Affiliation:
1. Cleveland Clinic Lerner College of Medicine Cleveland Ohio USA
2. Cleveland Clinic Head and Neck Institute Cleveland Ohio USA
3. Case Western Reserve University School of Medicine Cleveland Ohio USA
4. Cleveland Clinic Taussig Cancer Institute Cleveland Ohio USA
Abstract
AbstractBackgroundResected oral cavity carcinoma defects are often reconstructed with osteocutaneous or soft‐tissue free flaps, but risk of osteoradionecrosis (ORN) is unknown.MethodsThis retrospective study included oral cavity carcinoma treated with free‐tissue reconstruction and postoperative IMRT between 2000 and 2019. Risk‐regression assessed risk factors for grade ≥2 ORN.ResultsOne hundred fifty‐five patients (51% male, 28% current smokers, mean age 62 ± 11 years) were included. Median follow‐up was 32.6 months (range, 1.0–190.6). Thirty‐eight (25%) patients had fibular free flap for mandibular reconstruction, whereas 117 (76%) had soft‐tissue reconstruction. Grade ≥2 ORN occurred in 14 (9.0%) patients, at a median 9.8 months (range, 2.4–61.5) after IMRT. Post‐radiation teeth extraction was significantly associated with ORN. One‐year and 10‐year ORN rates were 5.2% and 10%, respectively.ConclusionsORN risk was comparable between osteocutaneous and soft‐tissue reconstruction for resected oral cavity carcinoma. Osteocutaneous flaps can be safely performed with no excess concern for mandibular ORN.