Neuronal anastomosis of the cutaneous ramus of the intercostal nerve to achieve sensibility in the latissimus dorsi transplant.
OBJECTIVE
The return of sensory qualities in microvascular free myocutaneous transplants is of great importance in oral and maxillofacial surgery, because such sensations are responsible for improved speech and chewing. This study evaluated the results of neuronal anastomosis of sensory nerves in free microvascular anastomosed myocutaneous flaps.


METHODS
Anastomosis of the lateral cutaneous ramus of the intercostal nerve and the greater auricular nerve was performed to reestablish sensibility of the latissimus dorsi transplant. All patients had undergone tumor surgery because of an oral carcinoma and had been treated with a free microvascular myocutaneous latissimus dorsi transplant. Clinical follow-up was performed at monthly intervals postoperatively, and pain, temperature, and pressure sensations were tested, as well as 2-point discrimination and vibration perception.


RESULTS
Only 1 patient showed no sensibility in the transplant. In all other patients, pressure and pain sensations were elicited first. Next, slight touch, vibration, and sharp and blunt discrimination recovered. Thermal stimuli were sensed by only 1 patient.


CONCLUSIONS
Improved sensation of a latissimus dorsi transplant can be achieved by sensory nerve anastomosis.
Schultes
G
G
Clinical Department of Oral and Maxillofacial Surgery, University Hospital Graz/Austria.
Gaggl
A
A
Kärcher
H
H
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D004431:Ear, External / Q000294:innervation; D005260:Female; D006801:Humans; D007367:Intercostal Nerves / Q000601:surgery*; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery; D008866:Microsurgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation / Q000637:transplantation*; D009416:Nerve Regeneration; D019635:Neurosurgical Procedures / Q000379:methods; D019647:Oral Surgical Procedures / Q000379:methods*; D011184:Postoperative Period; D012677:Sensation; D012678:Sensation Disorders / Q000209:etiology; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation*; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods