Cost analysis of osteoradionecrosis

Park, L; Lilic, Nikola; Addison, Ben; Patel, Rajan S.

doi:10.1017/s0022215116009956

Cited by 20 publications

(20 citation statements)

References 12 publications

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“…However, fully restoring facial contour and jaw function is extremely complex and not always possible even with modern surgical techniques. Therefore, together with the risk of surgical complications and high costs for society, it is important to investigate the impact of this complex reconstruction procedure on the HRQoL for ORN patients fulfilling the indications for this type of surgery.…”

Section: Discussionmentioning

confidence: 99%

Quality of life after microvascular mandibular reconstruction for osteoradionecrosis—A prospective study

et al. 2019

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Background: Reconstructive surgery for mandibular osteoradionecrosis is increasing; however, evidence regarding the impact on health-related quality of life is lacking. The current exploratory study prospectively investigates whether resection with reconstruction is associated with changes in HRQoL parameters for these patients. Methods: Seventeen patients underwent microvascular reconstruction for mandibular osteoradionecrosis between 2012 and 2015, and 16 completed the EORTC quality of life questionnaires QLQ-C30 and QLQ-H&N35 1 month before and 1 year after surgery. Results: Increases in emotional (P = 0.01) and social functioning (P = 0.004) were observed, together with improvements in the fatigue (P = 0.04), appetite loss (P = 0.02) and pain (P = 0.02) scores, as evaluated by the QLQ-C30. Pain reduction was further confirmed by the QLQ-H&N35 (P = 0.04), which also showed improved scores for feeling ill (P = 0.001) and sexual difficulties (P = 0.04). Conclusion: This exploratory study suggests that microvascular reconstruction after mandibular osteoradionecrosis may improve HRQoL, with an emphasis on pain reduction; however, further studies are needed.

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Section: Discussionmentioning

confidence: 99%

Quality of life after microvascular mandibular reconstruction for osteoradionecrosis—A prospective study

et al. 2019

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“…While we did not specifically examine the financial cost attributed to managing this patient cohort, the median cost of managing patients with late stage ORN who require resection and free-flap reconstruction among an Auckland, New Zealand cohort was estimated at $105 000 NZD per patient, without factoring in the cost of HBOT. 34 This is $19 000 NZD per patient greater than the cost of managing patients who require free-flap reconstruction surgery for reasons other than ORN. The increased cost of managing ORN patients is likely due to increased rates of post-operative complications as a result of poorer tissue quality and healing due to radiation damage.…”

Section: Discussionmentioning

confidence: 99%

Osteoradionecrosis: Experience from the Oral and Maxillofacial Surgery Unit at Christchurch Hospital, New Zealand

Khor

Graham

Coghlan

et al. 2022

FACE

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Background and objectives: Osteoradionecrosis of the jaws (ORN) is a debilitating complication of radiotherapy among head and neck cancer patients. Dentists are critical to the management of patients at risk and may be the first clinicians to encounter new onset ORN. Oral and Maxillofacial Surgical teams are commonly involved in the surgical management of such patients. To the best of our knowledge there have been no studies examining the referral pathways of patients with ORN to Oral and Maxillofacial Surgical Services in New Zealand. Methods: A retrospective study was conducted and included all patients with ORN referred to the Oral and Maxillofacial Surgical Service at Christchurch Hospital, New Zealand in the 3-year period 1st January 2018 to 31st December 2020. Clinical records were accessed to collect data endpoints. To illustrate the potential severity of ORN we also present a case report of a patient with mandibular ORN and pathologic fracture that was managed. Results: Thirteen patients with ORN were referred to the Oral and Maxillofacial Surgical Service at Christchurch Hospital over the study period. The majority of patients were referred by internal Christchurch Hospital colleagues (Otorhinolaryngology and Hospital Dentists). A wide range of presenting signs/symptoms were found. All patients presented with exposed necrotic bone however no other symptoms were found to be of high sensitivity for ORN. Patients required a range of treatment modalities, from conservative management to resection and fibula free-flap reconstruction. Conclusions: Most patients at risk of ORN are being maintained on long-term Hospital based recall lists for clinical review. Given the wide range of presenting signs/symptoms of ORN, oral health practitioners must exercise a high degree of clinical suspicion when encountering these in irradiated patients.

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“…Complication rates following free flap reconstruction of head and neck ORN are cited between 30%-60% [16,26,44,46,49,50] . While most institutions cite free flap survival rates following head and neck reconstruction as 95% or greater, free flap survival rates following ORN reconstruction are cited at 89-93% [26,46,50,51] . Additionally, it was found that patients undergoing free flap reconstruction for ORN had a higher incidence of late complications compared to patients undergoing free flap reconstruction for malignancy [3] .…”

Section: Surgical Complicationsmentioning

confidence: 99%

A review of advanced head and neck osteoradionecrosis

Mayland¹,

Sweeny²

2021

PAR

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Cost analysis of osteoradionecrosis

Abstract: The significant financial burden on the health system, and the growing evidence for the effectiveness of pentoxifylline, tocopherol and clodronate, should prompt us to explore this alternative treatment further.

Cited by 20 publications

References 12 publications

Quality of life after microvascular mandibular reconstruction for osteoradionecrosis—A prospective study

Quality of life after microvascular mandibular reconstruction for osteoradionecrosis—A prospective study

Osteoradionecrosis: Experience from the Oral and Maxillofacial Surgery Unit at Christchurch Hospital, New Zealand

A review of advanced head and neck osteoradionecrosis

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