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Abstract
Introduction. The priority in the oral cavity reconstruction after radical surgical treatment for malignant tumors is restoration of vital functions such as swallowing, speech, protection of the respiratory tract from aspiration and maintenance of normal intraoral sensation.
Purpose. To determine the benefits of innervated autografts usage for sensory recovery in reconstructed organs.
Materials and methods. This study was performed prospectively on 62 patients with oral cavity malignant tumors who underwent radical surgical resection. 32 patients were included in experimental group, in which reconstruction was performed using innervated flaps, and 30 were in control group without innervation. The sensory recovery was evaluated by following subjective methods: pain, warm and cold senses, the Weber test, the Semmens-Weinstein test and a survey. For morphologic evaluation of nerve fibers in autografts tissue, a biopsy was performed followed by immunohistochemical (IHC) staining with S100 and NF markers. Each section from each sample was studied for the presence and number of nerve fibers. StatTech v.3.0.9 program was used for statistical calculations.
Results. Statistically significant differences were found in favor of the experimental group in assessing of cold and warm senses - 90.6% (29) vs. 66.7% (20) (p = 0.029); in assessing acute pain - 78.1% (25) vs. 33.3% (10) (p < 0.001); in Semmens-Weinstein test - 71.9% (23) versus 36.7% (11) (p = 0.005); in two point discriminations following results were observed: at distance less than 5 mm - 12.5% (4) versus 0%, at distance from 5 to 10 mm - 34.4% (11) versus 6.7% (2), at distance more than 10 mm - 53.1% ( 17) versus 93.3% (28). By IHC staining, the differences in nerve fiber presents were not statistically significant (p=0.078). However, the median rate of number of the nerve fibers in innervated flaps group were Me=3 (Q1-0; Q3-5), while in non-innervated flaps group Me=0 (Q1-0; Q3-1), (p=0.005).
Conclusions. Statistically significant differences were obtained, confirming that innervated flaps are superior to non-innervated flaps in terms of restoration of sensitivity and the number of nerve fibers.
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