Surgical therapeutics and operative technique . On dissection of the lateral suprahyoidâthat is to say, sub-maxillaryâregion, we notice from behind forwards: (1) Sterno-cleido-mastoid muscle, and internal jugular vein, in which the thjTO-linguo-faciaJvein terminates. (2) Below and to right side, the primitive carotid artery andits bifurcation; the hypoglossal nerve and its internal descending branch;the external carotid artery, with its inferior thyroid, lingual, and facialbranches; the superior laryngeal nerve; the small external laryngeal nerve,a branch of the hypoglossal. (3) The digastric
Surgical therapeutics and operative technique . On dissection of the lateral suprahyoidâthat is to say, sub-maxillaryâregion, we notice from behind forwards: (1) Sterno-cleido-mastoid muscle, and internal jugular vein, in which the thjTO-linguo-faciaJvein terminates. (2) Below and to right side, the primitive carotid artery andits bifurcation; the hypoglossal nerve and its internal descending branch;the external carotid artery, with its inferior thyroid, lingual, and facialbranches; the superior laryngeal nerve; the small external laryngeal nerve,a branch of the hypoglossal. (3) The digastric muscle passing across thetendon of the stylo-mastoid, and the fibrous expansion which fixes its inter-mediate tendon to the hyoid bone. (4) Below it, the hyo-glossus muscle,which covers the lingual artery, the course of which is indicated by the 148 SURGICAL THERAPEUTICS AND OPERATIVE TECHNIQUE dotted line, (5) On the right, the mylohyoid muscle and anterior belly ofthe digastric. The submaxillary gland, grasped by its anterior pole, has. Pig. 260.âDissection of the Submaxillary Eegion, showing the Course andEelations of the Lingual Artery. been drawn upwards in order to expose the deep structures. At the levelof the angle of the maxilla we distinguish the inferior extremity of theparotid gland. Ligature of the Lingual Artery. We tie the lingual artery either in the hypoglosso-hyoid triangleâthatis to say, after the origin of the dorsal artery of the tongueâor near theorigin of the vessel, at some millimetres from the external carotid trunkâbetween the posterior extremity of the great cornu of the hyoid bone andthe posterior belly of the digastric. The artery may be tied in either positionthrough the same horizontal submaxillary incision. When discussing operations on the neck, we will see that the lingualartery can be tied at its origin, as well as the external carotid, superiorthyroid, facial, and occipital arteries, through a vertical incision made atthe anterior borde
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