title: Quality of life for patients requiring surgical resection and reconstruction for mandibular osteoradionecrosis: 10-year experience at the University of California San Francisco.
abstract: BACKGROUND
  Mandibular osteoradionecrosis is the most devastating complication after radiation therapy for head and neck malignancies. Quality of life (QOL) after surgical treatment is unclear.
  
  
  METHODS
  A retrospective cohort analysis (1997-2007) was conducted of all patients treated at our institution for stage II and III mandibular osteoradionecrosis. Nineteen of 35 patients responded to a modified University of Washington QOL questionnaire. Twenty had undergone reconstruction using free flaps, and the remainder with plates, plates and local flaps, or debridement alone.
  
  
  RESULTS
  Complications included 3 infections, 5 with hardware, 5 flap-specific, and 1 nonunion. Four patients had recurrent squamous cell carcinoma (SCC). The factors of greatest concern to patients were appearance, swallowing, and chewing. Average overall QOL was good to very good, and very good compared to preoperative.
  
  
  CONCLUSIONS
  Despite a 37% complication rate, a multidisciplinary team approach with adequate debridement, resection, and reconstruction can greatly improve QOL.
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: Edward I
authors.initials: EI
authors.lastname: Chang
authors.forename: Pablo
authors.initials: P
authors.lastname: Leon
authors.forename: William Y
authors.initials: WY
authors.lastname: Hoffman
authors.forename: Brian L
authors.initials: BL
authors.lastname: Schmidt
mesh_terms: D002280:Basal Cell Carcinoma / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy; D010025:Osteoradionecrosis / Q000601:surgery*; D010348:Patient Care Team; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps; D014062:Tongue Neoplasms / Q000532:radiotherapy