Abstract
Thirteen patients who had undergone ablative surgery for advanced squamous cell carcinoma in which more than half of the tongue had been resected underwent reconstruction in which the cutaneous nerve of a free flap was anastomosed to the stump of the transected lingual nerve. Eight of the patients underwent reconstruction with an innervated anterolateral thigh flap and five patients underwent reconstruction with an innervated rectus abdominis musculocutaneous flap. Sensory recovery of the flap at least 6 months postoperatively was compared in these 13 patients and in 16 additional patients who received noninnervated versions of the same flaps for the same defect. The degree of sensory recovery of innervated thigh flaps was significantly greater than that of noninnervated ones in all modalities and that of innervated rectus abdominis flaps was also greater than that of noninnervated flaps, except for hot and cold perception. These results indicate that sensory regrowth occurs in most areas through the surgically created pathways. However, results of Semmes-Weinstein testing showed that recovery did not reach the level of protective sensation in either type of innervated flap. Although these findings must be followed by additional objective and functional tests and the need for sensory reeducation should be considered, this simple operative procedure can improve postoperative intraoral function and should be attempted whenever possible after ablative surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 1307-1313 |
| Number of pages | 7 |
| Journal | Plastic and Reconstructive Surgery |
| Volume | 104 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 1999 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
Cite this
Comparison of innervated and noninnervated free flaps in oral reconstruction. / Kimata, Yoshihiro; Uchiyama, Kiyotaka; Ebihara, Satoshi; Kishimoto, Seiji; Asai, Masao; Saikawa, Masahisa; Ohyama, Waichiro; Haneda, Tastumasa; Hayashi, Ryuichi; Onitsuka, Tetsuro; Nakatsuka, Takashi; Harii, Kiyonori.
In: Plastic and Reconstructive Surgery, Vol. 104, No. 5, 10.1999, p. 1307-1313.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Comparison of innervated and noninnervated free flaps in oral reconstruction
AU - Kimata, Yoshihiro
AU - Uchiyama, Kiyotaka
AU - Ebihara, Satoshi
AU - Kishimoto, Seiji
AU - Asai, Masao
AU - Saikawa, Masahisa
AU - Ohyama, Waichiro
AU - Haneda, Tastumasa
AU - Hayashi, Ryuichi
AU - Onitsuka, Tetsuro
AU - Nakatsuka, Takashi
AU - Harii, Kiyonori
PY - 1999/10
Y1 - 1999/10
N2 - Thirteen patients who had undergone ablative surgery for advanced squamous cell carcinoma in which more than half of the tongue had been resected underwent reconstruction in which the cutaneous nerve of a free flap was anastomosed to the stump of the transected lingual nerve. Eight of the patients underwent reconstruction with an innervated anterolateral thigh flap and five patients underwent reconstruction with an innervated rectus abdominis musculocutaneous flap. Sensory recovery of the flap at least 6 months postoperatively was compared in these 13 patients and in 16 additional patients who received noninnervated versions of the same flaps for the same defect. The degree of sensory recovery of innervated thigh flaps was significantly greater than that of noninnervated ones in all modalities and that of innervated rectus abdominis flaps was also greater than that of noninnervated flaps, except for hot and cold perception. These results indicate that sensory regrowth occurs in most areas through the surgically created pathways. However, results of Semmes-Weinstein testing showed that recovery did not reach the level of protective sensation in either type of innervated flap. Although these findings must be followed by additional objective and functional tests and the need for sensory reeducation should be considered, this simple operative procedure can improve postoperative intraoral function and should be attempted whenever possible after ablative surgery.
AB - Thirteen patients who had undergone ablative surgery for advanced squamous cell carcinoma in which more than half of the tongue had been resected underwent reconstruction in which the cutaneous nerve of a free flap was anastomosed to the stump of the transected lingual nerve. Eight of the patients underwent reconstruction with an innervated anterolateral thigh flap and five patients underwent reconstruction with an innervated rectus abdominis musculocutaneous flap. Sensory recovery of the flap at least 6 months postoperatively was compared in these 13 patients and in 16 additional patients who received noninnervated versions of the same flaps for the same defect. The degree of sensory recovery of innervated thigh flaps was significantly greater than that of noninnervated ones in all modalities and that of innervated rectus abdominis flaps was also greater than that of noninnervated flaps, except for hot and cold perception. These results indicate that sensory regrowth occurs in most areas through the surgically created pathways. However, results of Semmes-Weinstein testing showed that recovery did not reach the level of protective sensation in either type of innervated flap. Although these findings must be followed by additional objective and functional tests and the need for sensory reeducation should be considered, this simple operative procedure can improve postoperative intraoral function and should be attempted whenever possible after ablative surgery.
UR - http://www.scopus.com/inward/record.url?scp=13044256406&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=13044256406&partnerID=8YFLogxK
U2 - 10.1097/00006534-199910000-00010
DO - 10.1097/00006534-199910000-00010
M3 - Article
C2 - 10513910
AN - SCOPUS:13044256406
VL - 104
SP - 1307
EP - 1313
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
SN - 0032-1052
IS - 5
ER -