Lymph nodes are close to the submental artery and its perforators. The submental lymph node flap has a constant vascular supply by the submental artery. Submental artery was located on average at 64 mm (e.g., 66%) of the mandible, with an average diameter of 1.34 ± 0.2 mm. Here, the nerve always lay superficial to the FA and was on average 0.96 ± 0.14 mm in diameter. The MMN consistently crossed the mandible body and the facial artery (FA) from dorso-caudal to ventro-cranial at 72 ± 5.2 mm, e.g., 75% of the mandible's length. Projection of the LNN on the mandible, measured from the gnathion (GT, median-sagittal-plane) toward the gonion (GN, mandibular angle), was at 63.4 ± 5.8 mm (e.g., 65%) of the mandible for the first lymph node (LN), and for the following LNN was at 50.4 ± 7.7 mm (e.g., 52%), 44.0 ± 8.6 mm (e.g., 45%), and 40.50 ± 2.1 mm (e.g., 42%). Within the designated SLNF (10 × 5 cm 2 ), the number of LNN was on average 3 ± 0.6, with an average size of 4.5 ± 1.8 mm × 2.9 ± 1.2 mm. In addition, the number of lymph nodes (LNN) was evaluated through dissection and ultrasound. The diameter, length, and caliber of the SA and its relation to bony anatomic landmarks were measured. The authors examined the characteristics and landmarks of 18 SLNF in nine fresh cadavers. The aim of this study was to evaluate surgical anatomical landmarks and variations of the submental lymph node flap (SLNF). Harvesting the submental flap for vascularized lymph node transfer (VLNT) presents a challenging procedure because of, the topographic variation of the submental artery (SA) and the marginal mandible nerve (MMN) and the limited pedicle length for a free tissue transfer.
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