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Quality of life for patients requiring surgical resection and reconstruction for mandibular osteoradionecrosis: 10-year experience at the university of California San Francisco

✍ Scribed by Edward I. Chang; Pablo Leon; William Y. Hoffman; Brian L. Schmidt


Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
177 KB
Volume
34
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background

Mandibular osteoradionecrosis is the most devastating complication after radiation therapy for head and neck malignancies. Quality of life (QOL) after surgical treatment is unclear.

Methods

A retrospective cohort analysis (1997–2007) was conducted of all patients treated at our institution for stage II and III mandibular osteoradionecrosis. Nineteen of 35 patients responded to a modified University of Washington QOL questionnaire. Twenty had undergone reconstruction using free flaps, and the remainder with plates, plates and local flaps, or debridement alone.

Results

Complications included 3 infections, 5 with hardware, 5 flap‐specific, and 1 nonunion. Four patients had recurrent squamous cell carcinoma (SCC). The factors of greatest concern to patients were appearance, swallowing, and chewing. Average overall QOL was good to very good, and very good compared to preoperative.

Conclusion

Despite a 37% complication rate, a multidisciplinary team approach with adequate debridement, resection, and reconstruction can greatly improve QOL. © 2011 Wiley Periodicals, Inc. Head Neck, 2012