{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:27:59Z","timestamp":1789514879713,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteoradionecrosis (ORN) is a severe complication following radiotherapy (RT), particularly after mandibular reconstruction with a fibula free flap. Risk prediction remains challenging due to limited data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective study including 294 patients who underwent fibula free flap reconstruction and adjuvant RT. A predictive nomogram for ORN was developed using logistic regression with stepwise backward selection, validated via 10\u2010fold cross\u2010validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ORN occurred in 9.9% of patients. Eight variables were retained in the final model, which demonstrated excellent discrimination (AUC\u2009=\u20090.94) and good calibration (mean absolute error\u2009=\u20090.017). The optimal threshold for classification was 0.30, with the model achieving a sensitivity of 1.0, specificity of 0.80, and an overall accuracy of 0.82.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is the first nomogram developed to predict ORN following fibula free flap mandibular reconstruction. It provides a personalized risk estimate, supporting individualized clinical decision\u2010making and improved pre\u2010 and postoperative planning. Prospective validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70138","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T09:21:25Z","timestamp":1765790485000},"page":"1294-1302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Nomogram for Predicting Osteoradionecrosis After Fibula Free Flap for Mandibular Reconstruction"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-7785","authenticated-orcid":false,"given":"Andrea","family":"Costantino","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8785-9277","authenticated-orcid":false,"given":"Bianca","family":"Festa","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital  Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7997-964X","authenticated-orcid":false,"given":"Filippo","family":"Marchi","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Surgical Sciences and Integrated Diagnostics (DISC) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-5894","authenticated-orcid":false,"given":"Chung\u2010Kan","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"Center for Tissue Engineering Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Pellini","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery IRCCS Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Gazzini","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Hospital of Bolzano (SABES\u2010ASDAA)  Bolzano Italy"},{"name":"Teaching Hospital of the Paracelsus Medical Private University (PMU)  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter T.","family":"Dzi\u0119gielewski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Ciniglio","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery USL Toscana Centro, SOC otorinolarigoiatria 1  Prato Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1533-8832","authenticated-orcid":false,"given":"Francesco","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery IRCCS Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Hospital of Bolzano (SABES\u2010ASDAA)  Bolzano Italy"},{"name":"Teaching Hospital of the Paracelsus Medical Private University (PMU)  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sarno","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery USL Toscana Centro, 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