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Axial T2 FS of oral cavity demonstrating bilateral defects (red arrows) in the mylohyoid muscles (*). The right sublingual gland protrudes through the defect into the submandibular space giving the impression of a boutonniere deformity. The defect is smaller on the left side with only protrusion of of fat and vessels.
Coronal images again showing bilateral defects in the mylohyoid muscles in the mid coronal images (B and D). Note the intact muscle sling on the sequential anterior (A and C) and posterior (C and E) images.
Mylohyoid boutonniere is a normal focal discontinuity in the mylohyoid muscle, which may permit the sublingual salivary gland, fat or vessels, or a combination of each, to protrude out from the sublingual space into the submandibular space.