title: Sensory recovery of non-innervated free flaps and nasolabial island flaps used for tongue reconstruction of oncological defects.
abstract: The aims of this study were to assess sensory recovery and impact on life quality after tongue reconstruction of oncological defects using different flap types. Thirty-two patients who underwent tongue reconstruction for oncological defects 9·3 months after surgery with non-innervated radial forearm free flaps (RFFFs) (N = 16), non-innervated anterolateral thigh free flaps (ALTFFs) (N = 8) and nasolabial island flaps (NLIFs) (N = 8), and 20 age- and gender-matched healthy controls participated in the study. The modalities assessed were cold detection threshold, warm detection threshold (WDT), cold pain threshold, heat pain threshold (HPT), mechanical detection threshold (MDT), mechanical pain threshold (MPT) and the Chinese version of Oral Health Impact Profile-49. ALTFFs was significantly more sensitive than RFFFs (P = 0·005) and NLIFs (P = 0·014) for WDT, and showed a better sensory recovery than RFFFs for HPT (P = 0·011). ALTFFs and NLIFs showed significantly better sensory recovery than RFFFs for MDT (P < 0·005). NLIFs showed the best sensory recovery for MPT, followed by ALTFFs and lastly RFFFs (P = 0·004). NLIFs also showed the least impact on quality of life measures related to psychological discomfort compared to RFFFs and ALTFFs (P < 0·019). All modalities of sensory recovery in RFFFs did not depend on gender and post-operative radiotherapy (P > 0·05). Different flaps for tongue reconstruction of oncological defects appear to have different patterns of sensory recovery and impact on quality of life measures. A longer follow-up period and larger number of participants will be needed in future studies.
authors.affiliation: Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.|Institute of Stomatology & Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.|Department of Stomatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Institute of Stomatology & Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
authors.forename: X
authors.initials: X
authors.lastname: Song
authors.affiliation: Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.|Institute of Stomatology & Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
authors.forename: W
authors.initials: W
authors.lastname: Hou
authors.affiliation: Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.|Institute of Stomatology & Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
authors.forename: S
authors.initials: S
authors.lastname: Wu
authors.affiliation: Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.|Institute of Stomatology & Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
authors.forename: W
authors.identifier: http://orcid.org/0000-0001-9858-4961
authors.initials: W
authors.lastname: Chen
authors.affiliation: Section of Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.|Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Svensson
authors.affiliation: Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.|Center for Sensory-Motor Interaction (SMI) Aalborg University, Aalborg, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm; D058752:Free Tissue Flaps; D005927:Glossectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D060052:Nasolabial Fold / Q000098:blood supply*; D009619:Nociceptors / Q000502:physiology*; D017288:Pain Threshold / Q000502:physiology*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology*; D013697:Thermosensing; D013848:Thigh; D014059:Tongue / Q000503:physiopathology / Q000601:surgery*; D014062:Tongue Neoplasms / Q000601:surgery*
keywords: Oral Health Impact Profile; non-innervated free flaps; quantitative sensory testing; sensory recovery; tongue reconstruction