关键词: Flap reconstruction Osteoradionecrosis of the jaw (ORNJ) Perioperative abnormal index Perioperative management Retrospective study

Mesh : Head and Neck Neoplasms / radiotherapy surgery Humans Jaw Jaw Diseases / etiology surgery Osteoradionecrosis / surgery Quality of Life Retrospective Studies

来  源:   DOI:10.1016/j.bjoms.2020.07.031   PDF(Sci-hub)

Abstract:
Osteoradionecrosis of the jaw (ORNJ) is one of the most devastating and progressive complications of head and neck radiotherapy. It can cause emaciation, deformity, and pathological fractures, resulting in decreased quality of life. The aim of this study was to evaluate the preoperative index and outcomes of treatment for ORNJ. A retrospective study of 252 ORNJ cases treated at one institution between January 2010 and January 2018 was made. The abnormal items from the preoperative examination and follow-up after different treatments were recorded, and the differences between the noteworthy items were compared using univariate and multivariate models. Most ORNJ patients in the middle and late stages had abnormal items, such as hypoproteinaemia, anaemia, and leucocytosis. Partial mandibulectomy with flap reconstruction was significantly more effective than without reconstruction. Advanced ORNJ patients tended to have more abnormal items, which might have a negative influence on treatment. For better outcomes, it is essential and effective to completely remove the necrotic lesion and reconstruct it with a flap. The surgeons should provide sufficient perioperative management and strive for suitable surgical treatment.
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