar region, where it may contact the lingual plate or lie at or above the alveolar crest. This close and variable relationship places it at risk from lingual flap elevation, retraction, distal bone removal and instrumentation during third-molar surgery. Although the nerve originates in the infratemporal fossa, that proximal segment is remote from the extraction field. It subsequently enters the floor of the mouth, but the more anterior segment described in C is not the principal site endangered during third-molar removal. The submandibular triangle and lateral pharyngeal wall do not represent the relevant close surgical relationship.

Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. Parameters of care for patients undergoing mandibular third molar surgery, section: Risk of nerve injury. 2021. https://www.rcseng.ac.uk/-/media/Files/RCS/FDS/Guidelines/3rd-molar-guidelines--April-2021-v4.pdf