Outcomes after definitive surgery for mandibular osteoradionecrosis.
Outcomes after definitive surgery for mandibular osteoradionecrosis.
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DOI：
10.1002/hed.27024
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发表时间：
2022-06
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影响因子：
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中科院分区：
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分析下颌骨放射性骨坏死（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76例接受下颌骨节段性切除和重建的患者。49例（65%）患者发生并发症，与术前引流相关（比值比[OR] 4.40，95%置信区间[CI] 1.01-19.27）。调整后的中位费用为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）相关。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）相关。5年ORN无复发生存率为93%，而总生存率为63%，与肺部疾病相关（HR [风险比] 3.57，95%CI 1.43-8.94）。虽然ORN的复发是罕见的，手术并发症是常见的，费用高。手术预后差和费用高与术前因素有关。
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.
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