American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What nerve is most commonly at risk during submandibular gland resection?

1. Facial nerve

2. Marginal mandibular nerve

3. Hypoglossal nerve

4. Vagus nerve

The correct answer is: Marginal mandibular nerve

The marginal mandibular nerve is most commonly at risk during submandibular gland resection due to its anatomical proximity to the area where the procedure is performed. This nerve is a branch of the facial nerve and is responsible for innervating the muscles of the lower lip. During surgery to remove the submandibular gland, surgical dissection in the area can inadvertently result in injury to this nerve, leading to complications such as weakness or asymmetry of the lower lip. Understanding the anatomy is crucial for surgical planning and risk management. The marginal mandibular nerve typically runs close to the mandible, making it susceptible to damage during procedures involving the submandibular region. Surgeons are trained to identify and preserve this nerve when possible, but its location necessitates caution. The other nerves listed—such as the facial nerve, hypoglossal nerve, and vagus nerve—are generally located further from the operative field for submandibular gland surgery, making them less likely to be at risk in this specific procedure. While the facial nerve is indeed critical in facial movements and the hypoglossal nerve in tongue movements, their anatomical pathways are situated in areas that are less directly involved with a typical submandibular gland resection,