Comparison of sensory recovery and morphologic change between sensate and nonsensate flaps in oral cavity and oropharyngeal reconstruction.

BACKGROUND

Sensory recovery after oral cavity and oropharyngeal reconstruction is 1 of the most important goals of free flap reconstruction. The aim of this study was to compare sensory recovery of sensate and nonsensate free flaps and to evaluate the morphologic differences between sensate and nonsensate free flaps.

METHODS

A total of 27 cases of radial forearm free flap reconstruction after oral cavity and oropharyngeal cancer resection were included in this study. Fifteen flaps were sensate flaps, and the other 12 flaps were nonsensate flaps. The sensory recovery was evaluated in 5 subjective senses: light tough, deep pressure, pain, warm, and cold senses. The 2-point discriminations were also recorded. For morphologic evaluation, the shapes of nerve fibers and nerve fiber bundles were observed and counted after immunohistochemical stains with S-100 protein and neuron-specific enolase and observed with transmission electron microscope.

RESULTS

The scores of the 5 subjective senses in the sensate flaps and 2-point discrimination capabilities were significantly higher than those in the nonsensate flaps (p <.05). The number and the shape of the nerve fibers in the sensate flaps were more prominent (p <.05).

CONCLUSION

There were significant differences in sensory recovery between sensate and nonsensate flaps in oral cavity and oropharyngeal reconstruction, and the nerve fibers were larger, better arranged, and more numerous in sensate than nonsensate flaps.