title: Intraoperative localization of the marginal mandibular nerve: a landmark study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Canada. kqresearch@hotmail.com.|Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. kqresearch@hotmail.com.|King Abdul Aziz University Hospital, King Saud University, PO Box no-245, Riyadh, 11411, Kingdom of Saudi Arabia. kqresearch@hotmail.com.
authors: Khalid
authors: K
authors: Al-Qahtani
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Canada. alexmlynarek@hotmail.com.
authors: Alex
authors: A
authors: Mlynarek
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Canada. jenntse7@telus.net.
authors: Jon
authors: J
authors: Adamis
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Canada. Jeff.Harris@albertahealthservices.ca.
authors: Jeffery
authors: J
authors: Harris
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Canada. Hadi.Seikaly@albertahealthservices.ca.
authors: Hadi
authors: H
authors: Seikaly
authors: College of Medicine and Research Center, King Saud University, Riyadh, Saudi Arabia. tahera@ksu.edu.sa.
authors: Tahera
authors: T
authors: Islam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008340:Mandibular Nerve / Q000033:anatomy & histology*; D008875:Middle Aged; D055815:Young Adult