The mylohyoid raphe is the tendinous midline fusion of the two mylohyoid muscles forming the muscular floor of the mouth. It runs from the mental symphysis to the hyoid body and represents the midline aponeurotic junction of the bilateral mylohyoid muscles.
The mylohyoid raphe is the site of herniation of sublingual gland contents producing a plunging ranula extending into the submandibular space through gaps in the raphe. Surgical repair of floor of mouth injuries requires identification and repair of the raphe. It is a reference point in transoral robotic surgery of the floor of mouth and in glossectomy extent assessment.
Mucous extravasation from the sublingual gland herniating through a defect in the mylohyoid raphe into the submandibular or parapharyngeal space, presenting as a painless neck mass requiring surgical excision of the sublingual gland.
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