Laser-evoked potentials as a novel tool for sensibility assessment following inferior pedicle breast reduction

Background: Nipple-areola complex numbness is common following breast reduction with most techniques. The aim of our study was to objectively quantify specific sensory outcomes before and after inferior pedicle breast reduction with two combined neurophysiological methods: dermatomal somatosensory evoked potentials (D-SEPs) and laser-evocated potentials (LEPs). Methods: Patients' subjective breast sensation was assessed preoperatively and postoperatively by accurate clinical examinations. Thirty patients underwent quantitative measurements preoperatively and at 3 and 6 months following inferior pedicle breast reduction to assess tactile and vibratory sensitivity (D-SEP recordings) and painful and thermic sensitivity (LEP recordings). Results: The collected data did not reveal significant differences in D-SEP latencies or amplitudes between preoperative and postoperative evaluations following inferior pedicle breast reduction. However, LEP data showed significant alterations in latency and amplitude in accordance with clinical examinations. Conclusions: This study provides the basis for a new approach to selectively investigate painful and thermic sensitivity, which is necessary to find the best technique to preserve breast sensitivity. This study also provides the first objective neurophysiologic evidence of breast sensitivity modifications and introduces a new technique that provides a simple, inexpensive, and dependable investigative tool for breast sensitivity assessment in breast surgery. Level of Evidence: Level III, diagnostic study © 2013 European Union.