Sensory recovery of non‐innervated free flaps and nasolabial island flaps used for tongue reconstruction of oncological defects

Abstract

The aims of this study were to assess sensory recovery and impact on life quality after tongue reconstruction of oncological defects using different flap types. Thirty-two patients who underwent tongue reconstruction for oncological defects 9·3 months after surgery with non-innervated radial forearm free flaps (RFFFs) (N = 16), non-innervated anterolateral thigh free flaps (ALTFFs) (N = 8) and nasolabial island flaps (NLIFs) (N = 8), and 20 age- and gender-matched healthy controls participated in the study. The modalities assessed were cold detection threshold, warm detection threshold (WDT), cold pain threshold, heat pain threshold (HPT), mechanical detection threshold (MDT), mechanical pain threshold (MPT) and the Chinese version of Oral Health Impact Profile-49. ALTFFs was significantly more sensitive than RFFFs (P = 0·005) and NLIFs (P = 0·014) for WDT, and showed a better sensory recovery than RFFFs for HPT (P = 0·011). ALTFFs and NLIFs showed significantly better sensory recovery than RFFFs for MDT (P < 0·005). NLIFs showed the best sensory recovery for MPT, followed by ALTFFs and lastly RFFFs (P = 0·004). NLIFs also showed the least impact on quality of life measures related to psychological discomfort compared to RFFFs and ALTFFs (P < 0·019). All modalities of sensory recovery in RFFFs did not depend on gender and post-operative radiotherapy (P > 0·05). Different flaps for tongue reconstruction of oncological defects appear to have different patterns of sensory recovery and impact on quality of life measures. A longer follow-up period and larger number of participants will be needed in future studies.

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

“…Several factors influence the choice of flap for extremity reconstruction, including the size of the defects, their localization, the flap's overall transplantation success rate, the vessel length, flap diameter, and considerations regarding the recipient site and donor site (Zhu et al, ).…”

Anatomical analysis of antebrachial cutaneous nerve distribution pattern and its clinical implications for sensory reconstruction

“…The direction of nerve regeneration can be guided by the alignment of nerve tissues, so that Schwann cells at both ends can directly restore material communication channels, and the regenerated nerve fibers can grow smoothly into the distal neurotubules [28]. However, the important factors for flap recovery are distribution of sensory nerves in the donor site of the flap, the choice of the cutaneous nerve, and its site of coaptation [29, 30]. Therefore, if the recipient nerve is rich, a rich donor nerve should be matched to increase the probability of nerve contact.…”

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

“…Type of flap used in reconstruction, either innervated or non-innervated (ALTF, RFFF, NLIS, etc.) [7][8][9][10][12][13][14][15][16][17].…”