The lingual nerve provides general sensation to the anterior tongue and floor of mouth, carrying the taste and salivary fibres of the chorda tympani. Its intimate relationship with the third molar root at the level of the mandibular lingual plate makes it the most commonly injured nerve in wisdom tooth surgery. Lingual nerve injury produces tongue numbness and taste disturbance in 0.5-2% of lower third molar extractions.
An expanded entry for Lingual Nerve.
| Origin | Posterior trunk of the mandibular nerve (V3), joined by the chorda tympani in the infratemporal fossa |
|---|---|
| Course | Descends in the pterygomandibular space medial to the mandible, curves beneath the submandibular gland duct (Wharton's duct), passes medial to the third molar root level on the lingual plate of the mandible |
| Motor |
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| Sensory |
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Lingual nerve injury during lower third molar extraction produces hemilingual numbness and taste disturbance. Risk factors: deeply impacted teeth, lingual plate proximity, and inexperienced surgeon. Microsurgical repair (direct suture or cable graft) within 3 months provides better outcomes than delayed repair. Most partial injuries recover spontaneously within 6 months.
Hemilingual numbness from lingual nerve damage during mandibular third molar extraction managed with observation and microsurgical repair for complete injuries.
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