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Updated: Oct 1, 2025
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Outcomes after definitive surgery for mandibular osteoradionecrosis
Kevin J Contrera1,2, Steven B Chinn3, Randal S Weber1
1Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
Objectives:
To analyze charges, complications, survival, and functional outcomes for definitive surgery of mandibular osteoradionecrosis (ORN).
Materials And Methods:
Retrospective analysis of 76 patients who underwent segmental mandibulectomy with reconstruction from 2000 to 2009.
Results:
Complications occurred in 49 (65%) patients and were associated with preoperative drainage (odds ratio [OR] 4.40, 95% confidence interval [CI] 1.01-19.27). The adjusted median charge was $343 000, and higher charges were associated with double flap reconstruction (OR 8.15, 95% CI 2.19-30.29) and smoking (OR 5.91, 95% CI 1.69-20.72). Improved swallow was associated with age <67 years (OR 3.76, 95% CI 1.16-12.17) and preoperative swallow (OR 3.42, 95% CI 1.23-9.51). Five-year ORN-recurrence-free survival was 93% while overall survival was 63% and associated with pulmonary disease (HR [hazard ratio] 3.57, 95% CI 1.43-8.94).
Conclusions:
Although recurrence of ORN is rare, surgical complications are common and charges are high. Poorer outcomes and higher charges are associated with preoperative factors.
