Sensory Recovery of Free Flaps Used in Reconstruction of Tongue after Resection of Squamous Cell Carcinoma: What Factors Could Influence the Process?

Abstract

Background: Reconstruction of defects after resection of tongue squamous cell carcinoma (TSCC) becomes an insurmountable thing that aims to improve the life quality of patients. Recently, reconstruction procedure not only aims to restore function and bulk of tongue, but also to restore the sensation modalities that increase efficacy of the neotongue. Sensory recovery of neo-tongue remains a very difficult topic that influenced by multiple factors that could delay or diminish sensory recovery process. Until now, no agreement about these factors and their effects, therefore this systematic review was performed to find out factors that could have an impact on sensory recovery of neo-tongue.Methods: A search in five databases (PubMed, science direct, web of science, Cochrane library, Ovid) was released. All articles that related to sensory recovery of neo-tongue were identified.Results: (22) articles were included in our systematic review, in which 310 flaps of different types were performed, where the most performed flaps in the reviewed articles were anterolateral free flap (ALTF) and radial forearm free flaps (RFF). Different degrees of Sensory recovery were reported in association with different types of flaps used in reconstruction; innervated ALTF and RFF flaps were associated with the greatest degree of sensory recovery. Reci-pient nerve also reported to have clear influence on the degree of sensory recovery; lingual nerve and inferior alveo-lar nerve have superiority over other recipient nerves. Patient-related factors (age, gender, and smocking habit), ad-juvant therapies (radiotherapy/chemotherapy), size of resection, and follow-up period all are factors that still a matter of converser.