Levator submandibuli muscle (Banjo Muscle) a rare muscle in human beings; anatomy, morphogenesis, function and incidence

چکیده

A rare muscle named Levator Submandibuli (LS) or Banjo muscle (after the author) is present in few persons. It is situated in the submandibular region superficial to the mylohyoid muscle. It consists of two triangular right and left halves whose fibres originate by interdigitating with each other from a median intermuscular septum attached above to the mandible, below to the
hyoid bone, parallel and continuous with the intermuscular septum of the mylohyoid muscle. Levator Submandibuli muscle fibres of each side insert into a tendon which is continuous at each side with the central tendon of the digastric muscles. Contraction of the muscle would elevate and support the submandibular region particularly during swallowing and during any activity which increasesthe oro-pharyngeal pressure such as blowing a trumpet. The muscle is not an accessory/anomaly of the digastric nor of mylohyoid muscle. Its anatomy indicated that, it is a separate muscle innervated by a branch from the mylohyoid nerve. It is suggested that, there is predilection for the appearance of a separate muscle in the submandiblar region distinct from mylohyoid and digastric muscles. It is further suggested that during myogenesis when the migrating myogenic (myoblasts) cells destined to form levator submandibuli are halted at the proximity of the site of formation of anterior belly of the digastric muscle, an anomalous/accessory muscle of the digastric is formed. But when the myoblasts reach their predestined position in the submandibular region, an independent muscle, levator submandibuli (Banjo muscle) is formed. The muscle has an incidence of about 0.3% in Caucasian and 0.4% in black Africans.

Keywords: Levator Submandibuli, Banjo muscle, submandibular region, digastric, mylohyoid, intermuscular septum

Résumé
Un muscle rare nomme Levator Submandibu1i ou bien 1e muscle Banjo (apres le nom de l’auteur) se trouve chez peu de gens. Il se situe dans triangle sous-mental, a la surface du muscle mylohyiod. Il consiste en 2 moitiestriangulaires droite et gauche dont les fibres prennent sources par interdigiter l’un avec l’autre a partir d’un septum median intermusculaire attaché par 1e dessus au mandible et par le dessous a l’os hyoid, parallel et continu avec le septum intermusculaire du muscle mylohyoid. Les fibers du muscle de chaque cote s’inserrent dans le tendon qui est f. continu avec le tendon central du muscle digastric du leur cote. La contractiondu muscle leverait et soutiendrait la region submandibulaire surtout lors d’un avalement. et pendant toute activite susceptible d’augmenter la pression oro-pharyngeale. Le muscle n’est pas un accessoire/anomalie du digastric anterieur. Il est ennerve par un petit. nerf provenant du nerf mylohyoid. Notre hypothese a suggere qu’il y a une predilection pour l’apparition d’un muscle distinct dans le triangle sous-mental, different du digastric anterieur. Il est en plus suggere que pendant la morphogenese lorsque les myoblastes migrants destines a former le levator submandibuli sont arretes aux environs du site de formation du ventral anterieur du muscle digastric, un muscle anomaleux/accessoire du digastric est forme. Mais quand les myoblastes atteignent leur position predestinee dans le triangle sous-mental, un nouveau muscle independant, le muscle Banjo ou bien le levator submandibuli est forme. L’incidence de ce muscle est inconnue. II est. probablement moins de 0.3 % chez les Caucassiens aussi 0.4% que chez les noir Africains.

Correspondence:  Dr. Adesegun O. Banjo, 21, Talbot Road, Ijebu Ode, Ogun State, Nigeria.

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Research Grant: From James Henry Memorial Hospital and Research Centre. Ilesa, Nigeria.