Escandón Joseph M, Mroueh Jessica, Reid Christopher M, Singh Devinder, Sweitzer Keith, Ciudad Pedro, Nazerali Rahim, Forte Antonio J, Manrique Oscar J
Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, USA.
American University of Beirut Faculty of Medicine, Beirut, Lebanon.
Ann Transl Med. 2024 Aug 1;12(4):76. doi: 10.21037/atm-23-504. Epub 2023 Jun 27.
While significant sensation recovery improvements in neurotized breasts following reconstruction have been reported, sensation testing methods and surgical techniques have been widely variable. This narrative review aims to summarize available literature on current neurotization practices and sensory recovery outcomes in patients undergoing innervated breast reconstruction.
A comprehensive literature search of PubMed Medline, Web of Science, and Embase was conducted to identify all studies reporting outcomes of neurotization in breast reconstruction surgeries. Data analyzed included operative times, neurotization techniques, sensory outcomes, and methods as well as patient reported outcomes.
Despite the heterogeneity of various studies reviewed, all forms of neurotization achieved earlier and superior sensory recovery throughout the reconstructed breast skin compared to non-innervated breasts. In absence of randomized controlled trials or high-quality comparative studies, further evidence is required to objectively confirm this technique offers better sensory recovery.
Neurotization at the time of breast reconstruction may lead to improved sensation and patient reported outcomes delineating improved quality of life compared to non-innervated breasts. Future studies need to standardize the way that breast sensation is measured and determine pre-operative variables leading to expected changes in final sensation recovery to help manage surgical outcome expectations of both the surgeon and the patient.
虽然已有报道称乳房重建术后神经化乳房的感觉恢复有显著改善，但感觉测试方法和手术技术差异很大。本叙述性综述旨在总结有关接受神经支配乳房重建患者的当前神经化实践和感觉恢复结果的现有文献。
对PubMed Medline、Web of Science和Embase进行全面文献检索，以确定所有报告乳房重建手术中神经化结果的研究。分析的数据包括手术时间、神经化技术、感觉结果和方法以及患者报告的结果。
尽管所综述的各种研究存在异质性，但与未接受神经支配的乳房相比，所有形式的神经化在整个重建乳房皮肤中均实现了更早且更好的感觉恢复。由于缺乏随机对照试验或高质量的比较研究，需要进一步的证据来客观证实该技术能提供更好的感觉恢复。
与未接受神经支配的乳房相比，乳房重建时进行神经化可能会改善感觉以及患者报告的结果，从而提高生活质量。未来的研究需要规范乳房感觉的测量方式，并确定导致最终感觉恢复预期变化的术前变量，以帮助管理外科医生和患者对手术结果的期望。
