Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
Department of Plastic and Reconstructive Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
Head Neck. 2022 Jun;44(6):1313-1323. doi: 10.1002/hed.27024. Epub 2022 Mar 3.
To analyze charges, complications, survival, and functional outcomes for definitive surgery of mandibular osteoradionecrosis (ORN).
Retrospective analysis of 76 patients who underwent segmental mandibulectomy with reconstruction from 2000 to 2009.
Complications occurred in 49 (65%) patients and were associated with preoperative drainage (odds ratio [OR] 4.40, 95% confidence interval [CI] 1.01-19.27). The adjusted median charge was $343 000, and higher charges were associated with double flap reconstruction (OR 8.15, 95% CI 2.19-30.29) and smoking (OR 5.91, 95% CI 1.69-20.72). Improved swallow was associated with age <67 years (OR 3.76, 95% CI 1.16-12.17) and preoperative swallow (OR 3.42, 95% CI 1.23-9.51). Five-year ORN-recurrence-free survival was 93% while overall survival was 63% and associated with pulmonary disease (HR [hazard ratio] 3.57, 95% CI 1.43-8.94).
Although recurrence of ORN is rare, surgical complications are common and charges are high. Poorer outcomes and higher charges are associated with preoperative factors.
分析放射性颌骨骨坏死（ORN）确定性手术的费用、并发症、生存率和功能结局。
回顾性分析了 2000 年至 2009 年间接受节段性下颌骨切除术和重建的 76 例患者。
49 例（65%）患者发生并发症，与术前引流有关（优势比[OR] 4.40，95%置信区间[CI] 1.01-19.27）。调整后的中位数费用为 343000 美元，较高的费用与双瓣重建（OR 8.15，95%CI 2.19-30.29）和吸烟（OR 5.91，95%CI 1.69-20.72）有关。吞咽改善与年龄<67 岁（OR 3.76，95%CI 1.16-12.17）和术前吞咽（OR 3.42，95%CI 1.23-9.51）有关。5 年 ORN 无复发生存率为 93%，总生存率为 63%，与肺部疾病有关（HR[风险比]3.57，95%CI 1.43-8.94）。
尽管 ORN 复发罕见，但手术并发症常见，费用高昂。较差的预后和较高的费用与术前因素有关。
