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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
Author(s) -
Chang Edward I.,
Leon Pablo,
Hoffman William Y.,
Schmidt Brian L.
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21715
Subject(s) - osteoradionecrosis , medicine , surgery , quality of life (healthcare) , cohort , nonunion , swallowing , complication , trismus , head and neck , retrospective cohort study , debridement (dental) , radiation therapy , general surgery , nursing
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