Vestibular Landmarks to Minimize Injury to the Mental Nerve During Transoral Endoscopic Thyroidectomy-Vestibular Approach (TOETVA) Procedure: An Anatomical Study

The aim of this study is to reveal the morphometry of the mental nerve to describe a safe zone for minimizing mental nerve damage during transoral endoscopic thyroidectomy-vestibular approach (TOETVA). This study was performed on 12 cadavers. Localization of mental foramen according to teeth, distances of buccogingival sulcus-lip (BG & ndash;L), mental foramen-midline (MF-Midline), mental foramen & ndash; buccogingival sulcus (MF & ndash; BG), commissure & ndash; branching point (Cm & ndash; Br), branching point -vertical projection of branching point on lower lip (Br & ndash; LVP), vertical projection of branching point on lower lip & ndash; commissure (LVP & ndash; Cm), commissure & ndash; midline (Cm & ndash; midline), angles of mental (AM), angular (AA) and labial branches (AL) and branching patterns were recorded. Type 1 was mostly found as branching pattern in this study (45.8 %). A new branching pattern (type 9) was found on one cadaver. Mental foramen was mostly located at level of second premolar teeth. According to morphometric results of this study; supero-lateral to course of angular branch and infero-medial to course of mental branch of mental nerve on lower lip after exiting the mental foramen were described as safe zones during surgery for preserving mental nerve and its branches.