Mapping the Mandibular Lingual Foramina for Safer Chin Surgery: CT Morphometry and Predictive Modeling.

backgroundSubmental hematoma after genioplasty is rare but can be life-threatening, and current imaging data give limited patient-specific guidance for chin osteotomy design.

methodsWe combined targeted cadaveric dissection of two perfused heads with cranial CT analysis of 211 adults (70 long chin, 71 retrogenia, 70 controls; 621 lingual foramina). Standardized three-dimensional measurements described lingual foramen (LF) number, diameter, location, and canal trajectory, and their distances to tooth apices, genial spines, the mental foramen, and the mandibular border. Multivariable linear regression models related these metrics to facial type and chin height. Nonlinear machine learning regressors, including random forest, were trained and internally validated to predict midline LF depth.

resultsLFs clustered in the symphyseal midline, where they were larger and mainly descended toward the submental region. Facial pattern and chin height changed LF position relative to lower incisor roots but not to the inferior border. Chin height and LF-genial spine relationship were the dominant predictors in midline multivariable linear regression models (adjusted R

conclusionThis integrated cadaveric, CT, and modeling study defines a central high-risk corridor for chin surgery and provides interpretable, millimeter-level tools to refine osteotomy and fixation planning in aesthetic genioplasty. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .