Osteoradionecrosis in osseous free flap reconstruction: Risk factors and treatment.

Head & Neck
Peter T DziegielewskiRaja Sawhney

Abstract

To determine the rate and risk factors for osteoradionecrosis (ORN) in osseous free flaps after postoperative radiation therapy (PORT). To describe the treatment of free flap ORN. Seventy-four patients undergoing osseous free flap reconstruction were analyzed. Thirty-eight completed PORT. Patients were followed for ≥6 months. The rate of ORN was 34% overall; 0% with 50 to 59.9 Gy; 8% with 60 Gy; 40% with 66 Gy; 56% with 70 to 74.4 Gy. Mean time to ORN was 13.1 months. 0/28 patients without PORT developed free flap osteonecrosis. Multivariate analysis found the only factor predicting ORN: PORT >60 Gy, which increased the risk 21-fold. Treatment included PENTACLO, hyperbaric oxygen, and surgical debridement with 75% within 2 years. PORT >60 Gy is significantly associated with free flap ORN. As the dose of adjuvant RT increases beyond 60 Gy, the risk of ORN in free flaps rises. Consideration should be given to lower PORT doses or delaying free flap reconstruction when feasible.

References

May 1, 1983·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·R E Marx
May 8, 2002·Plastic and Reconstructive Surgery·Naci CelikYi-chieh Chen
Nov 3, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·William M Mendenhall
Feb 8, 2005·International Journal of Oral and Maxillofacial Surgery·G StøreI Olsen
Oct 24, 2007·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Batya R GoldwaserMeredith August
Nov 9, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·T CollinM Ragbir
Mar 31, 2009·International Journal of Radiation Oncology, Biology, Physics·Ik Jae LeeIn Ho Cha
May 17, 2011·International Journal of Radiation Oncology, Biology, Physics·Daniel R GomezNancy Y Lee
Jun 7, 2012·Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology·Syed Nabil, Nabil Samman
Jul 17, 2012·International Journal of Radiation Oncology, Biology, Physics·Chiaojung Jillian TsaiLei Dong
Jun 25, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Hanna R MortensenCai Grau
Nov 10, 2013·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Kristine E DayEben L Rosenthal
Jul 6, 2014·European Annals of Otorhinolaryngology, Head and Neck Diseases·L RobardS Delanian
Oct 11, 2014·Future Microbiology·Stephen J McConougheyPaul Stoodley
Mar 11, 2015·Head & Neck·Peter T DziegielewskiTheodoros N Teknos
Oct 3, 2015·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Migie LeeSuchitra Paramaesvaran
Jan 28, 2017·CA: a Cancer Journal for Clinicians·William M LydiattJatin P Shah
Jul 25, 2017·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·UNKNOWN MD Anderson Head and Neck Cancer Symptom Working Group
Jan 24, 2018·American Journal of Clinical Oncology·William M MendenhallAlfio Ferlito
Aug 14, 2018·Oral Oncology·C Burton WoodRobert J Sinard
Feb 10, 2019·Head & Neck·Vladimir AvkshtolThomas J Galloway

❮ Previous
Next ❯

Citations

Sep 6, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·J Le GuevelouUNKNOWN GORTEC
Feb 23, 2021·Craniomaxillofacial Trauma & Reconstruction·William M MendenhallRui P Fernandes

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
Chi MaoChuan-bin Guo
Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
Jeffrey D SuhVishad Nabili
Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale
Artur GevorgyanKevin M Higgins
© 2021 Meta ULC. All rights reserved