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. 2022 Jun;44(6):1313-1323.
doi: 10.1002/hed.27024. Epub 2022 Mar 3.

Outcomes after definitive surgery for mandibular osteoradionecrosis

Kevin J Contrera  1   2 , Steven B Chinn  3 , Randal S Weber  1 , Dianna Roberts  1 , Jeffery N Myers  1 , Stephen Y Lai  1   4 , Carol M Lewis  1 , Amy C Hessel  1 , Ann M Gillenwater  1 , Collin F Mulcahy  1 , Peirong Yu  2 , Matthew M Hanasono  2 , Clifton D Fuller  4 , Mark S Chambers  1 , Mark E Zafereo  1
Affiliations

Outcomes after definitive surgery for mandibular osteoradionecrosis

Kevin J Contrera et al. Head Neck. 2022 Jun.

Abstract

Objectives: To analyze charges, complications, survival, and functional outcomes for definitive surgery of mandibular osteoradionecrosis (ORN).

Materials and methods: Retrospective analysis of 76 patients who underwent segmental mandibulectomy with reconstruction from 2000 to 2009.

Results: Complications occurred in 49 (65%) patients and were associated with preoperative drainage (odds ratio [OR] 4.40, 95% confidence interval [CI] 1.01-19.27). The adjusted median charge was $343 000, and higher charges were associated with double flap reconstruction (OR 8.15, 95% CI 2.19-30.29) and smoking (OR 5.91, 95% CI 1.69-20.72). Improved swallow was associated with age <67 years (OR 3.76, 95% CI 1.16-12.17) and preoperative swallow (OR 3.42, 95% CI 1.23-9.51). Five-year ORN-recurrence-free survival was 93% while overall survival was 63% and associated with pulmonary disease (HR [hazard ratio] 3.57, 95% CI 1.43-8.94).

Conclusions: Although recurrence of ORN is rare, surgical complications are common and charges are high. Poorer outcomes and higher charges are associated with preoperative factors.

Keywords: hospital charges; mandibular; osteoradionecrosis; outcomes; survival.

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Figures

FIGURE 1
FIGURE 1
Functional outcomes for diet (A) and speech (B) between preoperative and final postoperative
FIGURE 2
FIGURE 2
Survival outcomes, including overall survival (A), overall survival stratified by pulmonary disease (B), disease-specific survival (C), and recurrence of osteoradionecrosis (ORN) (D)
See this image and copyright information in PMC

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