{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:09:56Z","timestamp":1776132596660,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005768","name":"West Virginia Space Grant Consortium","doi-asserted-by":"publisher","award":["NNX10AK62H"],"award-info":[{"award-number":["NNX10AK62H"]}],"id":[{"id":"10.13039\/100005768","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Mylohyoid musculature may be included in the submental artery flap to protect perforators. However, blood vessels may pass through the mylohyoid muscle and therefore cause bleeding and risk to pedicle or perforator injury when a mylohyoid\u2010containing flap is lifted. The objectives of this study were to identify the prevalence of the submental and sublingual arteries that traverse the mylohyoid and to assess relationships between vasculature transmitted through mylohyoid muscles and mylohyoid boutonni\u00e8res.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional human cadaveric study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The West Virginia University School of Medicine human gross anatomic laboratories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A total of 43\u00a0intact mylohyoid muscles from 22 cadavers were dissected. The prevalence of submental vasculature perforating the mylohyoid was recorded in addition to the prevalence and contents of mylohyoid boutonni\u00e8res.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 43\u00a0mylohyoid muscles, 21 (48.8%) transmitted the submental or sublingual arteries, and 30 (69.1%) possessed boutonni\u00e8res. One muscle had 2 boutonni\u00e8res. Of 31\u00a0mylohyoid boutonni\u00e8res, 21 transmitted blood vessels (67.7%). Specifically, 9 transmitted an artery and a vein (29.0%), and 12 transmitted an artery (38.7%). Ten boutonni\u00e8res (32.3%) were exclusively occupied by fascia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This report identifies the importance of identifying and carefully ligating branches of the submental artery that pierce the mylohyoid during elevation of the submental island flap. This report also identifies that a boutonni\u00e8re is often present where a submental or sublingual artery is traversing the mylohyoid to supply sublingual glands, tongue, and anterior mandible.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820939852","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T04:05:42Z","timestamp":1595304342000},"page":"322-327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical Implications of the Submental and Sublingual Arteries in Relation to the Mylohyoid Boutonni\u00e8re"],"prefix":"10.1002","volume":"164","author":[{"given":"Matthew J.","family":"Zdilla","sequence":"first","affiliation":[{"name":"Department of Biological Sciences West Liberty University West Liberty West Virginia USA"},{"name":"Department of Graduate Health Sciences West Liberty University West Liberty West Virginia USA"},{"name":"Department of Pathology, Anatomy, and Laboratory Medicine Robert C. 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