Intraoral reconstruction with innervated forearm flap: a comparison of sensibility and reinnervation in innervated versus noninnervated forearm flap.
OBJECTIVE
To evaluate the cutaneous sensibility and sensory reinnervation in patients who underwent intraoral reconstruction with an innervated or noninnervated forearm flap.


METHODS
Results of the use of innervated forearm flaps in oral reconstruction was compared with the use of noninnervated flaps. The evaluation of sensibility and reinnervation comprised clinical sensibility tests and immunohistochemical investigation of postoperative biopsy specimens against S-100 and neurofilament.


RESULTS
The innervated flaps (4 patients) provided earlier and qualitatively better recovery of sensation than the noninnervated flaps (9 patients). Immunohistochemical investigation revealed the existence of a larger number of regularly arranged sensory nerve fibers in the cutaneous tissue of the innervated flaps than in the noninnervated flaps. Examination with an electron microscope found the structure of these nerve fibers to be well preserved in the innervated flaps, whereas nerve fibers in the noninnervated flaps were degenerative.


CONCLUSIONS
These findings suggest (1) that the innervated flaps are superior to the noninnervated flaps not only for the repair of defects but also for the restoration of function and (2) that the innervated flaps contribute to the improvement of the quality of life for patients.
Katou
F
F
Department of Oral and Maxillofacial Surgery 1, School of Dentistry, Tohoku University, Sendai, Japan.
Shirai
N
N
Kamakura
S
S
Ohki
H
H
Motegi
K
K
Andoh
N
N
Date
F
F
Nagura
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D005542:Forearm; D006801:Humans; D007124:Immunoenzyme Techniques; D008036:Lingual Nerve / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods*; D016900:Neurofilament Proteins / Q000032:analysis; D010147:Pain Measurement; D012189:Retrospective Studies; D009418:S100 Proteins / Q000032:analysis; D012867:Skin / Q000294:innervation; D013524:Surgical Flaps / Q000379:methods* / Q000502:physiology; D013697:Thermosensing; D014110:Touch; D016896:Treatment Outcome
D016900:Neurofilament Proteins; D009418:S100 Proteins