Pirogov triangle

triangle Pirogov
Triangle Pirogov: 1 - a. facialis; 2 - m. mylohyoideus; 3 - front abdomen m. digastricus; 4 - n. hypoglossus; 5 - m. hyoglossus; 6 - rear abdomen m. digastricus; 7 - m. stylohyoideus; 6 - platysma.

Pirogov triangle (trigonum linguale) - triangular space in the side of the suprahyoid the neck (Fig.), formed from below (from behind) the tendon of the digastric muscle (m. digastricus), top - hypoglossal nerve (n. hypoglossus)passing obliquely with speaking Vienna, and inside (front) - outside (rear) edge oral sublingual muscles (m. mylohyoideus). The bottom of the triangle busy sublingual-speaking muscle (m. hyoglossus). Pirogov triangle - the place of choice for bandaging lingual artery. For operations on P. I. patient is placed with thrown back and turned in the opposite side of the head. An incision is performed from the front edge sternoclavicular-liners muscles in the middle between the lower jaw and the hyoid bone. When he reached the submandibular salivary gland, it usepreview and throw back up, divided by a thin blunt the medial wall of her bed, and then exposed tissue lining the P. T., and under it - sublingual-speaking muscle. On its lateral surface passes hypoglossal nerve (n. hypoglossus) and lower - speaking Vienna (v. lingualis). If you cut across or to push stupidly fiber muscles over the hyoid bone, the underlying tissue find much throbbing lingual artery. Describes the relationship artery with named entities are so precise that bandaging her in this place is relatively easy.
There are cases when Pirogov triangle is very small or absent, which impedes the search lingual artery. P. so very small in the case when the hypoglossal nerve and the hyoid bone draw near to each other; then hypoglossal nerve too close runs near the tendon of the digastric muscle. Pirogov triangle is missing, if the tendon named muscles kept at the hyoid bone wider and longer than usual, tendon loop; as a result, the tendon of the digastric muscle will go up, you will depart from the hyoid bone 3-4 cm and will be or above the hypoglossal nerve, or above it. At the approach to the lingual artery in this case it is necessary to create P. T. artificially by pulling tendons digastric muscle down.