title: Increased plate and osteosynthesis related complications associated with postoperative concurrent chemoradiotherapy in oral cancer.
abstract: BACKGROUND
  Plate osteosynthesis is a widely used technique in head and neck reconstructive surgery. The objective of this study was to determine whether postoperative chemoradiotherapy, which was recently introduced for high-risk head and neck cancer, affects plate and osteosynthesis related complications.
  
  
  METHODS
  Fifty-two consecutive patients, who had undergone plate osteosynthesis for mandibular reconstruction between October 2003 and September 2006, were included in the study. The patients were divided into 3 groups: (1) surgery alone (n = 19), (2) surgery with postoperative radiotherapy (n = 14), and (3) surgery with concurrent chemoradiotherapy (n = 19). Outcome measures included any bone or plate related complications.
  
  
  RESULTS
  The plate and osteosynthesis related complications occurred in 10.5% of patients in surgery-alone group, 28.6% in surgery with postoperative radiation group, and 63.2% in surgery with postoperative concurrent chemoradiotherapy group. The differences in the complication rates among these 3 groups were statistically significant (p = .003). In univariate analysis, postoperative radiation (p = .007) and concurrent chemotherapy (p = .003) were found to be significantly associated with complications. In multivariate analysis, only concurrent chemotherapy was found to be statistically significant (p = .002) with odds ratio of 7.72.
  
  
  CONCLUSIONS
  Postoperative concurrent chemoradiotherapy significantly increases plate and osteosynthesis related complications in oral cancer.
authors.affiliation: Head and Neck Institute, Amrita Institute of Medical Sciences and Research Centre, Amrita Lane, Elamakkara PO, Kochi, Kerala, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sharan
authors.forename: Subramania
authors.initials: S
authors.lastname: Iyer
authors.forename: Shilpa S
authors.initials: SS
authors.lastname: Chatni
authors.forename: Jacob
authors.initials: J
authors.lastname: Samuel
authors.forename: Karimassery R
authors.initials: KR
authors.lastname: Sundaram
authors.forename: Richard F
authors.initials: RF
authors.lastname: Cohen
authors.forename: Keechilat
authors.initials: K
authors.lastname: Pavithran
authors.forename: Moni Abraham
authors.initials: MA
authors.lastname: Kuriakose