Vriens J P, Acosta R, Soutar D S, Webster M H
West of Scotland Regional Plastic and Oral Surgery Unit, Canniesburn Hospital, Glasgow, Scotland.
Plast Reconstr Surg. 1996 Sep;98(4):649-56. doi: 10.1097/00006534-199609001-00008.
The purpose of this study was to find out to what extent sensory function recovers in a free radial forearm flap used for intraoral reconstruction after surgery for oral cancer. In 40 free radial forearm flaps we investigated the perception of light touch, two-point discrimination, pain, directional sensation, and temperature between 6 months and 11 years after flap transfer to the oral cavity. Four flaps (10 percent) were anesthetic, 21 flaps (52.5 percent) recovered partly, and 15 flaps (37.5 percent) had perception of all sensory modalities tested in at least two-thirds of the flap area. All patients with positive sensation in the surrounding area subsequently had good sensory recovery in the flap. This suggests that recovery of sensation in a nonreinnervated free flap is due to nerve ingrowth from the surrounding mucosa. The present results suggest that sensory function in intraoral free radial forearm flaps returns again. Further study is necessary to define the use of neurofasciocutaneous radial forearm flaps in reconstruction of the oral cavity.
本研究的目的是了解在用于口腔癌术后口腔重建的游离桡侧前臂皮瓣中，感觉功能在术后的恢复程度。我们对40例游离桡侧前臂皮瓣进行了研究，在皮瓣转移至口腔后6个月至11年期间，调查了轻触觉、两点辨别觉、疼痛、方向觉和温度觉。4例皮瓣（10%）无感觉，21例皮瓣（52.5%）部分恢复，15例皮瓣（37.5%）在至少三分之二的皮瓣区域对所有测试的感觉模式有感知。所有在周围区域有阳性感觉的患者随后皮瓣的感觉恢复良好。这表明未重新神经支配的游离皮瓣感觉恢复是由于周围黏膜的神经长入。目前的结果表明口腔游离桡侧前臂皮瓣的感觉功能再次恢复。有必要进一步研究以明确带神经血管蒂的桡侧前臂皮瓣在口腔重建中的应用。
