Evaluation of discriminative sensibility recovery in patients with buccinator myomucosal flap oral cavity reconstructions

Background: Sensitive restoration is the primary aim of oral reconstructive surgery. Discriminative sensibility is an important index of innervation density of a tissue. Instruments normally used to assess this type of skin sensibility are bulky and difficult to introduce in the oral cavity, even in healthy patients with a normal mouth opening. This study was intended to evaluate the recovery of static and dynamic two-point discrimination sensitivity of the reconstructed areas of the oral cavity. Methods: Surgical staples, calibrated in predetermined width (from 1 to 30 mm) and introduced in the oral cavity with a Mayo needle holder, were used to evaluate two-point discrimination recovery in 57 patients who underwent reconstructive surgery with buccinator myomucosal flaps. Tests were conducted both on the reconstructive flap and on the non-operated contralateral side. The latter also included the non-operated cheek. Results: All of the considered flaps showed a recovery of tactile sensitivity. The overall average discriminative threshold value assessed on this sample was 9.11 ± 2.46 mm for the static and 6.56 ± 2.46 mm for the dynamic. Conclusions: The use of surgical staples allows easy assessment of tactile sensitivity in all oral cavity areas, even in operated patients who often present lockjaw or microstomia. In our series, buccinator myomucosal flaps demonstrate a much greater recovery of the sensation compared to results found in the literature on fasciocutaneous free flaps, even those reinnervated. Level of Evidence: Level III, prognostic study