You see a 56-year-old man in clinic who has presented with left submandibular swelling related to eating. He has had an ultrasound scan which shows a

Subject
Surgery
System
Miscellaneous (Multisystem)

DianaZ

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You see a 56-year-old man in clinic who has presented with left submandibular swelling related to eating. He has had an ultrasound scan which shows a 1.5 cm stone within the substance of the left submandibular gland and you discuss the management options with him, including surgical removal of the gland. Which of the following nerves would you tell him are at risk during this operation?

A. Accessory, marginal mandibular and lingual nerves
B. Accessory, hypoglossal and lingual nerves
C. Glossopharyngeal, marginal mandibular and lingual nerves
D. Hypoglossal, marginal mandibular and lingual nerves
E. Marginal mandibular, hypoglossal and glossopharyngeal nerves

Explanatory Notes:
Damage to the hypoglossal nerve causes deviation of the tongue to the affected side. Damage to the marginal mandibular nerve causes weakness of the depressor anguli oris muscle, which pulls the corner of the lower lip downwards. Damage to the lingual nerve causes numbness of the ipsilateral side of the tongue.
 
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