Original Article

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

  1. Edward I. Chang MD1,
  2. Pablo Leon MD1,
  3. William Y. Hoffman MD1,
  4. Brian L. Schmidt DDS, MD, PhD2,3,*

Article first published online: 16 MAY 2011

DOI: 10.1002/hed.21715

Issue

Head & Neck

Head & Neck

Volume 34, Issue 2, pages 207–212, February 2012

Additional Information

How to Cite

Chang, E. I., Leon, P., Hoffman, W. Y. and Schmidt, B. L. (2012), Quality of life for patients requiring surgical resection and reconstruction for mandibular osteoradionecrosis: 10-year experience at the university of California San Francisco. Head Neck, 34: 207–212. doi: 10.1002/hed.21715

Author Information

  1. 1

    Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California

  2. 2

    Department of Oral Maxillofacial Surgery, New York University, New York, New York

  3. 3

    Bluestone Center for Clinic Research, New York University College of Dentistry, New York

*Department of Oral Maxillofacial Surgery, New York University, New York, New York

  1. †

    This work was presented at the California Society of Plastic Surgeons Annual Meeting 2010, Rancho Palos Verdes, California.

Publication History

  1. Issue published online: 7 JAN 2012
  2. Article first published online: 16 MAY 2011
  3. Manuscript Accepted: 11 NOV 2010

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Keywords:

  • mandibular osteoradionecrosis;
  • quality of life;
  • reconstruction;
  • oral surgery

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

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