Can we predict which patients are likely to develop severe complications following reconstruction for osteoradionecrosis?

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• 作者：Andrew J. Lyons ; Iain Nixon ; Dionyssia Papadopoulou ; Siobhan Crichton
• 关键词：Osteoradionecrosis ; Reconstruction ; Complications
• 刊名：British Journal of Oral and Maxillofacial Surgery
• 出版年：December, 2013
• 年：2013
• 卷：51
• 期：8
• 页码：707-713
• 全文大小：787 K

文摘

High morbidity has been reported for free vascularised reconstruction for osteoradionecrosis (ORN) and there are no apparent risk factors. A single nucleotide polymorphism in the transforming growth factor beta 1 gene (TGF-尾1) has been implicated in the cause of ORN and may also predict these complications. We studied a series of 30 consecutive patients who had had reconstruction for severe ORN with free tissue transfer in relation to their outcomes and complications for a number of risk factors including TFG-尾1 genotype, age, sex, comorbidities, site and stage of tumour, type of initial operation, and dose of radiotherapy or chemoradiotherapy. Two patients died and 2 flaps failed. Using the Clavien-Dindo classification, 16 patients developed grade III complications and 6 grade II. Median (IQR) duration of inpatient stay was 19.5 (12-25) days and the median (IQR) duration of outpatient treatment was 6 (4-11) weeks. No specific risk factors for postoperative complications were identified. In view of the severity and unpredictability of the complications, careful preoperative counselling of patients is essential.