{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:41:47Z","timestamp":1788392507918,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the rate and risk factors for osteoradionecrosis (ORN) in osseous free flaps after postoperative radiation therapy (PORT). To describe the treatment of free flap ORN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010four patients undergoing osseous free flap reconstruction were analyzed. Thirty\u2010eight completed PORT. Patients were followed for \u22656 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of ORN was 34% overall; 0% with 50 to 59.9\u2009Gy; 8% with 60\u2009Gy; 40% with 66\u2009Gy; 56% with 70 to 74.4\u2009Gy. Mean time to ORN was 13.1 months. 0\/28 patients without PORT developed free flap osteonecrosis. Multivariate analysis found the only factor predicting ORN: PORT &gt;60\u2009Gy, which increased the risk 21\u2010fold. Treatment included PENTACLO, hyperbaric oxygen, and surgical debridement with 75% within 2\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PORT &gt;60\u2009Gy is significantly associated with free flap ORN. As the dose of adjuvant RT increases beyond 60\u2009Gy, the risk of ORN in free flaps rises. Consideration should be given to lower PORT doses or delaying free flap reconstruction when feasible.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26118","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T13:00:21Z","timestamp":1583413221000},"page":"1928-1938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Osteoradionecrosis in osseous free flap reconstruction: Risk factors and treatment"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3025-9086","authenticated-orcid":false,"given":"Peter T.","family":"Dziegielewski","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Florida  Gainesville Florida"},{"name":"University of Florida Health Cancer Center  Gainesville Florida"},{"name":"Division of Otolaryngology\u2010Head and Neck Surgery University of Alberta  Edmonton Alberta 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