Mylohyoid boutonniere
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At the time the article was created Charlie Chia-Tsong Hsu had no recorded disclosures.
View Charlie Chia-Tsong Hsu's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures- Mylohyoid boutonnière
Mylohyoid boutonniere is a normal focal discontinuity in the mylohyoid muscle, which may permit the sublingual salivary gland, fat or vessels - or a combination thereof - to protrude out from the sublingual space into the submandibular space.
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Epidemiology
The finding has been observed in up to 77% of normal individuals undergoing head and neck cross-sectional imaging studies, of whom it is seen bilaterally in 67% 1.
Gross anatomy
The mylohyoid muscle is a sling-like structure that forms the floor of the oral cavity. This muscle divides the sublingual space from the submandibular space; however, communication between the two spaces posterior to the mylohyoid muscle is maintained.
The mylohyoid muscle consists of two halves, both of which have a broad origin from the mylohyoid line along the inner mandible and the body of the hyoid bone. The two halves insert centrally at the fibrous median raphe to form a sling. Traditionally, the mylohyoid muscle is depicted as a continuous muscle sling; however, cross-sectional imaging (CT and MRI) studies have demonstrated discontinuity in the mylohyoid muscle, allowing normal structures of the sublingual space to protrude through the defect 1.
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History and etymology
Boutonnière is French for buttonhole, a befitting term as the morphology resembles a buttonhole.
Related pathology
Rarely, pathologic entities (e.g. ranula) can also extend through the boutonniere defect.
References
- 1. White D, Davidson H, Harnsberger H, Haller J, Kamya A. Accessory Salivary Tissue in the Mylohyoid Boutonnière: A Clinical and Radiologic Pseudolesion of the Oral Cavity. AJNR Am J Neuroradiol. 2001;22(2):406-12. PMC7973941 - Pubmed
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