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Related Experiment Video

Updated: Feb 1, 2026

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Mandibular Osteoradionecrosis: Mandibular Preservation Using Humeral Periosteal Free Flap Wrapping.

Sandrine Vlavonou1, Jean Philippe Foy1,2, Mourad Benassarou1

  • 1Service de Chirurgie Maxillo-Faciale, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.

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|January 31, 2026
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Summary

The humeral periosteal free flap offers a viable surgical option for advanced mandibular osteoradionecrosis (ORN), potentially avoiding extensive resection. This approach demonstrated a 64.7% healing rate in patients with ORN.

Keywords:
free flapfree tissue transferhead and neck cancermandibular osteoradionecrosisperiosteum flapreconstructive surgery

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • Mandibular osteoradionecrosis (ORN) presents significant management challenges, often necessitating extensive surgical resection.
  • Mandibular preservation techniques, including periosteal free flap reconstruction, offer an alternative for selected patients.

Purpose of the Study:

  • To evaluate the success rate and associated morbidity of mandibular ORN revascularization using a humeral periosteal free flap.

Main Methods:

  • A retrospective analysis of 34 patients who underwent humeral periosteal free flap reconstruction for mandibular ORN.
  • Data collected included patient demographics, ORN characteristics (site, Notani grade), and clinical/radiological outcomes.
  • The primary endpoint was ORN healing at 6 months, defined by the resolution of symptoms like exposure, infection, fistula, or fracture.

Main Results:

  • The study included 36 lesions in 34 patients with mandibular ORN involving bone exposure, infection, or pathologic fracture.
  • Overall healing at 6 months was achieved in 64.7% of treated sites.
  • A high healing rate of 91.6% was observed in patients with a viable flap.

Conclusions:

  • The humeral periosteal free flap is a feasible surgical strategy for advanced mandibular ORN.
  • This technique may help patients avoid more extensive procedures like segmental mandibulectomy.