Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden; Patient Area Craniofacial Diseases, Karolinska University Hospital, Stockholm, Sweden.
Department of Otorhinolaryngology, Head and Neck Surgery, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
Int J Oral Maxillofac Surg. 2020 Jan;49(1):1-6. doi: 10.1016/j.ijom.2019.06.009. Epub 2019 Jul 8.
Better cancer treatment has led to a steadily growing population of cancer survivors suffering from late adverse effects after cancer treatment. The aim of this study was to investigate whether there has been an increase in free flap reconstruction due to osteoradionecrosis (ORN). A retrospective review was conducted to identify all consecutive head and neck free flap reconstructions performed over an 18-year period (1995-2012) at Karolinska University Hospital. A total of 235 free flaps were identified. Cases were divided into two groups: head and neck cancer reconstructions and ORN reconstructions. A comparison between the two groups showed longer survival (P<0.001) and higher rates of late complications (P<0.001) among ORN cases. ORN as an indication for reconstruction increased over time, from 7.0% of the total number of free flaps performed in 1995-2000, to 15.2% during the period 2001-2006, and to 27.3% in 2007-2012 (P<0.001). This, in accordance with the results of other studies, highlights the importance of the appropriate allocation of resources within the healthcare system to treat this patient group within the steadily increasing population of cancer survivors.
更好的癌症治疗导致越来越多的癌症幸存者在癌症治疗后遭受晚期不良反应。本研究旨在探讨由于骨放射性坏死（ORN）是否导致游离皮瓣重建增加。对 1995-2012 年间在卡罗林斯卡大学医院进行的连续 18 年的头颈部游离皮瓣重建进行回顾性研究。共确定了 235 例游离皮瓣。病例分为两组：头颈部癌症重建和 ORN 重建。两组之间的比较显示，ORN 病例的生存率更高（P<0.001），晚期并发症发生率更高（P<0.001）。ORN 作为重建的指征随着时间的推移而增加，从 1995-2000 年实施的游离皮瓣总数的 7.0%增加到 2001-2006 年的 15.2%，再到 2007-2012 年的 27.3%（P<0.001）。这与其他研究的结果一致，强调了在医疗保健系统内适当分配资源以治疗不断增加的癌症幸存者群体中这一患者群体的重要性。
