Schultes G, Gaggl A, Kärcher H
Department of Oral and Maxillofacial Surgery, University Hospital, Graz, Austria.
Plast Reconstr Surg. 1999 Mar;103(3):857-61. doi: 10.1097/00006534-199903000-00012.
The question as to whether anastomosis of sensory nerves is recommended for free transplants of the myocutaneous latissimus dorsi flap, reanastomosed by microvascular surgery, remains a controversial issue. In this study, a microsurgical nerve anastomosis was performed to sensitize a latissimus dorsi transplant. To determine sensation in the transplanted tissue, six patients were examined clinically. All patients had free transplants of latissimus dorsi flaps reanastomosed by microvascular surgery after tumor resection in the oral cavity. An anastomosis of the sensible auricular magnus nerve with the motor thoracodorsalis nerve was performed. Resulting sensation was determined clinically by testing for pain, temperature, pressure, two-point discrimination, and vibration. All patients showed sensation in the latissimus dorsi flap beginning between the third and the fifth month postoperatively. Therefore, resensitization of a large and voluminous myocutaneous latissimus dorsi flap should be attempted by a nerve anastomosis in this transplant.
对于通过微血管手术进行再吻合的背阔肌肌皮瓣游离移植是否推荐进行感觉神经吻合，这一问题仍然存在争议。在本研究中，进行了显微外科神经吻合以使背阔肌移植具有感觉功能。为了确定移植组织中的感觉，对6例患者进行了临床检查。所有患者均在口腔肿瘤切除后接受了通过微血管手术进行再吻合的背阔肌瓣游离移植。将感觉性耳大神经与运动性胸背神经进行了吻合。通过测试疼痛、温度、压力、两点辨别觉和振动来临床确定产生的感觉。所有患者在术后第三个月至第五个月之间开始在背阔肌瓣中表现出感觉。因此，在这种移植中应尝试通过神经吻合对大体积的背阔肌肌皮瓣进行感觉再恢复。
