Oral sensation and function: A comparison of patients with innervated radial forearm free flap reconstruction to healthy matched controls

Abstract

Although some sensory ability is preserved in patients who have had tongue reconstruction with an innervated RFFF, functional outcomes such as masticatory ability and speech intelligibility may be affected in some patients.

A systematic review on the sensory reinnervation of free flaps for tongue reconstruction: Does improved sensibility imply functional benefits?

“…17 When tongue sensibility after sensate RF flap tongue reconstruction is compared to healthy controls, instead of the contralateral tongue or non-sensate flaps, RF flaps showed inferior sensibility. 13,14 These results question the use of healthy subjects as controls in sensory testing, as Boyd et al and Katou et al described no significant difference between sensate RF flap tongue reconstruction and the contralateral tongue. 8,9 A reason for this discrepancy may be that the innervation of the contralateral tongue suffers from radiotherapy or the resection of the affected tongue tissue.…”

“…It is known that questionnaires regarding subjective results require extensive psychometric testing to measure valid, reliable, and reproducible results. Second, as Loewen et al reported, 14 functions such as texture recognition, taste, and mastication are largely dependent upon the resection's extent and the amount of sensibility of the remainder of the oral cavity. As defect sizes varied, the contribution of healthy surrounding tissues differed, and their impact on these functions was unclear.…”

“…3,4,14 All articles reported superior sensibility of innervated ALT flaps in light touch, pain sensation, temperature, SemmeseWeinstein monofilament tests, and two-point discrimination as compared with non-sensate ALT flaps. In addition, in these articles, the return of sensibility in non-sensate ALT flaps did not occur in the majority of patients.…”

“…9 ALT flap Five articles described the sensory recovery of the tongue after reconstruction using an ALT flap. 3,4,11,13,14 A total of 65 patients were examined, of which 40 flaps were sensate and 25 flaps were used as non-sensate flaps (Table 3).…”

Microsurgical Reconstruction of the Oral Cavity and Oropharynx After Cancer Ablation

“…Previous research demonstrated that nervous ingrowth may occur in noninnervated flaps (Sebesan et al, 2008), but this finding is controversial (Vries et al, 1996). In a case-control study comparing oral tongue resection patients after antebrachial cutaneous nerve-lingual nerve anastomosis and healthy controls, recovery of some sensory ability was demonstrated in all patients but significant differences were noted when compared to controls in mastication, speech intelligibility and sensory capabilities of the neotongue (Loewen et al, 2010).…”