Sensory Reconstruction Research Articles

Sensory Reconstruction of a Posterior Heel Defect Using a Proximally Based Sensate Medial Plantar Flap with Retrograde Nerve Cleavage Technique.

Reconstruction of posterior heel defects is important because it requires thick and durable skin that can withstand pressure and shear from shoe and bed contact. Therefore, the sensate flap could be a better option for the defect. This paper reports on the safety of a medial plantar sensory flap for these defects as well as an objective measurement of the sensation of the medial plantar flap and the plantar surface distal to the donor site. Twelve patients had soft-tissue defects in the posterior heel and underwent reconstructive surgery using a proximally based sensate medial plantar sensory flap. Cases of plantar defects involving not posterior heel were excluded. For wider flap coverage, special neurovascular dissection was required. We evaluated levels of sensation quantitatively using Semmes-Weinstein (SW) monofilaments and a two-point discriminator at the final follow-up. All flaps survived without major complications. Postoperative follow-up was 12 to 64 months (mean 26 months). All 12 flaps healed without postoperative complications. There was no significant difference in minimal two-point discrimination and SW evaluator size between the transferred medial plantar flap area and the contralateral heel area or between the plantar area distal to the donor site and the contralateral side. Patients could walk normally and sleep without protective shoes or brace. A proximally based sensate medial plantar flap is a good option for the reconstruction of posterior heel defects. It can restore the characteristics of the posterior heel for shoe wearing and sleeping.

Application of 3D Image Technology in Motor and Sensory Nerve Classification

Objective. To explore the application of 3D image technology in motor and sensory nerve classification. Methods. A total of 200 sections of the 5cm-long popliteal fossa peroneal nerve from adult volunteers were cut and frozen. The slices were 10 m thick, and the interval between the slices was 0.25 mm. Acetylcholinesterase histochemical staining was used to observe the changes of nerve bundles under the microscope. The stained sections were transformed into digital images by the digital camera system, and the images were stitched to obtain a two-dimensional panoramic image 100 times magnified. The properties of the functional bundles were manually judged. Using Amira 3.1 three‐dimensional reconstruction software to realize the three-dimensional reconstruction and visualization of nerve can not only accurately perceive the complex three-dimensional surface structure of nerve, but also arbitrarily display, rotate, scale, and segment the three-dimensional structure inside nerve, and carry out three-dimensional measurement in time. It has made preliminary achievements in brachial plexus, lumbosacral plexus, neural stem functional bundle (group), and intramuscular nerve routing and distribution, including the regeneration process of sensory nerve and three-dimensional reconstruction and visualization of composite tissue containing sensory nerve. Conclusion. Based on histology and computer technology, the functional band of short peroneal nerve can be reconstructed in 3D, which provides a feasible basis for the three-dimensional reconstruction of the functional band of the long peripheral nerve.

The Overall Distribution Pattern of the Hand’s Cutaneous Nerves and Its Clinical Implications in Sensory Reconstruction

The Overall Distribution Pattern of the Hand’s Cutaneous Nerves and Its Clinical Implications in Sensory Reconstruction

Skeletonizing the Dynamics of Soft Continuum Body from Video.

Soft continuum bodies have demonstrated their effectiveness in generating flexible and adaptive functionalities by capitalizing on the rich deformability of soft material. Compared with a rigid-body robot, it is in general difficult to model and emulate the morphology dynamics of a soft continuum body. In addition, a soft continuum body potentially has an infinite degree of freedom, requiring considerable labor to manually annotate its dynamics from external sensory data such as video. In this study, we propose a novel noninvasive framework for automatically extracting the skeletal dynamics from video of a soft continuum body and show the applications and effectiveness of our framework. First, we demonstrate that our framework can extract skeletal dynamics from animal videos, which can be effectively utilized for the analysis of soft continuum body including animal motion. Next, we focus on a soft continuum arm, a commonly used platform in soft robotics, and evaluate the potential information-processing capability. Normally, to control such a high-dimensional system, it is necessary to introduce many sensors to completely capture the motion dynamics, causing the deterioration of the material's softness. We illustrate that the evaluation of the memory capacity and sensory reconstruction error enables us to verify the minimum number of sensors sufficient for fully grasping the state dynamics, which is highly useful in designing a sensor arrangement for a soft robot. Also, we release the software developed in this study as open source for biology and soft robotics communities, which contributes to automating the annotation process required for the motion analysis of soft continuum bodies.

СУЧАСНІ МЕТОДИ ПОДОЛАННЯ ЕСТРАДНОГО ХВИЛЮВАННЯ МАЙБУТНІМИ ВЧИТЕЛЯМИ МУЗИЧНОГО МИСТЕЦТВА ПІД ЧАС ПУБЛІЧНОГО ВИСТУПУ

In the article the phenomenon of pop excitement, its essential and qualitative features of detection in the music art are considered. The author notes that public performance is always accompanied by excitement. In this state the process of music creating happens, during which all musician’s creative abilities are activated, the reserve capabilities of the individual are accumulated to create vivid concepts of musical works and convey them to the audience. Also, in the article the features of professional and psychological preparation of performers for public performances are revealed. The author considers innovative approaches, methods, techniques, exercises, directions that should be used by future music art teachers to overcome the negative effects of pop excitement during performance on stage. To achieve comfortable mental state during the performance, it is proposed to use the following psychotherapeutic directions in the process of preparing students for performance: NLP – neuro-linguistic programming; body-oriented training; vocal therapy. Thus, the use of NLP allows the teacher to penetrate into the inner world of the individual to reveal his/her reserve capabilities, expand worldview, intensify creative and mental processes. In the process of preparing future music art teachers for public performance, the author pays attention to the fact that the method of «anchoring» will help to overcome negative emotional states, and methods of associations, analogies, comparisons, metaphors, symbols will help to activate various mental states, form new creative ideas. In the article body-oriented training that helps to overcome future music art teachers’ muscle cramps, their emancipation through physical, instrumental and vocal exercises is considered. The author proposes to use the method of vocal therapy, role preparation, the method of playing a concert program in front of an imaginary audience and playing music to overcome the pop excitement on stage, which will ensure performance stability and reliability during the presentation of the program to the audience. The author indicates that the technique of «sensory reconstruction» will help to implement of self-regulation of emotional states in the process of preparation for public performance and during it, and to relieve nervous and mental stress and master the optimal concert state, it is recommended to use methods of autogenic and meditative immersion.

Holistic reconstruction of mandible defect, lower lip and chin sensation, and smile reanimation in an advanced gum cancer patient: A case report

Facial deformity, facial paralysis, and sensory loss are inevitable after some head and neck tumor resection and reconstruction, especially in high stage cancer. To overcome these obstacles, we present a case of T4a gum cancer patient (41-year-old) who received holistic reconstruction of the mandible defect via an osteo-peroneal-artery-perforator combined flap for defect coverage and cross-mental nerve graft for lower lip and chin sensation at the primary stage, followed by ipsilateral facial nerve (lower trunk) innervated gracilis functioning free muscle transplantation for facial reanimation and correction of the sunken face 3 years later. After 4.5 years of follow-up, the patient was satisfied with his appearance, and obtained a spontaneous and symmetrical smile without sensory deficit. This experience showed a possible solution to the reconstruction for complicated head and neck cancer patients.

Free extended posterior tibial artery perforator flap with the neurovascular plexus of a saphenous nerve branch for large soft tissue and sensory reconstruction: Anatomic study and clinical application.

The posterior tibial artery perforator (PTAP) flap is a useful tool for reconstruction of soft tissue defects in the leg. However, the size and reliability of the flap largely depends on the quality of the perforator by which the flap is supplied, and the sensory recovery of the flap is limited. In this study, the anatomy of the saphenous nerve branches and their accompanying vessels was investigated, and a free extended PTAP flap with the neurovascular plexus of a saphenous nerve branch was designed for large soft tissue and sensory reconstruction in a series of clinical cases. Sixteen adult cadaveric legs perfused with red latex in the femoral artery were dissected. The number and location of the saphenous nerve branches and the features of their accompanying vessels were dissected and studied. From January 2016 to December 2017, six patients with soft tissue defects ranged from 8 × 2.5 cm to 21 × 4 cm were repaired by the free extended PTAP flap. The patients' average age was 48 years. The causes of the defects included machine injuries in three patients and traffic injuries in the other three. The defects located at the hand in three cases, foot in two cases, and ankle in one case. The flap was designed based on the perforators of the posterior tibial artery and included a branch of saphenous nerve. The perforator pedicle and the nerve branch were connected to the vessels and nerve in the recipient site, respectively. The saphenous nerve gave off 5.8 ± 1.1 branches, with a relatively constant one issuing 8.1 ± 0.7 cm distal to the medial femoral condyle. Every nerve branch had an accompanying vessel, which connected with the PTAPs and supplied the skin. The size of the flap ranged from 10 × 3.5 cm to 23 × 5 cm. All of the flaps survived completely without complications. Follow-up varied from 6 to 12 months. All the patients obtained cold/hot sensation and pain sensation. The results of Semmes-Weinstein monofilament test ranged from 4.31(2 g) to 5.46 (26 g), and the 2-point discrimination test varied from 20 to 35 mm. The free extended PTAP flap, containing the saphenous nerve branch and its accompanying vessels, may be an alternative for large soft tissue reconstruction with improved sensation recovery.

Sihler's staining of the cutaneous nerves of the leg and its implications for sensory reconstruction.

This study aimed to reveal the entire cutaneous nerve distribution pattern of the leg and provide a morphological basis for sensory reconstruction during skin flap transplantation. Twelve adult cadavers were fixed with formalin, and the whole leg skin with subcutaneous fat was removed close to the muscle surface. The cutaneous nerves were visualized using modified Sihler's staining to reveal the distribution and innervation density of the cutaneous nerves. The saphenous nerve innervated the anterior part, 82.2% of the upper-middle region of the lateral part of the anterolateral leg, and the upper 63.4% of the medial posterior leg. The superficial peroneal nerve innervated 90.1% of the lateral lower one-third of the anterolateral leg. The medial sural cutaneous nerve covered 26.4% of the posterior leg. The lateral sural cutaneous nerve covered 42.3% (approximately 28.6% overlap with the saphenous nerve) of the upper-middle region of the anterolateral and posterolateral leg. The number of branches differed between certain cutaneous nerves in the leg. Communications were observed between the arborizations of the four cutaneous nerves mentioned above. The highest density of primary and secondary nerve branches was observed in the upper one-third of the lateral posterior leg. The upper one-third of the posteromedial leg contained the highest density of intracutaneous nerve branches and highest number of total nerve branches. These results may be used to map sensory regions when designing leg skin flaps for reconstruction surgery to obtain improved sensory recovery.

Collaboration between breast and reconstructive surgery in optimizing outcomes for women with breast cancer.

Performing successful breast reconstruction after mastectomy requires communication and collaboration between the breast and reconstruction surgery teams. This allows for oncologic safety while providing esthetic and functional reconstruction. In this article, we discuss the numerous techniques we have adopted successfully into our breast reconstructive practice that were possible due to this collaboration including prophylactic lymphaticovenous bypass (LVB), tumor ultrasound-guided incision (TUGI), esthetic closure in patients not eligible or desiring reconstruction, nerve identification at time of mastectomy to allow for sensate reconstruction, and the prevention of chronic pain and strategic oncoplasty.

Reconstruction of Finger Pulp Defects With an Innervated Distally-Based Neurovascular Flap

Finger pulp resurfacing is a challenging reconstructive problem. This article introduces sensory reconstruction of finger pulp defects using an innervated distally-based neurovascular flap raised from the dorsum of the thumb. From May 2015 to May 2017, the innervated distally-based neurovascular flap was used in 36 patients. The mean age at surgery was 37 years (range, 18-61 years). All patients were assessed using the total active motion (TAM) scoring system of the American Society for Surgery of the Hand. The sensitivity of the flap was tested using static 2-point discrimination. Full flap survival was achieved in 35 cases. Partial necrosis at the distal margin of the flap was observed in 1 case. At the final follow-up (mean, 20 months; range, 18-23 months), the mean TAM of the thumb was 206° (range, 188°-238°), including 8 excellent and 28 good results. The mean TAM of fingers was 266° (range, 251°-282°), including 4 excellent and 32 good results. The mean value of static 2-point discrimination was 5 mm (range, 4-7 mm) in the flap, including 31 excellent and 5 good results. The innervated distally-based neurovascular flap raised from the dorsum of the thumb is a reliable alternative for sensory reconstruction of finger pulp defects. Therapeutic IV.

A Comparative Study of Finger Pulp Reconstruction Using Free Distal Ulnar Artery Perforator Flaps and Reverse Dorsal Homodigital Island Flaps

This study aimed to compare and analyze the outcomes of finger reconstruction using free distal ulnar artery perforator (FDUAP) and reverse dorsal homodigital island (RDHI) flaps. The study included 27 patients with finger pulp defects that were reconstructed using FDUAP or RDHI flaps. Standardized assessment of outcomes included objective sensory recovery, duration of operation, range of motion in the repaired fingers, pain at the reconstructed finger pulps and donor sites, and recovery time before returning to work. Subjective assessment of outcomes included the cold intolerance, aesthetic appearance, and functional recovery. All flaps in the series showed complete survival. The average surgical time for the RDHI flaps was significantly smaller than that for the FDUAP flaps. Sensory recovery was significantly better with FDUAP flaps than with RAHI flaps. No significant differences were detected between the 2 procedures regarding range of motion, cold intolerance, or pain of the injured finger pulps and donor sites. The outcomes of aesthetic result and functional recovery satisfied all patients. Optimal cosmetic satisfaction was obtained in the FDUAP flap group. Although both types of flaps offer a satisfactory approach for finger reconstruction with small-to-medium defects, FDUAP flaps are more suitable for such operations because of the better sensory reconstruction and aesthetic results.

The free neurovascular transverse wrist crease flap for repairing soft tissue defects of the fingers: clinical outcomes of multiple centers

BackgroundFlap transplantation is often needed for soft tissue defects of the fingers that cannot be closed directly. Sensory reconstruction of the fingers is important for patients to recover feelings. In this study, we report clinical outcomes of using free neurovascular transverse wrist crease flap for repairing finger defects from multiple centers.MethodsThis case series includes 72 consecutive patients with finger defects between June 2013 and June 2016 from multiple centers. A neurovascular transverse free radial artery superficial palmar branch flap, named transverse wrist crease flap, was designed to reconstruct soft tissue defects of the fingers with microvascular anastomosis. When there were soft tissue defects of the fingers with digital nerve defect, end-to-end neurorrhaphy between the median palmar cutaneous branch and the digital nerves was also performed. The donor incision was sutured directly. All the patients were followed-up for more than 24 months.ResultsThe soft tissue defects of the fingers were all completely covered with this free neurovascular transverse wrist crease flap, and the flaps in 71 patients survived completely without ischemia. Vascular crisis appeared in one case, and the wound healed gradually after changing wound dressing for nearly 1 month. Slight infections of wounds appeared in eight cases. There were no complications in the donor site, like infection and poor wound healing. At the last follow-up, the mean static two-point discrimination was 9.6 ± 2.4 mm on the injured finger and 4.5 ± 0.8 on the contralateral corresponding finger. The motion range of the distal interphalangeal joint and proximal interphalangeal joint on the injured finger were 72.5 ± 23.3% and 78.7 ± 32.5% of the contralateral corresponding finger, respectively. Patient self-evaluations were good in 53 cases and fair in 19 cases.ConclusionsThe results indicate that the free neurovascular transverse wrist crease flap is a good choice for repairing soft tissue defects of the fingers.Level of evidenceTherapeutic IV

Use of free sensate SCIA flap for reconstruction of distal limb defects of moderate size

Recent attempts have been made to direct the sensory neurotisation of free superficial circumflex iliac artery (SCIA) flaps. However, donor nerves enabling sensory recovery are limited. We report our findings in fifteen patients who underwent distal limb defect reconstruction using a sensate SCIA flap, including the lateral cutaneous branch of the subcostal nerve (LCSN), between August 2017 and September 2018. The distance from the anterosuperior iliac spine to the point where the LCSN crossed the iliac crest ranged between 6.5 and 10cm. The diameter ranged between 1.5 and 4.0mm. The flap size ranged between 8×4 and 13×10cm2. All of the flaps survived uneventfully. Tests of sensory modalities, including the Semmes-Weinstein (SW) touch, vibration, pinprick, temperature and static two-point discrimination (s2PD) tests were applied in nine regions of each flap post-operatively. One or more modalities were present in at least one region at 6 months post-operatively, and the recovery of vibration perception was more consistent than that of SW touch and pinprick perception. The recovery of s2PD was noted in 4 cases over a follow-up period of more than 12 months. A reliable sensate flap with the LCSN can be considered as an attractive option for the sensory reconstruction of distal limb defects of moderate size.

A Novel Method of Treatment of Macrodactyly with Digital Nerve Resection and Nerve Allograft.

Macrodactyly is a rare and debilitating pediatric hand anomaly that has historically been treated with amputation. Recent advances in our understanding of macrodactyly have increasingly implicated the digital nerve as the underlying cause of the condition. In addition, much progress has been made toward digital salvage in treating macrodactyly. Modern techniques often advocate for digital nerve resection to prevent recurrence and treat the underlying etiology. However, little if any emphasis has been given to sensory reconstruction for purposes of protective sensation and acceptable 2-point discrimination at the volar digital pulp. We report 2 cases of macrodactyly treated with digital nerve resection and nerve allograft reconstruction of large sensory nerve gaps which show early promising sensory outcomes. There remain little if any data on the use of nerve allograft in pediatric populations, and its application in the treatment of macrodactyly. This technique permits digit salvage with the potential for improved sensory outcomes without the donor morbidity of autologous nerve harvest.

Anatomical analysis of antebrachial cutaneous nerve distribution pattern and its clinical implications for sensory reconstruction.

This study aimed to reveal the distribution pattern of antebrachial cutaneous nerves and provide a morphological basis for sensory reconstruction during flap transplantation. Forearm specimens containing skin and subcutaneous fat were obtained from 24 upper extremities of 12 adult cadavers. Cutaneous nerves were visualized using modified Sihler's staining. Then the data was used to show the distribution pattern and innervation area of the forearm cutaneous nerve. The anterior branch of lateral antebrachial cutaneous nerve innervates 26% of the medial anterior forearm; the posterior branch innervates 38.21% of the lateral anterior forearm and 24.46% of the lateral posterior forearm. The anterior branch of medial antebrachial cutaneous nerve innervates the medial aspect of the forearm covering 27.67% of the anterior region; the posterior branch the lateral part of the forearm covering 7.67% and 34.75% of the anterior and posterior regions, respectively. The posterior antebrachial cutaneous nerve covers 41.04% of the posterior forearm. Coaptations were found between the branches of these cutaneous nerves. The relatively dense secondary nerve branches were found in the middle 1/3 of the lateral anterior forearm and the middle 1/3 of the medial posterior forearm. The relatively dense tertiary nerve branches were the middle 1/3 and lower 1/3 of the medial anterior forearm. The intradermal nerve branches were the relatively dense in the middle 1/3 of the medial anterior and lateral posterior forearm. The middle 1/3 of the medial and lateral forearm had the relatively dense total nerve branches. These results can be used sensory matching while designing forearm flaps for reconstruction surgeries to obtain improved recovery of sensory.

Sensory Nerve Transfer for Lower Roots Brachial Plexus Injury: Superficial Radial Nerve to the Dorsal Cutaneous Branch and the Superficial Branch of the Ulnar Nerve

In the treatment of brachial plexus injury to lower nerve roots, the priority is to restore motor function to the paralyzed hand. In addition, it is also important to consider sensory reconstruction, which is crucial to the optimal restoration of prehensile function. We report the surgical technique and sensory recovery of a nerve transfer in a case in which the superficial radial nerve was transferred to the dorsal cutaneous branch and the superficial branch of the ulnar nerve in a patient with C7, C8, and T1 roots injury. The nerve transfer successfully restored sensation in the ulnar one and a half digits as well as the ulnar border of the hand, with minimal donor site deficit. This technique provides a useful sensory reconstructive option in patients with brachial plexus injury to lower roots.

Clinical application of posterior tibial artery perforator flap within saphenous nerve branch for sensory reconstruction

Objective To explore the operative technique and clinical results of posterior tibial artery perforator flap within saphenous nerve branch for sensory reconstruction. Methods From January, 2016 to June, 2018, 9 patients suffered from soft tissue defect were treated by the posterior tibial artery perforator flap containing saphenous nerve branch. Seven patients were males and 2 were females, with age ranged from 31 to 62 years. Soft tissue defects located in hands in 5 patients, plantar in 2 patients, ankle in 1 patient and dorsal foot in 1 patient. The size of soft tissue defects ranged from 8.0 cm×2.5 cm to 21.0 cm×4.0 cm. The regular post-operative followed-up was performed. Results All flaps survived without complications. The size of flap ranged from 10.0 cm×3.5 cm-23.0 cm×5.0 cm. Donor sites were primarily closed in 5 patients and secondary closed in 4 patients. Followed-up ranged from 6 to 15 months with 10 months in average. The contour of flaps were satisfied and the sensory function of the donor sites were normal. At 6 months followed-up, SW test reached 5.07 in all flaps, and 2PD ranged from 14 to 35 mm. Conclusion The novel sensory flap can provide satisfied sensory outcome without sacrificing main artery and saphenous nerve, and is a good candidate for sensory reconstruction of soft tissue defects. Key words: Posterior tibial artery; Perforator flap; Saphenous nerve; Sensory reconstruction; Soft tissue defect

Clinical application of the dual V-Y advancement flap based on proper digital artery perforator with sensory reconstruction for repair of soft tissue defects of fingers

Objective To explore the feasibility of the dual V-Y advancement flap based on proper digital artery perforator with sensory reconstruction for repair of soft tissue defects in the middle part of the fingers. Methods From January 2012 to December 2016, 18 patients with soft tissue defects of the dorsal fingers in different segments except for the distal segment were treated by V-Y advancement flap based on proper digital artery dorsal perforator with dorsal branch of proper digital nerve near the proximal and distal wounds. Results The flap and donor site achieved primary healing. All the patients were follow-up from 3 to 22 months with an average of 11 months. The appearance and texture of the flap and finger were good. Three months after the operation, the results of TAM were excellent in 13 cases, good in 4 cases and fair in 1 case. The sensory recovery of flaps was evaluated as S3in 2 cases, S3+in 4 cases, S4 in 12 cases. Conclusion The application of V-Y advancement flap based on proper digital artery dorsal perforator with dorsal branch of proper digital nerve near the proximal and distal wounds to repair the soft tissue defects of the dorsal fingers has the advantages of safety and convenience with high survival rate, good postoperative sensory recovery and satisfactory appearance of the injured fingers. Key words: Finger injuries; Surgical flaps; Proper digital artery perforator; Sensory reconstruction

Successful recovery of sensation loss in upper brachial plexus injuries.

Injuries of the upper trunk of the brachial plexus may trigger motor and sensory deficits. There exists a growing body of literature with respect to the reconstruction of motor deficits in upper trunk brachial plexus injuries by using nerve transfers; albeit to date, very few old reports have focused on the reconstruction of sensory loss resulting from upper trunk injuries. In this case series, we review six cases (five males and one female) with upper trunk brachial plexus injuries undergoing sensory nerve transfers. Sensory reconstruction was carried out by using transfer of the ulnar to the median nerves, innervating adjacent aspects of the little and ring fingers (the fourth web space) and adjacent aspects of the thumb and the index finger (the first web space), respectively. The mean age of our six patients was 30.5 ± 9years old (range 20-45). The mean time interval between the injury and subsequent surgery was 6.6 ± 1.8months (range 5-10). Five patients achieved S3 or S3+ in both the thumb and the index finger while the sixth one regained S2+ in the index finger while also achieving S3 in the thumb according to the Highet-Zachary system scoring scale. These results suggest that nerve transfers can achieve satisfactory outcomes in patients having sensory reconstruction after upper brachial plexus injuries, and thus, we lay emphasis on reviving the use of sensory nerve transfer techniques in such patients.

Sifting through the Evidence: A Comprehensive Review and Analysis of Neurotization in Breast Reconstruction.

An untoward outcome following breast reconstruction is diminished or complete loss of sensation. As the reconstructive paradigm continues to evolve, sensory restoration following reconstruction remains a research focus. Despite the multitude of published outcomes, there is marked heterogeneity across studies, thus confounding published outcomes. This study critically appraises the literature to summarize outcomes and establish a framework to guide clinical practice and future research. A literature review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in an effort to perform a meta-analysis. The Ovid MEDLINE, PubMed, Embase, Scopus, Cochrane, and ClinicalTrials.gov online databases were queried to capture all publications between 1990 and 2017 that investigated postreconstruction breast sensation. The primary outcome of interest was breast sensation following both implant-based and autologous reconstruction with or without neurotization. Secondary outcomes of interest included time to sensory testing and patient-reported outcomes. Overall, 503 titles were screened, from which 37 articles were ultimately included for analysis, accounting for 1299 patients. There was major methodologic variability and inconsistent measurable outcomes across studies. It can be deduced that postoperative sensation returns spontaneously and unpredictably, neurotization enhances the magnitude and rapidity of sensory restoration when compared to nonneurotized reconstruction, and a sensate reconstruction improves patient-reported outcomes. Significant study design discrepancies exist, making it difficult to combine data and assess results. To effectively study breast sensation and the impact of neurotization, future investigation will depend on standardizing the way in which breast sensation is measured.