{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T22:22:47Z","timestamp":1781907767052,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To determine the frequency and management of short\u2010 and long\u2010term complications related to oromandibular free flap reconstruction and identify potentially predictive factors of hardware complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective database from chart review was formed consisting of 266 oromandibular free flap reconstructions performed at a single institution over a 15\u2010year period. Data were collected on demographics, surgical treatment, complications, and management of complications. Subgroup univariate and multivariate analyses were performed to compare patients with hardware complications and those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010one of 266 patients (30.5%) that underwent oromandibular reconstruction had an early complication (&lt;4\u2009weeks after surgery), and the most common complications were cervical wound dehiscence (11.3%) and fistulas (9.40%). Eighty of 266 patients (30.1%) had a long\u2010term complication (&gt;4\u2009weeks after surgery) and the most common complication was plate exposure (26.7%). Univariate and multivariate analyses showed no association between whether there was hardware extrusion and fibula versus scapula, smoking history, virtual surgical planning (VSP), and dental implantation (<jats:italic>P<\/jats:italic>\u2009&gt;\u2009.05). Only early complications (OR, 3.59, 95% CI, 1.83\u20137.05, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01) and patients undergoing oromandibular reconstruction for osteoradionecrosis (OR, 2.26, 95% CI, 1.10\u20134.64, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) were strongly and independently associated with subsequent hardware extrusion on univariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both short\u2010 and long\u2010term complications are common after oromandibular reconstruction. The most important predictive factor for a late complication is an early complication and prior radiation. There was no difference of plate complications among the various free flap types. Dental implantation and use of VSP were not associated with hardware complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:1997\u20132005, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29430","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T04:12:18Z","timestamp":1613275938000},"page":"1997-2005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["A Comprehensive Analysis of Complications of Free Flaps for Oromandibular Reconstruction"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1061-0561","authenticated-orcid":false,"given":"Amit","family":"Walia","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-5338","authenticated-orcid":false,"given":"Craig A.","family":"Bollig","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan J.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4626-2324","authenticated-orcid":false,"given":"Ryan S.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason T.","family":"Rich","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidharth V.","family":"Puram","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."},{"name":"Department of Genetics Washington University School of Medicine in St. Louis  St. Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-9855","authenticated-orcid":false,"given":"Sean T.","family":"Massa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Pipkorn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Washington University School of Medicine in St. Louis  St Louis Missouri 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