Changing indications for maxillomandibular reconstruction with osseous free flaps: A 17‐year experience with 620 consecutive cases at UCLA and the impact of osteoradionecrosis

Abstract

2b.

Quality of life after microvascular mandibular reconstruction for osteoradionecrosis—A prospective study

“…The use of microvascular reconstruction as a treatment for severe cases of ORN is well‐established and has increased as an indication for free tissue transfer in head and neck surgery . However, there is a lack of evidence regarding the impact on HRQoL parameters after these procedures, which often are demanding for patients as well as health care providers.…”

“…In mild cases of ORN, treatments include surgical debridement, possible tooth extractions, sequestrotomies, and antibiotics when indicated. Severe cases require extensive resection of both bone and soft tissue, creating continuity defects calling for complex composite microvascular reconstruction, which is frequently associated with postoperative complications . These procedures are demanding for the patients as well as the health care system.…”

The oral management of oncology patients requiring radiotherapy, chemotherapy and/or bone marrow transplantation

“…This is then followed by radical ablative surgery to remove all the necrotic bone and soft tissue, including hemi-mandibulectomy and reconstruction with either a pedical or microvascular free flap. These procedures aim to achieve closure of orocutaneous fistulae and restore function and aesthetics (NICE-NG36, 2016) (Rice et al, 2015) (Zaghi and Hendizadeh, 2014) (Gevorgyan et al, 2013) (Baumann et al, 2011).…”

Worldwide 10-Year Systematic Review of Treatment Trends in Fibula Free Flap for Mandibular Reconstruction

“…However, the studies in the last five-year period included more patients (165 vs. 28). This increase in the number of patients could be attributed to the more acceptance among clinicians to treat BRONJ and ORN using osseous free flaps [14][15][16]. The use of radiotherapy as a primary treatment modality for human papillomavirus-associated oropharyngeal cancer that has a dramatically rising incidence in the past years [17], may eventually lead to an increase in ORN rates in the coming years leading to more publications.…”