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Prospective Long-term Sensory Outcomes In Patients Undergoing Gender-affirming Mastectomy With Targeted Nipple Reinnervation (TNR)
Kristyn Abood Vicente, BA1, Makayla Kochheiser, BA
1, Katya Remy, MD
2, Chase C. Alston, MHS
1, Katherine H. Carruthers, MD
2, Eleanor G. Tomczyk, MD
2, Jonathan M. Winograd, MD
2, William G. Austen, MD
2, Ian L. Valerio, MD
2, Lisa Gfrerer, MD-PhD
1.
1Weill Cornell Medicine, New York City, NY, USA,
2Massachusetts General Hospital, Boston, MA, USA.
PurposeWe have previously reported on sensory outcomes following gender-affirming mastectomy (GAM) with targeted nipple reinnervation (TNR) using nerve allograft. However, we have transitioned to TNR using direct nerve coaptation (DC) and present the long-term sensory outcomes.
Methods:32 subjects (GAM +TNR with DC) were compared to 32 controls (GAM -TNR). Surveys were administered, and Quantitative Sensory Testing (QST) was performed (light touch, pinprick, vibration, temperature, pressure, and 2-point discrimination (2PD) thresholds) at 3, 6, 9, and 12 months postoperatively.
Results:At 12 months postoperatively, 82% of subjects versus 4% of controls reported "complete," or "a lot," of NAC sensation (Figure 1). Subject’s light touch at the chest and NAC was greater than that of controls at all timepoints (p<0.05, see Figure 2). At 12 months, subject’s NAC light touch was significantly greater than baseline (p<0.005), while controls demonstrated significantly less light touch and pinprick sensation than preoperatively (p<0.001, p<0.005). See Figure 3 for 12-month QST results.
Conclusion Subjects who undergo FNG with TNR using DC demonstrate significantly improved NAC sensation compared to controls and recover baseline preoperative sensation.
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