Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study

Abstract

This study compares sensory recovery after total lower lip reconstruction in a wide variety of flaps including bilateral depressor anguli oris flap, submental island flap, bilateral fan flaps, radial forearm flap, and pectoralis major myocutaneous flaps in a large number of patients. Spontaneous return of flap sensation was documented by clinical testing in the majority (3%) of patients who underwent total lower lip reconstruction. Sensory recovery occurred more often in patients with fasciocutaneous free flaps than in those with musculocutaneous flaps. Flap sensation to touch, two-point discrimination, and temperature perception was correlated with age, smoking, and radiation treated patients. We conclude that reasonable sensory recovery may be expected in noninnervated flaps, provided that the major regional sensorial nerve has not been sacrificed, and also provided that the patients age is relatively young and that enough surface contact area of the recipient bed is present without marked scarring. This trial was regestered with Chinese Clinical Trial Registry (Chi CTR) with ChiCTR-ONC-13003656.

Comparison of spontaneous sensory recovery of noninnervated anteromedial thigh flap, latissimus dorsi flap, and gracilis muscle flap in lower extremity reconstruction: A prospective comparative study

“…The sensory recovery of the reconstructed lower extremities becomes an important issue, because a protective sensibility is imperative in preventing unintentional injuries resulting from pressure sores or burns. Although sensory recovery was extensively studied in various fields such as autologous breast reconstruction (Beugels et al, ; Santanelli, Longo, Angelini, Laporta, & Paolini, ), mammoplasty (Chiari Jr., Nunes, Grotting, Cotta, & Gomes, ), digital repair (Bulut et al, ; Lin & Chen, ), burn scars (Meirte et al, ), oral reconstruction (Boyd et al, ; Kimata et al, ), and lower lip reconstruction,(Ayhan Oral et al, ) only little is known about this issue in free flap extremity reconstruction. In addition, the reported studies were performed with different sensory test modalities and examination times, thereby making comparison invalid.…”

“…There are little data concerning differences between the spontaneous sensory recovery of fasciocutaneous and musculocutaneous flaps. Some authors assumed that sensory recovery was more pronounced in patients with fasciocutaneous free flaps than in musculocutaneous flaps (Ayhan Oral et al, ). However, the literature remains controversial on this point.…”

“…Some authors assumed that a complete recovery over the entire flap does not normally occur, especially in free flaps with a thick skin paddle (Ayhan Oral et al, ). However, no systematic study has yet been conducted on this topic.…”

“…Most of the previous studies that compared spontaneous sensory recovery and recovery after nerve coaptation yielded controversial results. Certain studies showed a benefit in sensory recovery after nerve coaptation, whereas others reported satisfactory spontaneous reinnervation from the surrounding skin (Ayhan Oral, Zeynep Sevim, Gorgu, & Yucel Oztan, ; Schultes, Gaggl, & Karcher, ; Vesper, Heiland, Blake, Flinzberg, & Schmelzle, ; Vesper, Heiland, Flinzberg, & Schmelzle, ). Furthermore, a comparison of the existing literature is difficult as different examination modalities and times were employed (Beugels et al, ).…”

Colgajo dorsolateral versus colgajo en isla mediopalmar radial para el tratamiento de lesiones traumáticas distales de pulgar. Evaluación clínica

“…informaron que el grado de recuperación sensitiva fue mayor en colgajos utilizados para defectos más pequeños, probablemente debido a una reinervación espontánea a cargo de nervios residuales de la zona receptora. 19,20 Finalmente, Dykes y cols., Vriens y cols., y Close y cols., mediante biopsias incisionales en pacientes tratados con colgajos, encontraron pruebas histoquímicas significativas de regeneración de los nervios en los márgenes, a las tres semanas de la cirugía. [21][22][23] Este estudio tiene algunos factores limitantes: se trata de una serie de pacientes estudiados retrospectivamente, es una muestra acotada tratada por diferentes cirujanos y con técnicas quirúrgicas distintas, que compara un colgajo inervado con uno no inervado.…”