Surgical treatment of osteoradionecrosis of the jaw following radiotherapy for oropharyngeal cancer: A retrospective clinical analysis in a single-center.
- 1Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan.
- 2Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Abstract
Background/purpose
Osteoradionecrosis of the jaw (ORNJ) is an intractable disease that develops within the radiation field in patients with head and neck cancer. This study aimed to investigate differences in healing rates among surgical treatments for mandibular ORN that developed after radiotherapy for oropharyngeal cancer.Materials and methods
We retrospectively evaluated 318 patients who underwent radiotherapy or chemoradiotherapy for oropharyngeal cancer at our institution to determine the incidence of ORNJ. Furthermore, 16 patients (15 males and 1 female) with a mean age of 63.3 years were included in the surgical analysis. Healing was defined as the absence of symptom recurrence for 3 months after surgery. Various factors, including age, sex, use of hyperbaric oxygen therapy, type of surgical treatment, smoking history, alcohol consumption, and nutritional status, were investigated.Results
Among the 318 patients, 36 developed ORNJ, resulting in an incidence rate of 11.3%. Among the 16 surgically treated patients, primary treatments included sequestrectomy in 8 cases, mandibular marginal resection in 1 case, and segmental resection in 7 cases. The overall healing rate was 50.0% (8/16). Of the 16 cases, 8 required secondary treatment. Most cases initially treated with sequestrectomy required secondary treatment, whereas segmental resection achieved the highest healing rate.Conclusion
For refractory ORNJ, segmental resection with a vascularized free flap may provide reliable healing by removing necrotic tissue and restoring local blood supply to the ischemic area.
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BibTeX
@article{nakai2026surgical,
title = {{Surgical treatment of osteoradionecrosis of the jaw following radiotherapy for oropharyngeal cancer: A retrospective clinical analysis in a single-center.}},
author = {Yu Nakai and Ken-Ichiro Sakata and Kazuhito Yoshikawa and Taku Maeda and Tougo Tanabe and Masayuki Shinohara and Kenji Imamachi and Hiroshi Hikasa and Jun Sato and Ikuya Miyamoto},
journal = {Journal of dental sciences},
year = {2026},
month = oct,
doi = {10.1016/j.jds.2025.07.3511},
url = {https://europepmc.org/article/MED/42923705},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Surgical treatment of osteoradionecrosis of the jaw following radiotherapy for oropharyngeal cancer: A retrospective clinical analysis in a single-center.
AU - Yu Nakai
AU - Ken-Ichiro Sakata
AU - Kazuhito Yoshikawa
AU - Taku Maeda
AU - Tougo Tanabe
AU - Masayuki Shinohara
AU - Kenji Imamachi
AU - Hiroshi Hikasa
AU - Jun Sato
AU - Ikuya Miyamoto
PY - 2026
DA - 2026/10/01
JO - Journal of dental sciences
DO - 10.1016/j.jds.2025.07.3511
UR - https://europepmc.org/article/MED/42923705
AB - Background/purpose Osteoradionecrosis of the jaw (ORNJ) is an intractable disease that develops within the radiation field in patients with head and neck cancer. This study aimed to investigate differences in healing rates among surgical treatments for mandibular ORN that developed after radiotherapy for oropharyngeal cancer.Materials and methods We retrospectively evaluated 318 patients who underwent radiotherapy or chemoradiotherapy for oropharyngeal cancer at our institution to determine the incidence of ORNJ. Furthermore, 16 patients (15 males and 1 female) with a mean age of 63.3 years were included in the surgical analysis. Healing was defined as the absence of symptom recurrence for 3 months after surgery. Various factors, including age, sex, use of hyperbaric oxygen therapy, type of surgical treatment, smoking history, alcohol consumption, and nutritional status, were investigated.Results Among the 318 patients, 36 developed ORNJ, resulting in an incidence rate of 11.3%. Among the 16 surgically treated patients, primary treatments included sequestrectomy in 8 cases, mandibular marginal resection in 1 case, and segmental resection in 7 cases. The overall healing rate was 50.0% (8/16). Of the 16 cases, 8 required secondary treatment. Most cases initially treated with sequestrectomy required secondary treatment, whereas segmental resection achieved the highest healing rate.Conclusion For refractory ORNJ, segmental resection with a vascularized free flap may provide reliable healing by removing necrotic tissue and restoring local blood supply to the ischemic area.
SN - 1991-7902
SN - 2213-8862
ER -