Free flap reconstruction for osteoradionecrosis of the jaws--outcomes and predictive factors for success.

Abstract

BACKGROUND:

The purpose of this study was to determine factors to predict the success of free flap surgery in the treatment of osteoradionecrosis (ORN).

METHODS:

Univariate analysis of overall and flap complications was performed. The effect of time to ORN, and the time interval between ORN to reconstruction was evaluated.

RESULTS:

Fifty-five flaps on 53 patients for ORN were done with a 90% resolution rate. Univariate parameter analysis was significant for infield mandibulotomy. An increased time interval from radiation therapy (XRT) to ORN development significantly predicted for flap-specific complications and flap loss (p < .05). Increased time from ORN diagnosis to flap surgery resulted in greater length of bone involvement (p = .01). Anastomotic complications occurred in 13 cases resulting in 7 complete flap losses.

CONCLUSION:

An increased risk of complication was encountered with greater time from XRT to ORN. Thus, in patients developing ORN long after treatment, surgery should be accordingly more aggressive.

• Authors: Steven B Cannady, Nichole Dean, Andrew Kroeker, Thomas A Albert, Eben L Rosenthal, Mark K Wax
• Journal: Head & neck (Head Neck) Vol. 33 Issue 3 Pg. 424-8 (Mar 2011) ISSN: 1097-0347 [Electronic] United States
• PMID: 20645290 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Aged, 80 and over
• Analysis of Variance
• Chi-Square Distribution
• Cohort Studies
• Female
• Follow-Up Studies
• Free Tissue Flaps (blood supply)
• Graft Rejection
• Graft Survival
• Head and Neck Neoplasms (mortality, pathology, radiotherapy)
• Humans
• Jaw (radiation effects)
• Logistic Models
• Male
• Middle Aged
• Neoplasm Staging
• Orthognathic Surgical Procedures
• Osteoradionecrosis (pathology, surgery)
• Postoperative Complications (physiopathology)
• Predictive Value of Tests
• Plastic Surgery Procedures (adverse effects, methods)
• Retrospective Studies
• Risk Assessment
• Survival Analysis
• Treatment Outcome