Salvage of the exposed irradiated mandible

Maintaining the continuity of the tumor-free mandible is a priority objective in managing the patient with head and neck cancer. After review of seven patients with cutaneous or intraoral bone exposure from osteoradionecrosis of the mandible, we recommend treatment consisting of debridement of soft necrotic bone, retention of dry sclerotic bone, and coverage with well-vascularized flap tissue. Utilizing this therapeutic plan, we have preserved mandibular architecture and obtained primary healing of the wounds.