Mandibular resection in patients with head and neck cancer: acute and long-term complications after reconstruction.

The treatment of head and neck cancer is an intensive multimodal treatment that has a great impact on the individual patient. This study aimed to evaluate acute and long-term complications associated with mandibular resections and reconstructions. We retrospectively retrieved data on complications and recurrences among patients that underwent mandibular resections and reconstructions for treating oral cavity cancer (n = 190 patients) and osteoradionecrosis (ORN, n = 72). Reconstructions included composite grafts (n = 177), soft tissue flaps (n = 61), or primary closure without any graft (n = 24). Forty-two patients that underwent reconstructions with composite grafts displayed serious complications (Clavien–Dindo ≥ IIIa). The complication rates were similar between patients treated for oral cavity cancer and patients treated for ORN. Patients that underwent a primary closure without any graft, had a significantly lower risk of complications compared to patients that underwent the other treatments. After hospitalization, 181 patients (69%) had at least one complication. A majority of patients undergoing resection and reconstruction due to oral cancer/ORN suffered from postoperative complications regardless of indication, comorbidity status or reconstruction technique. The risk of Clavien–Dindo grade IIIa–V events was significantly lower for patients treated with primary closure without grafts The results from this study clarifies the importance of in-depth analyse prior to decision of treatment for patients with head and neck cancer. [ABSTRACT FROM AUTHOR]

背景：头颈癌的治疗是一种强化型多模式治疗, 对患者造成很大影响。 目的：本研究旨在评估与下颌骨切除和重建相关的急性和长期并发症。 材料和方法：我们回顾性检索了因治疗口腔癌（n = 190 ）和放射性骨坏死（ORN, n = 72）而接受下颌骨切除和重建的患者的并发症和复发的数据。下颌骨重建包括复合移植物(n =177)、软组织瓣 (n = 61) 或没有任何移植物的闭合 (n = 24)。 结果：42 名接受复合移植物重建的患者表现出严重的并发症（Clavien-Dindo IIIa）。在接受口腔癌治疗的患者和接受 ORN 治疗的患者之间, 并发症发生率相似。接受无移植物闭合术的患者与接受其他治疗的患者相比, 并发症风险显著低。住院后, 181 名患者（69%）出现至少一种并发症。 结论：大部分患者因口腔癌/ORN而接受切除重建后, 都会出现术后并发症, 与适应症、合并症状态或重建技术无关。接受无移植物闭合治疗的患者, 发生 Clavien-Dindo IIIa-V 级事件的风险显著低。 意义：本研究的结果表明, 在决定头颈癌患者的治疗方法之前, 进行深入分析是很重要的。 [ABSTRACT FROM AUTHOR]

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