Free flap reconstruction for osteoradionecrosis of the jaws-Outcomes and predictive factors for success.
Summary of "Free flap reconstruction for osteoradionecrosis of the jaws-Outcomes and predictive factors for success."
BACKGROUND.: The purpose of this study was to determine factors to predict the success of free flap surgery in the treatment of osteoradionecrosis (ORN). METHODS.: Univariate analysis of overall and flap complications was performed. The effect of time to ORN, and the time interval between ORN to reconstruction was evaluated. RESULTS.: Fifty-five flaps on 53 patients for ORN were done with a 90% resolution rate. Univariate parameter analysis was significant for infield mandibulotomy. An increased time interval from radiation therapy (XRT) to ORN development significantly predicted for flap-specific complications and flap loss (p < .05). Increased time from ORN diagnosis to flap surgery resulted in greater length of bone involvement (p = .01). Anastomotic complications occurred in 13 cases resulting in 7 complete flap losses. CONCLUSION.: An increased risk of complication was encountered with greater time from XRT to ORN. Thus, in patients developing ORN long after treatment, surgery should be accordingly more aggressive. (c) 2010 Wiley Periodicals, Inc. Head Neck, 2010.
Affiliation
The Head and Neck Center, Rochester, New York.
Journal Details
This article was published in the following journal.
Name: Head & neck
ISSN: 1097-0347
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20645290
- DOI: http://dx.doi.org/10.1002/hed.21463
Medical and Biotech [MESH] Definitions
Flap Endonucleases
Endonucleases that remove 5' DNA sequences from a DNA structure called a DNA flap. The DNA flap structure occurs in double-stranded DNA containing a single-stranded break where the 5' portion of the downstream strand is too long and overlaps the 3' end of the upstream strand. Flap endonucleases cleave the downstream strand of the overlap flap structure precisely after the first base-paired nucleotide, creating a ligatable nick.
Predictive Value Of Tests
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Keratomileusis, Laser In Situ
A surgical procedure to correct MYOPIA by CORNEAL STROMA subtraction. It involves the use of a microkeratome to make a lamellar dissection of the CORNEA creating a flap with intact CORNEAL EPITHELIUM. After the flap is lifted, the underlying midstroma is reshaped with an EXCIMER LASER and the flap is returned to its original position.
Keratectomy, Subepithelial, Laser-assisted
A surgical technique to correct REFRACTIVE ERRORS of the EYE, such as MYOPIA and ASTIGMATISM. In this method, a flap of CORNEAL EPITHELIUM is created by exposure of the area to dilute alcohol. The flap is lifted and then replaced after laser ablation of the subepithelial CORNEA.
Cherubism
A fibro-osseous hereditary disease of the jaws. The swollen jaws and raised eyes give a cherubic appearance; multiple radiolucencies are evident upon radiographic examination.
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