SENSORY RECOVERY IN NONINNERVATED RADIAL FOREARM FREE FLAPS IN ORAL AND OROPHARYNGEAL RECONSTRUCTION

Background: Reinnerveration of free flaps used in oral and oropharynge al reconstruction may provide a high level of sensory return. Spontane ous recovery of sensation in noninnervated flaps may also occur. Objec tive: To evaluate the extent of spontaneous sensory return among patie nts who underwent radial forearm free flap reconstruction in the oral cavity and oropharynx. Methods: A total of 40 patients were evaluated by 2 independent examiners. The median patient age was 60 years, and t he median time from surgery was 47 months. A total of 29 patients had received postoperative radiotherapy. The mean flap size was 25 cm(2). The following sensory modalities were rested: light touch, pinprick, h ot and cold, and moving and static 2-point discrimination. Results: Re covery of sensation of at least 1 modality was noted in 32 patients (8 0%), however, only 5 patients (13%) had return of all 5 modalities. Ei ght patients (20%) had no sensory return. There was a trend to improve d sensory recovery in flaps placed in the alveolar and retromolar trig one areas; however, on multivariate analysis, sensory return could not be predicted by any of die following factors: patient age, nap site, flap size, length of follow-up, and use of postoperative radiotherapy. Conclusions: Complete sensory recovery was uncommon, unpredictable, a nd variable, although some recovery of sensation occurred in 80% of pa tients. It is not valid to rely on spontaneous sensory recovery for se nsory innervation of free flaps. Correlation of sensory return with fu nction is still needed.