{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T03:54:14Z","timestamp":1768794854911,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Medication related osteonecrosis of the jaw (MRONJ) requiring free flap (FF) reconstruction is uncommon with limited reported findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicenter, retrospective case series of 49 consecutive adult patients presenting with advanced MRONJ requiring FF reconstruction from 2010 to 2022. Perioperative complications and outcomes were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010two percent (<jats:italic>n<\/jats:italic>\u2009=\u200940) of cases were of the mandible and 18% (<jats:italic>n<\/jats:italic>\u2009=\u20099) were of the maxilla. The mean follow\u2010up was 15\u2009months (\u00b119.6). The majority of FF survived (96%, <jats:italic>n<\/jats:italic>\u2009=\u200947). FF reconstructions of the maxilla were more likely to require postoperative debridement (56%, 95% CI [27, 81%] vs. 15%, 95% CI [7, 25%], <jats:italic>p<\/jats:italic>\u2009=\u20090.008) or develop intraoral bone exposure (56%, 95% CI [27, 81%] vs. 18%, 95% CI [9, 27%], <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Most patients (71%, <jats:italic>n<\/jats:italic>\u2009=\u200935) received preoperative antibiotics which was associated with a higher rate of FF survival (100% vs. 86%, 95% CI [60, 96%], <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and fewer complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients undergoing FF reconstruction for MRONJ do well with high rates of FF success. MRONJ of the maxilla have a higher rate of some complications. Preoperative antibiotics correlated with higher FF survival and fewer postoperative complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27653","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T12:19:50Z","timestamp":1706703590000},"page":"1902-1912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Microvascular reconstruction of medication related osteonecrosis of the head and neck"],"prefix":"10.1002","volume":"46","author":[{"given":"Larissa","family":"Sweeny","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of Miami  Miami Florida USA"},{"name":"Surgical Care Division Miami Veterans Affairs Health Care System  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sallie M.","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and 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Surgery Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne C.","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Mississippi  Jackson Mississippi USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4880-6172","authenticated-orcid":false,"given":"Brett A.","family":"Miles","sequence":"additional","affiliation":[{"name":"Department Otolaryngology Head and Neck Oncology Northwell Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Salama","sequence":"additional","affiliation":[{"name":"Division Oral and Maxillofacial Surgery Northwell Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven B.","family":"Cannady","sequence":"additional","affiliation":[{"name":"Department of 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