Jorge Henríquez; Sebastián Arteaga & David Thomas
The lingual nerve (LN) is a sensory branch of the mandibular division of the trigeminal nerve that provides sensation to the anterior two thirds of the tongue, the floor of the oral cavity, and the lingual gingival mucosa, in addition to conveying gustatory and parasympathetic fibers through its connection with the chorda tympani. Its anatomical course is complex and exhibits considerable variability, particularly in the posterior mandibular region, which exposes it to a high risk of iatrogenic injury during surgical procedures. The aim of this review was to describe the origin, course, and main anatomical variations of the LN, as well as to analyze its clinical relevance in oral and maxillofacial surgery. A narrative review of the literature was conducted through searches in PubMed, SciELO, MEDLINE, Scopus, and Web of Science, complemented by the review of classical anatomy textbooks, including human studies based on cadaveric dissections, imaging techniques, and clinical series, without restriction by year of publication. The results show that the LN exhibits relevant variations in its origin, depth, and relationship with the lingual cortical bone, particularly within the pterygomandibular space, the retromolar region, and the floor of the oral cavity, where it may follow superficial courses and establish direct contact with the mandibular lingual plate. These anatomical configurations explain the high susceptibility of the nerve to injury during procedures such as third molar extraction, orthognathic surgery, and surgeries of the floor of the oral cavity. Detailed knowledge of LN anatomical variations is essential to optimize surgical planning and reduce the risk of neurosensory complications in oral and maxillofacial surgery.
KEY WORDS: Lingual nerve; Anatomy; Anatomical variations; Retromolar region; Oral and maxillofacial surgery.
HENRÍQUEZ, J.; ARTEAGA, S. & THOMAS, D. Anatomical variations of the lingual nerve: Clinical relevance and considerations in oral and maxillofacial surgery. Narrative review. Int. J. Morphol., 44(2):580-587, 2026.
