Abstract
Purpose: This study aimed to evaluate the occurrence and treatment outcome of late complications after free fibula osteocutaneous flap reconstruction for mandibular osteoradionecrosis (ORN).Methods: We enrolled 15 consecutive patients (14 men, one woman; median age 65 years, range 57-80 years) who underwent free fibula reconstruction for advanced mandibular ORN during 2013-2017 with two or more years of follow-up. Late complications included infection, plate exposure, and recurrence at the resection margin. The effect of perioperative antibiotic administration on late complications was also assessed.Results: Late complications occurred in 33.3% (5/15) of patients, including two infections (local and distant), two plate exposures, and two recurrences (plate exposure and recurrence occurred in one patient). Perioperative antibiotic administration duration did not significantly affect the occurrence of postoperative late complications. All late complications were treated without problems.Conclusions: Late complications after ORN reconstructive surgery are not uncommon, but can be treated properly.
Highlights
Advances in radiation therapy (RT) have improved treatment outcomes in patients with head and neck malignancies
This study aimed to evaluate the occurrence and treatment outcome of late complications after free fibula reconstruction for mandibular ORN during routine postoperative observation of at least two years
There was no significant difference in the occurrence of late complications between the short and long postoperative antibiotic administration groups, there were no infections in the longadministration group
Summary
Advances in radiation therapy (RT) have improved treatment outcomes in patients with head and neck malignancies (e.g., human papilloma virus-positive oropharyngeal squamous cell carcinoma [1]). This longer patient survival has made it more likely for late effects of RT to become evident [2]. These late adverse effects present serious oral complications, the most problematic of which is osteoradionecrosis (ORN) of the jaw. This study aimed to evaluate the occurrence and treatment outcome of late complications after free fibula reconstruction for mandibular ORN during routine postoperative observation of at least two years
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