Sensory recovery of innervated and non-innervated radial forearm free flaps: Functional implications

Findings reported in the literature on the sensation provided by intraorall y applied innervated vs. non-innervated radial forearm free flaps differ. I n an effort to understand these differences in sensory recovery, the author s carried out sensory evaluations in 12 patients who had undergone radial f orearm free flaps. Seven patients had innervated flaps for defects of the t ongue and floor of mouth; five had noninnervated flaps to various sites. Fl ap sensitivity to temperature, light touch, dull touch, and sharpness and t wo-point discrimination was assessed at the donor site and contralaterally, and at the recipient site and contralateral mirror-image oral mucosa. Pati ents subjectively rated post-reconstruction sensation and provided quality of life (QOL) data. The innervated flaps demonstrated better sensory recovery than the non-inne rvated flaps, although the latter did restore reasonable sensation. This pa per describes the results, compares the study to other similar studies, and discusses Various factors in the sensory recovery of both innervated and n oninnervated intraoral radial forearm free flaps. The authors conclude that , although the trend in this study is toward improved function with the inn ervated flaps, these flaps do not appear to offer major intraoral functiona l advantage over the non-innervated flaps, which attain reasonably effectiv e sensory recovery from neural ingrowth, if the lingual nerve is intact.