Evaluation of Sensibility of Noninnervated, Intraoral, Microsurgically Transferred Flaps
Research article published in Plastic and reconstructive surgery (2026)
Abstract
BACKGROUND: This study investigated sensory recovery of microvascular free flaps in the oral cavity with functional magnetic resonance imaging to assess activation in the primary sensory cortex (S1). METHODS: The study included 20 patients with sensory recovery at the flap site in the tongue or floor of mouth after ablative cancer surgery that involved unilateral resection of the lingual nerve and reconstruction with a radial free forearm flap, anterolateral thigh flap, or lower leg perforator flap without nerve readaptation between 2012 and 2019. Control nonflap and contralateral flap sites were electrically stimulated with a patient-specific, sensation-inducing voltage for 10 minutes with 30-second on/off intervals. During this process, functional magnetic resonance imaging was conducted simultaneously to assess the signal area and level in S1. RESULTS: The stimulation voltage was higher at the flap site than at the control nonflap site (6.0 versus 3.0 V; P < 0.001). The signal area activated upon stimulation of the flap and control nonflap site was located in the cortical area representing the lingual nerve. The signal level in S1 upon stimulation of the flap site was similar to that upon stimulation of the control nonflap site (3.2 versus 3.5 T; P = 0.751). CONCLUSION: Activation of the cortical area representing the lingual nerve upon stimulation of the flap site implies that sensory recovery of microvascular free flaps in the tongue and floor of mouth region involves nerve ingrowth from the remaining lingual nerve into the flap tissue.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Por qué esto importa para la hirudoterapia
Este estudio utilizó resonancia magnética funcional en 20 pacientes para mapear las respuestas corticales después de la reconstrucción intraoral con colgajo libre microvascular tras una cirugía de cáncer que seccionó el nervio lingual, encontrando que la estimulación del colgajo activó la misma región de la corteza sensorial primaria que representa al nervio lingual (nivel de señal 3.2 vs 3.5 T en los sitios de control; P = 0.751) a pesar de requerir un voltaje de estimulación más alto (6.0 vs 3.0 V; P < 0.001), lo que implica una recuperación sensorial mediante el crecimiento de nervios a partir del nervio lingual restante. Para ASH, la relevancia es contextual más que directa: la reconstrucción con colgajo libre es la indicación aprobada por la FDA (510(k) K040187) en la que las sanguijuelas medicinales alivian la congestión venosa para salvar los colgajos, y la evidencia de que estos colgajos pueden recuperar una función sensorial significativa subraya por qué es importante proteger la viabilidad del colgajo en la ventana postoperatoria temprana. La advertencia honesta es que se trata de una pequeña cohorte observacional de imágenes que no estudió ni las sanguijuelas ni la congestión venosa, por lo que solo se refiere al panorama reconstructivo a largo plazo, no a la eficacia de la hirudoterapia.
Citación
Evaluation of Sensibility of Noninnervated, Intraoral, Microsurgically Transferred Flaps.
Modabber et al. · Plastic and reconstructive surgery, 2026
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026