Reinnervated Lateral Antebrachial Cutaneous Neurosome Flaps in Oral Reconstruction

Sensate Radial Forearm Free Flaps in Tongue Reconstruction

“…We have documented that, by microsurgical anastomosis of the lingual nerve to the lateral antebrachial cutaneous nerve, the sensory function of the radial forearm free flap approximates that of the normal tongue. The phenomenon of sensory upgrading has been previously reported in extremity reconstruction 24 and in tongue reconstruction by Boyd et al 19 The quality of sensory recovery of the reinnervated free flaps came close to that of the normal tongue as observed by Semmes-Weinstein monofilament testing and static and moving 2-point discrimination.…”

“…With the use of the same flap, Dubner and Heller 18 reported high-fidelity restoration of intraoral sensation. The most conclusive evidence of recovery of intraoral sensation was reported by Boyd et al 19 In this prospective study of 8 radial forearm free flaps, they observed the return of sensation in the reinnervated flaps approaching the quality of sensation of the adjacent normal tissue. Many of the potentially useful sensate flaps for head and neck reconstruction are listed in Table 3; some, such as the dorsalis pedis and tensor fascia lata, are included for their historical interest only.…”

Sensory Recovery in Noninnervated Radial Forearm Free Flaps in Oral and Oropharyngeal Reconstruction

“…5 Important areas of current focus are functional outcomes and quality of life among patients treated for head and neck cancers, and there is presently some debate about whether oral rehabilitation is compromised by lack of sensation in free flaps transferred to the oral cavity and oropharynx. [6][7][8] It has been demonstrated that excellent sensory recovery can be achieved by providing radial forearm flaps with sensory innervation by means of nerve anastomosis, [9][10][11] but spontaneous recovery of sensation has also been reported. 6,12 However, the relationship between sensory innervation and function has yet to be clearly established.…”

Reconstruction of Soft Tissue Defects in the Oral Cavity and Oropharynx

“…The radial forearm free flap is amenable to sensory reinnervation using the lateral antebrachial cutaneous nerve, and evidence suggests that there may be a functional benefit of sensory reinnervation in oral cavity recon-struction. 6 The rectus abdominis myocutaneous free flap is selected frequently for reconstruction in patients who undergo total or subtotal glossectomy. In this instance, the considerable bulk of the rectus flap allows for passive obturation of the oral cavity during speech and swallowing.…”