Abstract | OBJECTIVE: The objective of this study was to assess the outcomes, complications, and incidence of disease recurrence of mandibular osteoradionecrosis (ORN) after resection and microvascular free flap reconstruction. STUDY DESIGN: Case series with chart review. SETTING: Academic medical center. SUBJECTS AND METHODS: RESULTS: There were no free flap failures. The incidence of wound-related complications was 55 percent. Median time to complication was 10.6 months. Ten (25%) patients developed symptoms of residual or recurrent ORN, with 70 percent of the recurrences arising in unresected condyles that were adjacent to the segmental mandibulectomy. Statistical analysis revealed that current smokers were at reduced risk to develop residual or recurrent ORN. CONCLUSION: This present study confirms that microvascular free flaps are reliable for treatment of advanced mandibular ORN. Nevertheless, there remains a 55 percent incidence of wound-healing complications. The lack of objective clinical criteria to judge the appropriate amount of mandible resection in patients with ORN remains an unresolved issue that resulted in the development of recurrent ORN in 25 percent of patients. Further investigations are needed to better understand the pathophysiology of ORN to prevent postoperative wound complications and disease recurrence.
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Authors | Jeffrey D Suh, Keith E Blackwell, Joel A Sercarz, Marc Cohen, Jerome H Liu, Christopher G Tang, Elliot Abemayor, Vishad Nabili |
Journal | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
(Otolaryngol Head Neck Surg)
Vol. 142
Issue 4
Pg. 586-91
(Apr 2010)
ISSN: 1097-6817 [Electronic] England |
PMID | 20304283
(Publication Type: Journal Article)
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Copyright | Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Female
- Head and Neck Neoplasms
(drug therapy, radiotherapy)
- Humans
- Male
- Mandible
(surgery)
- Mandibular Diseases
(surgery)
- Middle Aged
- Osteoradionecrosis
(surgery)
- Postoperative Complications
- Plastic Surgery Procedures
- Recurrence
- Retrospective Studies
- Surgical Flaps
- Treatment Outcome
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