Neuronal anastomosis of the cutaneous ramus of the intercostal nerve to achieve sensibility in the latissimus dorsi transplant

Purpose: The return of sensory qualities in microvascular free myocutaneous transplants is of great importance in oral and maxillofacial surgery, beca use such sensations are responsible for improved speech and chewing. This s tudy evaluated the results of neuronal anastomosis of sensory nerves in fre e microvascular anastomosed myocutaneous flaps, Patients and Methods: Anastomosis of the lateral cutaneous ramus of the int ercostal nerve and the greater auricular nerve was performed to reestablish sensibility of the latissimus doni 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 oth er patients, pressure and pain sensations were elicited first. Next, slight tour, vibration, and sharp and blunt discrimination recovered. Thermal sti muli were sensed by only 1 patient. Conclusion: Improved sensation of a latissimus dorsi transplant can be achi eved by sensory nerve anastomosis.