ANATOMIC VARIATION OF THE SUBMANDIBULAR GANGLION DEPENDING ON THE SHAPE OF THE SKULL

Rozhnov V. G., Gorbachenko О. B., Shepitʹko K. V., Bilych А. М., Dubrovina O. V., Koptev M. M.

MORPHOLOGY

Scentific article

Lesions of the submandibular ganglion are manifested by multiple clinical signs. Symptoms prevailed in patients with the most diverse diagnosis call for monitoring by neurologist, dentists, otolaryngologists and other specialists. This can be somewhat associated with the complex relationship of the submandibular ganglion with other cranial parasympathetic ganglia of the head. Thus, the study of topography and structural organization of the submandibular ganglion is relevant due to inadequate knowledge of its structure on the other hand and the need to develop the most rational accesses to the ganglion itself on the other hand. The parasympathetic submandibular ganglia play an important role in the innervation of the mucous membranes of the nasal and oral mucosa, as well as salivary glands. Inflammation of the cranial parasympathetic ganglia, called ganglionitis, occurs in clinical practice. The nature of the inflammation progress depends mainly on the features of the topography of one or another ganglion and the presence of its relations with other cranial parasympathetic ganglia. The clinical picture of autonomic ganglionitis is different. This is due to the fact that the autonomic ganglia, nerves and plexus are located on a large area. Cranial parasympathetic ganglia (ciliary, pterygopalatine, otic, submandibular and sublingual) are interconnected anatomically and functionally and have relations with the superior cervical sympathetic ganglion, which is the collector of the peripheral part of the autonomic nervous system of the head. In clinical practice such complex structure leads to the occurrence of irritation syndromes of both segmental and ultrasectoral departments of the autonomic nervous system. The appropriate treatment of ganglionitis is dependent from the anthropometric variants of the topography of the submandibular parasympathetic ganglions. The need for improvement of the conservative methods of treatment and the correct and precise holding of the blockade in ganglionitis called for the analysis of the predicted lesions of the cranial parasympathetic ganglia. The total specimens of the submandibular ganglion (n=71) taken postmortem from dead persons aged 70-72 years have been studied. The anthropometric method, the method of macro- and microscopy, the method of manufacturing of semi-thin serial sections and statistical methods have been used. The shape and size of the submandibular ganglion has been determined using the method of macro-microscopy preparation, suggested by V.P. Vorobiyov, and method of manufacturing of semi-thin serial sections. Our studies confirm the existence of variations in the variability of the size, shape and position of the submandibular parasympathetic ganglion, depending on the shape of the skull. Posterosuperior position of the submandibular ganglion is typical to brachycephals, whereas anteroinferior position of the submandibular ganglion has been found in the dolichosephals. Strong relationship between the position of the submandibular parasympathetic ganglion and the surrounding masses has been found. In this way, at high position the ganglion lay next to the lingual nerve, and at low it was adjacent to the upper pole of the submandibular salivary gland. The shape of the submandibular ganglion is individually variable and was mainly of oblong, cylindrical and orbicular shape out of multiple shapes of the ganglion. The occurrence of the irregular shapes of the structure of the submandibular parasympathetic ganglion is related to the progress of pathological processes in the ganglion itself, which must be taken into account by clinicians in the diagnosis and treatment of ganglionitis.

parasympathetic nervous system, cranial autonomic ganglia, submandibular autonomic ganglion

1. Horbachenko OB, Rozhnov VH, Polovyk OYu, Bilych AM, Shepitko KV. Antropometrychni varianty minlyvosti topohrafii okremykh vehetatyvnykh vuzliv holovy ta yikh znachennia dlia obgruntuvannia klinichnykh oznak hanhlionitiv. Visnyk morfolohii. 2017;23(2):303-8. [in Ukrainian].
2. Horbachenko OB, Shvets AI, Polovyk OYu, Rozhnov VH, Suprunenko SM. Minlyvist formy i rozmiriv vushnoho vuzla u osib pokhyloho i starechoho viku v zalezhnosti vid formy cherepa liudyny. Visnyk problem biolohii i medytsyny. 2016;1.2(124):180-3. [in Ukrainian].
3. Rozhnov VH. Topohrafo-anatomichni osoblyvosti budovy pidnyzhnoshchelepnoho vehetatyvnoho vuzla u osib pokhyloho ta starechoho viku [dysertatsiia]. Kharkiv: Kharkiv. derzh. med. un-t; 1998. 116 s. [in Ukrainian].
4. Tubbs RS, Rizk E, Shoja MM, Loukas M, Barbaro N, Spinner RJ. Nerves and Nerve Injuries. Vol 1. History, Embryology, Anatomy, Imaging, and Diagnostics. Cambridge: Academic Press; 2015. 700 р.
5. Horbachenko OB. Topohrafiia, zviazky ta strukturna orhanizatsiia vushnoho vehetatyvnoho vuzla u osib zriloho ta pokhyloho viku [dysertatsiia]. Kharkiv: Kharkiv. derzh. med. un-t; 2004. 120 s. [in Ukrainian].
6. Holovatskyi AS, Cherkasov VH, Sapin MR, Parakhin AI. Anatomiia liudyny. T. 3. Vinnytsia: Nova Knyha; 2009. 376 s. [in Ukrainian].
7. Sadler TW. Medical Embryology. 12th. Philadelphia: Lippincott Williams & Wilkins; 2012. 384 р.
8. Park BY, Saint-Jeannet JP. Induction and Segregation of the Vertebrate Cranial Placodes. San Rafael: Morgan & Claypool Life Sciences; 2010. 90 р.
9. Ashwell K. Neurobiology of Monotremes: Brain Evolution in Our Distant Mammalian Cousins. Collingwood: CSIRO Publishing; 2014. 536 р.
10. Willson-Pawells L, Akesson EJ, Stewart PA. Cranial Nerves in Health and Disease. London: PMPH-USA; 2010. 247 р.
11. Bilash SM, Pronina OM, Koptev MM. Comprehensive morphological studies as an intergal part of modern medical science. Literature review. Visnyk problem biolohiyi i medytsyny. 2019;2.2(151):20-3. DOI: 10.29254/2077-4214-2019-2-2-151-20-23

«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 307-310 pages, index UDK 616.314:611.91

10.29254/2077-4214-2019-3-152-307-310