Outcomes after definitive surgery for mandibular osteoradionecrosis.

Area of Science:

• Oral and Maxillofacial Surgery
• Head and Neck Oncology
• Reconstructive Surgery

Background:

• Osteoradionecrosis (ORN) of the mandible is a serious complication following radiation therapy.
• Surgical intervention is often necessary for advanced ORN.
• Understanding surgical outcomes is crucial for patient management.

Purpose of the Study:

• To analyze surgical charges, complication rates, survival, and functional outcomes.
• To identify factors associated with higher costs and poorer results in mandibular ORN surgery.

Main Methods:

• Retrospective analysis of 76 patients undergoing segmental mandibulectomy with reconstruction.
• Data collected from 2000 to 2009.
• Statistical analysis including odds ratios and hazard ratios.

Main Results:

• Complications occurred in 65% of patients, linked to preoperative drainage.
• Median charges were $343,000, increased by double flap reconstruction and smoking.
• Improved swallowing associated with younger age and preoperative swallowing function.
• Five-year ORN-recurrence-free survival was 93%; overall survival was 63%, impacted by pulmonary disease.

Conclusions:

• Surgical treatment for mandibular ORN is associated with frequent complications and high costs.
• Preoperative factors are predictive of poorer outcomes and increased healthcare charges.
• While ORN recurrence is infrequent, careful preoperative assessment is vital for optimizing surgical results.