title: Bilateral inferior alveolar nerve reconstruction with a vascularized sural nerve graft included in a free fibular osteocutaneous flap after segmental mandibulectomy.
abstract: BACKGROUND
  Segmental mandibulectomy with bilateral inferior alveolar nerve (IAN) resection results in complete sensory loss in the lower lip and chin. The purpose of this study was for us to report on a bilateral IAN reconstruction with a vascularized nerve graft after chemoradiotherapy during cancer ablation.
  
  
  METHODS
  The mandible was reconstructed with a fibular osteocutaneous flap that included the sural nerve. The proximal ends of the right and left IAN were sutured to the proximal and distal ends of the sural nerve in an end-to-end manner. The 2 distal ends of the mental nerves were sutured to the sural nerve in an end-to-side manner. Sensations were measured using the Semmes-Weinstein monofilaments test.
  
  
  RESULTS
  Sensory recovery was first noted after 5 months and the quantitative results of the Semmes-Weinstein test 45 months after surgery were 2.83 to 4.08.
  
  
  CONCLUSIONS
  One-stage nerve reconstruction may be indicated for bilateral IAN resection. A vascularized nerve graft is effective especially in a perioperative radiotherapy case.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Homma
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan.|Department of Plastic Surgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yano
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
mesh_terms: D000368:Aged; D005360:Fibula / Q000601:surgery; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008340:Mandibular Nerve / Q000601:surgery*; D063168:Mandibular Osteotomy / Q000379:methods*; D009062:Mouth Neoplasms / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D013497:Sural Nerve / Q000637:transplantation*
keywords: bilateral reconstruction; fibular osteocutaneous flap; indocyanine green fluorescent angiography; inferior alveolar nerve reconstruction; vascularized sural nerve graft