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The treatment of head and neck cancer is an intensive multimodal treatment that has a great impact on the individual patient. This study aimed to evaluate acute and long-term complications associated with mandibular resections and reconstructions. We retrospectively retrieved data on complications and recurrences among patients that underwent mandibular resections and reconstructions for treating oral cavity cancer ( n  = 190 patients) and osteoradionecrosis (ORN,  n  = 72). Reconstructions included composite grafts ( n  = 177), soft tissue flaps ( n  = 61), or primary closure without any graft ( n  = 24). Forty-two patients that underwent reconstructions with composite grafts displayed serious complications (Clavien–Dindo ≥ IIIa). The complication rates were similar between patients treated for oral cavity cancer and patients treated for ORN. Patients that underwent a primary closure without any graft, had a significantly lower risk of complications compared to patients that underwent the other treatments. After hospitalization, 181 patients (69%) had at least one complication. A majority of patients undergoing resection and reconstruction due to oral cancer/ORN suffered from postoperative complications regardless of indication, comorbidity status or reconstruction technique. The risk of Clavien–Dindo grade IIIa–V events was significantly lower for patients treated with primary closure without grafts The results from this study clarifies the importance of in-depth analyse prior to decision of treatment for patients with head and neck cancer.

Mandibular resection in patients with head and neck cancer: acute and long-term complications after reconstruction