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Sensory reinnervation of free flaps in reconstruction of the breast and the upper and lower extremities

Neural Regeneration Research 2012年第29期7卷 2279-2285页

作者： Nektarios Sinis Androniki Lamia Helml Gudrun Thomas Schoeller Frank Werdin department of Plastic Hand-and Reconstructive MicrosurgerySt.Marien Krankenhaus BerlinBerlin 12249 Germany department of handsurgery Microsurgery and Reconstructive Surgery of the Breast Marienhospital StuttgartStuttgart 70199Baden-Württemberg Germany department of handsurgery Microsurgery and Reconstructive Surgery of the Breast Marienhospital StuttgartStuttgart 70199Baden-Württemberg Germany

There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons. The principle of connecting not only the vascular supply, but also sensitive nerves, in free tissue transfer is attractive. However, increased operating time and partial spontaneous innervation led to the common decision to restrict microsurgical tissue transfer to the vascular anastomosis and to leave the nerves ＂untreated＂. Nevertheless, in special cases such as breast reconstruction or extremity reconstruction, the question about sensory nerve coaptation of the flaps remains open. We present our experience with free microvascular tissue transfer for breast and extremity reconstruction and compare the data with previous literature and conclude that most free flap surgeries do not benefit from nerve coaptation.

关键词： free tissue flap mammaplasty dermatoplasty free tissue transfer flap free microvascular tissuetransfer breast reconstruction extremity reconstruction sensate flap non-sensate flap

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Facial reanimation with interposition nerve graft or masseter nerve transfer:a comparative retrospective study

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Neural Regeneration Research 2022年第5期17卷 1125-1130页

作者： Wen-Jin Wang Wei-Dong Zhu Mathias Tremp Gang Chen Zhao-Yan Wang Hao Wu Wei Wang department of Plastic and Reconstructive Surgery Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina department of Otolaryngology Head and Neck Surgery Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases ShanghaiChina Ear Institute Shanghai Jiao Tong University School of MedicineShanghaiChina department of Plastic ReconstructiveAesthetic and HandsurgeryUniversity Hospital BaselBaselSwitzerland

Both interposition nerve grafts and masseter nerve transfers have been successfully used for facial reanimation after irreversible injuries to the cranial portion of the facial ***,no comparative study of these two procedures has yet been *** this two-site,twoarm,retrospective case review study,32 patients were *** these,17 patients(eight men and nine women,mean age 42.1 years)underwent interposition nerve graft after tumor extirpation or trauma between 2003 and 2006 in the Ear Institute,School of Medicine,Shanghai Jiao Tong University,China,and 15 patients(six men and nine women,mean age 40.6 years)underwent masseter-to-facial nerve transfer after tumor extirpation or trauma between November 2010 and February 2016 in Shanghai Ninth People's Hospital,*** patients achieved House-Brackmann III recovery after masseter nerve repair than interposition nerve graft repair(15/15 vs.12/17).The mean oral commissure excursion ratio was also higher in patients who underwent masseter nerve transfer than in patients subjected to an interposition nerve *** findings suggest that masseter nerve transfer results in strong oral commissure excursion,avoiding obvious synkinesis,while an interposition nerve graft provides better resting *** study was approved by the Institutional Ethics Committee,Shanghai Ninth People's Hospital,China(approval ***9 H-2019-T332-1)on December 12,2019.

关键词： facial palsy facial reanimation facial symmetry House-Brackmann score interposition masseter nerve nerve graft oral commissure excursion resting symmetry synkinesis

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