Free flap reconstruction for osteoradionecrosis of the jaws—Outcomes and predictive factors for success

Abstract

An increased risk of complication was encountered with greater time from XRT to ORN. Thus, in patients developing ORN long after treatment, surgery should be accordingly more aggressive.

Outcomes of microvascular free flap reconstruction for mandibular osteoradionecrosis: A systematic review

“…All analyses were performed with Comprehensive Meta-analysis (version 2.0). Table 1 shows selected characteristics of the identified studies (Ioannides, Fossion et al 1994, Nakatsuka, Harii et al 1996, Curi and Dib 1997, Santamaria, Wei et al 1998, Chang, Oh et al 2001, Celik, Wei et al 2002, Store, Boysen et al 2002, Militsakh, Wallace et al 2005, Bozec, Poissonnet et al 2006, Suh, Blackwell et al 2010, Baumann, Yu et al 2011, Cannady, Dean et al 2011, Chandarana, Chanowski et al 2013, Sawhney and Ducic 2013, Hillerup, Elberg et al 2014. Eight studies examined populations from North America, one from South America, four from Europe and two from Asia.…”

“…Infection (n=1) Fistula (n=1) Cannady et al (2011) 13 Skin paddle necrosis (n=1) Fistula (n=2) Vessel thrombosis (n=4) Vessel rupture (n=1) Other (n=5) Celik et al (2002) 3 Fistula (n=3) Chandarana et al (2013) 20 Infection (n=1) Skin paddle necrosis (n=1) Fistula (n=6) Non-union (n=4) Plate exposure (n=5) Haematoma (n=1) Other (n=3) Chang et al (2001) 6 Infection (n=1) Skin paddle necrosis (n=2) Vessel thrombosis (n=2) Curi et al (2007) 2 Fistula (n=1) Vessel thrombosis (n=1) Hillerup et al (2014) 0 N/A Ioannides et al (1993) 13 Infection (n=3) Fistula (n=2) Haematoma (n=2) Vessel Thrombosis (n=4) Militsakh et al (2005) 0 N/A Nakatsuka et al (1996) 3 Skin paddle necrosis (n=1) Fistula (n=1) Non-union (n=1) Santamaria et al (1998) 4 Skin paddle necrosis (n=1) Fistula (n=2) Vessel thrombosis (n=1) Sawhney et al (2013) 15 Skin paddle necrosis (n=1) M A N U S C R I P T…”

Osteoradionecrosis of the Jaws

“…In advanced cases, surgery should be more aggressive [52]. In patients where a segmental mandibulectomy is required, nowadays, an ideal way to treat ORN is to transfer an osteogenic, appropriately vascularized flap, to the affected site [53][54][55][56][57] but there is a 55% incidence of wound-healing complications [58].…”

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

“…Cannady et al 26 recently described their multiinstitutional experience with microvascular flap reconstruction of parotidectomy defects. They reported a 100% success rate and argued that surveillance of primary site and regional nodal beds can be accomplished by computed tomography scanning, magnetic resonance imaging, and/or positron emission tomography in areas not ac- Rehabilitation of complete facial paralysis after nerve transection depends on nerve grafting procedures, static suspension procedures, regional myofascial procedures, and/or free tissue transfer.…”