Arterial Anastomosis in the Tongue

Purpose: Radical surgery for neoplasms of the tongue can endanger at least 1 lingual artery, threatening the survival of the remaining tissue and the recovery of speech and swallowing. Although there is little anastomosis in the substance of the tongue, this study investigated whether arterial anastomoses outside the tongue could provide collateral circulation to protect the surviving tissue. Materials and Methods: Parts of 9 embalmed cadaver heads were examined. In 2 specimens, the arteries had been previously injected with latex and India ink. In the remaining, a mixture of latex and India ink was injected into the lingual artery at its origin on 1 side. Five injections were successful. Results: There was considerable variation in the course and distribution of the lingual arteries. Arteries did not cross the midline of the tongue, but actual or potential anastomoses could be seen round the base of the tongue, in the floor of the mouth, and with facial artery branches. After the experimental injections, the mass filled the lingual artery and its branches on the injected side, but also reached the trunk and main branches of the opposite side. Conclusion: A mass injected into the lingual artery of 1 side can reach the trunk and territory of the lingual artery of the opposite side. In life, it is likely that a similar collateral circulation would exist. Some clinical literature supports this conclusion, but preoperative arteriography might be a reasonable precaution. (C) 2016 American Association of Oral and Maxillofacial Surgeons