Influence of Prior Hyperbaric Oxygen Therapy in Complications Following Microvascular Reconstruction for Advanced Osteoradionecrosis

Abstract

Microvascular reconstruction is effective in the treatment of patients with mandibular ORN. Management of mandibular ORN can be successfully achieved without the use of perioperative HBO therapy. Because only 3 patients received perioperative HBO therapy, we are unable to comment on its potential benefit. Patients in whom prior HBO therapy has failed are significantly more likely to have surgical complications than are other patients with Marx stage III disease, and further study is required to improve outcomes in this subgroup of patients.

Efficacy of small reconstruction plates in vascularized bone graft mandibular reconstruction

“…[20][21][22] Our group and others, however, have demonstrated that hyperbaric oxygen therapy did not improve wound healing in these patients and that it dramatically increased treatment costs. 23,24 What is evident from our data is that these patients are at higher risk of complications and that they should be followed closely during the postoperative period.…”

Efficacy and safety of treating T4 oral cavity tumors with primary chemoradiotherapy

“…Moreover, as the institutions involved in the current study gained more experience, it was recognized that the surgical resection and restoration of form and function in a complicated osteoradionecrosis setting was analogous to primary site composite resection and free flap reconstruction. 24,27 For many patients, the benefit of starting curativeintent therapy, without potential postoperative delays, may outweigh the potential risk of osteoradionecrosis.…”

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

“…However, it seems clear that ORN surgery comes with a significant risk of complications (21% to 43%) and flap loss (0% to 14%) and thus should not be offered without restraint or until deemed absolutely necessary. 10,12 In fact, a growing body of literature now exists suggesting that flap loss rates are slightly higher in patients undergoing ORN reconstruction, with excellent resolution of disease when successful, when compared with other free tissue transfers (Table 1). 10,[12][13][14][15][16][17][18][19][20][21][22] This study was designed to identify factors contributing to postoperative morbidity to help counsel patients preoperatively regarding their individual risks of flap loss and surgical complications.…”