Free Omental Transfer for Osteoradionecrosis of the Mandible: Objective Sequential Evaluation by Scintigraphy

Abstract

Objective: To evaluate the effectiveness of free omental transfer for osteoradionecrosis in patients with head and neck cancer.Patients and Methods: Five patients with osteoradionecrosis of the mandible undergoing free omental transfer were sequentially evaluated postoperatively by orthopantomography and bone scintigraphy. The bone remodelling of the osteoradionecrotic region was evaluated quantitatively 6 months and 1, 2, 3, and 5 years after free omental transfer by calculating the ratio of isotope uptake between the osteoradionecrotic region and the contralateral region.Results: All patients recovered completely with no signs of osteoradionecrosis, fistulas, or intolerable pain, although 2 patients developed pathological fractures after operation, which were successfully treated by conservative means. Isotope uptake in the osteoradionecrotic region diminished significantly postoperatively and bone remodelling was observed.Conclusions: Free omental transfer is promising for the management of osteoradionecrosis. The need for segmental resection of the mandible may be avoided.