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Evaluation of discriminative sensibility recovery in patients with buccinator myomucosal flap oral cavity reconstructions

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Abstract

Background

Sensitive restoration is the primary aim of oral reconstructive surgery. Discriminative sensibility is an important index of innervation density of a tissue. Instruments normally used to assess this type of skin sensibility are bulky and difficult to introduce in the oral cavity, even in healthy patients with a normal mouth opening. This study was intended to evaluate the recovery of static and dynamic two-point discrimination sensitivity of the reconstructed areas of the oral cavity.

Methods

Surgical staples, calibrated in predetermined width (from 1 to 30 mm) and introduced in the oral cavity with a Mayo needle holder, were used to evaluate two-point discrimination recovery in 57 patients who underwent reconstructive surgery with buccinator myomucosal flaps. Tests were conducted both on the reconstructive flap and on the non-operated contralateral side. The latter also included the non-operated cheek.

Results

All of the considered flaps showed a recovery of tactile sensitivity. The overall average discriminative threshold value assessed on this sample was 9.11 ± 2.46 mm for the static and 6.56 ± 2.46 mm for the dynamic.

Conclusions

The use of surgical staples allows easy assessment of tactile sensitivity in all oral cavity areas, even in operated patients who often present lockjaw or microstomia. In our series, buccinator myomucosal flaps demonstrate a much greater recovery of the sensation compared to results found in the literature on fasciocutaneous free flaps, even those reinnervated.

Level of Evidence: Level III, prognostic study

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Authors and Affiliations

  1. Operative Unit of Maxillo-Facial Surgery, University of Sassari Hospital, Viale San Pietro 43B, 07100, Sassari, Italy

    Luigi Angelo Vaira, Olindo Massarelli, Roberta Gobbi, Damiano Soma & Giacomo De Riu

  2. Operative Unit of Maxillo-Facial Surgery, University of Naples “Federico II” Hospital, Via Pansini 5, 80131, Naples, Italy

    Luigi Angelo Vaira & Giovanni Dell’aversana Orabona

  3. ENT Operative Unit, Second University of Naples Hospital, Via Pansini 5, 80131, Naples, Italy

    Pasquale Piombino

Authors
  1. Luigi Angelo Vaira
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  2. Olindo Massarelli
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  3. Roberta Gobbi
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  4. Damiano Soma
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  5. Giovanni Dell’aversana Orabona
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  6. Pasquale Piombino
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  7. Giacomo De Riu
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Correspondence to Luigi Angelo Vaira.

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Conflict of interest

Luigi Angelo Vaira, Olindo Massarelli, Roberta Gobbi, Damiano Soma, Giovanni Dell’aversana Orabona, Pasquale Piombino and Giacomo De Riu declare that they have no conflict of interest.

Patient consent

Patients provided written consent before their inclusion in this study. Additional consent was obtained for the use of their images.

Funding

No funding sources were necessary for this study.

Ethical approval

This study was approved by the Ethics Committee of the University of Sassari and therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Vaira, L.A., Massarelli, O., Gobbi, R. et al. Evaluation of discriminative sensibility recovery in patients with buccinator myomucosal flap oral cavity reconstructions. Eur J Plast Surg 40, 427–434 (2017). https://doi.org/10.1007/s00238-017-1277-z

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  • DOI: https://doi.org/10.1007/s00238-017-1277-z

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