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Sensate Radial Forearm Free Flaps in Tongue Reconstruction
M. Abraham Kuriakose, MD;
Thom R. Loree, MD;
Alice Spies, RN, RNFA, CNOR;
Sandy Meyers, MS, OTR;
Wesley L. Hicks, Jr, MD
Arch Otolaryngol Head Neck Surg. 2001;127:1463-1466.
Background Successful rehabilitation after ablative surgery requires not only the
reconstruction of 3-dimensional form but also the restoration of physiologic
function.
Objective To assess sensory recovery of reinnervated radial forearm flaps used
for tongue reconstruction.
Patients and Methods Seventeen patients, who underwent reconstruction of glossectomy defects
with reinnervated radial forearm free flaps, formed the study group. Recovery
of sensation was measured by both subjective and detailed objective tests
8 months after surgery. Sensory function of the flap was compared with that
of the normal residual tongue or the adjacent oral mucosa and the contralateral
forearm donor site.
Results All patients involved in this study had tongue defects of hemiglossectomy
or greater and adjacent floor of the mouth. Sensory recovery was observed
in all of the 17 patients within 8 months. Detailed sensory testing showed
that median static 2-point discrimination, moving 2-point discrimination,
and pressure sensitivity (1.2 cm, 0.8 cm, and 3.7 psi, respectively) were
subjectively greater in the innervated forearm flaps than in the contralateral
forearm donor site (2.3 cm, 1.7 cm, and 4.6 psi, respectively) (P=.064) and similar to those of the normal tongue (0.9 cm, 0.5 cm,
and 3.6 psi).
Conclusions In all modalities examined, sensate free flaps proved superior in sensory
fidelity to the native forearm donor site and closely approached that of the
normal tongue. Microsurgical reinnervation of flaps should be considered in
tongue reconstruction.
From the Department of Head and Neck Surgery, Roswell Park Cancer Institute,
Buffalo, NY.
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Arch Otolaryngol Head Neck Surg. 2001;127(12):1521-1522.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Fasciocutaneous Flap Reconstruction of the Tongue and Floor of Mouth: Outcomes and Techniques
Haughey et al.
Arch Otolaryngol Head Neck Surg 2002;128:1388-1395.
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