Clinical anatomy of the accessory mandibular foramen: application to mandibular ramus osteotomy

Joe Iwanaga, Shogo Kikuta, Soichiro Ibaragi, Koichi Watanabe, Jingo Kusukawa, R. Shane Tubbs

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Purpose: An accessory foramen around the mandibular foramen is called an accessory mandibular foramen (AMF). The clinical anatomy of the AMF has not been well described. The aim of this study was to reveal the clinical anatomy of the AMF for a better understanding of its implication during ramus surgeries. Methods: Twenty-two sides fresh-frozen cadaveric heads with a mean age of 76.2 ± 14.4 years at death underwent dissection. The neurovascular bundles passing through the AMF were observed. Additionally, a hemi-face of a latex injected embalmed cadaver was dissected medially to laterally and the neurovascular bundles of the AMF investigated. Results: A unilateral foramen, bilateral foramina, and absence of foramina were found in 45.4%, 18.2%, and 36.4%, respectively. The origin of the neurovascular bundle entering the AMF was a branch of the maxillary artery in 20% and a tributary of the inferior alveolar vein in 80%. In the latex embalmed cadaver, the AMF was found to contain a branch from the maxillary artery and a tributary of the maxillary vein. Conclusion: Given the practical meaning of the specific AMF located in the operative field of the ramus osteotomy, we suggest these be named “foramina for ramus osteotomy.”

Original languageEnglish
Pages (from-to)41-47
Number of pages7
JournalSurgical and Radiologic Anatomy
Issue number1
Publication statusPublished - Jan 1 2020


  • Hemorrhage
  • Inferior alveolar nerve
  • Mandibular canal
  • Mandibular foramen
  • Maxillary artery
  • Orthognathic surgery

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine
  • Radiology Nuclear Medicine and imaging


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