Sensory Recovery after Reconstruction of Oral Cavity and Oropharynx using Non-sensate Flap

ABSTRACT

The ablation surgery of the oral cavity and oropharyngeal carcinoma induced some disturbance in multiple aspects of normal anatomy and physiologic function. Sensation is one of the most important factor for restoration of many disturbed oral function like articulation, swallowing and mastication. Thirteen oral cavity and oropharyngeal carcinoma patients with reconstruction using non- sensate flap including free flap or musculocutaneous pedicled flap were subjects of this study. The sensory recovery was evaluated among the following 5 subjective senses light touch, deep touch(pressure), pain, warm and cold sense and the two point discriminations were also recorded after postoperative 6 months. For histologic examination, after the flap tissues including the normal mucosa were obtained, H&E and immunohistochemical stains with anti-S-100 protein were performed at the same time. The subjective sensation, especially deep touch(pressure) and pain were almost restored(92%) in the flap and histologic changes, such as loss of keratin, granular layer and hyperkeratosis were observed. But, only 15% of the flap revealed positive reaction in staining with S-100 protein. Our results demonstrates some recovery of sensation in the non-sensate flap and the changes in epidermis of the flap such as mucosalization. However, histologic evidence were lack on the sensory nerve regeneration. Therefore, detailed study should be included electromicroscopic examination and comparison between the sensate and non-sensate flap.