Denervated or innervated flaps for the lower lip reconstruction? Are they really different to get a good result?

摘要

OBJECTIVE: This study compares innervated and denervated flaps for the lower lip reconstruction in terms of oral sphincter function and sensation. STUDY DESIGN AND SETTING: A prospective trial. METHODS: This study was carried out on 31 patients with lower lip carcinoma. They were divided in 2 groups: 18 patients with denervated local flaps and 13 patients with innervated flaps. During the follow-up period, all patients were evaluated by electromyography tests and an assessment of the sensation on the lower lip and sphincter function was undertaken by clinical parameters. RESULTS: Compound muscle action potential (CMAP) was obtained in all patients. The amplitudes of CMAP were below normal and the values for distal motor latency (DML) were slightly longer than normal values. Interference patterns were observed on whistling in all cases. There were no differences in terms of sphincteric function in each group. CONCLUSIONS: The denervated random local flaps used for the lower lip reconstruction have no functional inferiority when compared to the innervated-pedicled local flaps. SIGNIFICANCE: This study demonstrates that denervated flaps can be employed for a functional lip reconstruction. EBM rating: B-2b.