The Anatomy of the Lingual Artery

The lingual artery supplies blood to the tongue and oral cavity. This portion of the external carotid artery branches out to supply blood to surrounding tissues.

Anatomy 

Here's an overview of the lingual artery's anatomy, including its structure, location, and anatomical variations.

Structure 

Collagen fibers make up the outer layer of arteries. Elastic fiber and smooth muscle make up the middle layers. The endothelium is the inner layer of the artery. Arteries have thick walls that allow them to sustain high pressures.

Moving away from the external carotid artery, the lingual artery becomes smaller and eventually breaks into multiple branches. Arterial branches of the lingual artery include the:

• Suprahyoid artery
• Dorsal lingual artery
• Sublingual artery
• Deep lingual artery 

The deep lingual artery passes under the tongue. The sublingual artery follows a path through the salivary glands and supplies blood to the gums and portions of the mouth.

The dorsal lingual artery has several small branches that travel to the back portion of the tongue, supplying parts of the mouth such as the tonsils, epiglottis, and soft palate. Finally, the suprahyoid artery runs along the length of the hyoid bone and supplies blood to the nearby muscle.

The lingual artery has a diameter of around 2 to 5 millimeters. It gets bigger the closer it gets to the external carotid artery. The artery follows the path of the tongue. The tongue incorporates the longest portion of the lingual artery.

Location 

The lingual artery is connected to the external carotid artery and follows a path towards the hyoid bone and back down towards the tongue. Basically, it starts from the carotid, which is located in the neck, and eventually ends up at the tip of the tongue.

Anatomical Variations 

Many anatomical variations are possible. Pathways for the artery may also differ. One cadaver study from 2017 separates the positional variations for the lingual artery into five types. Anatomical variations, for example, may include absent branches.

Function

The lingual artery’s primary function is to supply blood to the tongue and parts of the mouth, including the tonsils. A healthy blood supply via the lingual artery is necessary for its functions, such as eating, drinking, and speaking. That said, it is possible to live without your tongue.

Clinical Significance 

Because of its placement, there is a risk of lingual artery bleeding during particular head and neck surgeries. It’s important for surgeons to understand the artery's placement, including possible anatomic variations, to prevent injury and complications.

The lingual artery may be injured during intubation for surgery or medical procedures that require being placed on a ventilator. Facial trauma can also cause arterial injury.

According to the International Congress of Oral Implantologists, injury to the lingual artery can occur during dental implant surgeries, which are very common. Thankfully, injury to the artery only happens in rare cases.

Injuring the lingual artery can result in fatal blood loss or tongue necrosis. If the artery becomes inflamed by an injury, it may cause pain and swelling.

Chemotherapy may impact the lingual artery and tongue, according to one case study. Pseudoaneurysms of this artery can also happen. Special care must be taken to avoid injuring the lingual artery when removing certain tumors involving the tongue.

Cancer of the tongue is uncommon, but it does happen. In some cases, removal of the tongue is necessary to ensure a person's survival. Surgery to remove the tongue is called a glossectomy. People who get this type of surgery can learn to eat and talk without their tongue, but the process is challenging.

Certain types of vasculitis, such as giant cell arteritis (GCA), may impact the lingual artery. One case study suggests that involvement of the lingual artery with GCA is uncommon but possible.

In cases of arterial stenosis of the carotid artery, tissue death can occur in the tongue because the blood supply to the lingual artery gets cut off.

The lingual artery may be used as a recipient artery in reconstructive surgeries of the head and neck.