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Shedding light on the limited evidence to date, this study aims to summarize existing evidence and highlight the research gaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed and Embase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>A systematic search of PubMed and Embase was conducted up to May 2024, using relevant keywords to identify papers on ORNC. Data on the definition, incidence, risk factors, radiotherapy parameters, diagnostic methods, and management strategies were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty articles reporting on 42 ORNC patients were identified, revealing relatively poor data quality. There remains no consensus on a definition of ORNC. Patient\u2010 and disease\u2010related risk factors have been inconsistently documented. No conclusion could be reached regarding thresholds for radiation dose delivery, as only seven studies reported the total radiation dose, with a mean of 58.9\u2009Gy. Twenty\u2010five (60%) cases managed with wound care and antibiotics demonstrated a spectrum of success rates, while 90% of surgically managed ORNC wounds healed at various follow\u2010up points, ranging from 6 weeks to 9 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study proposes an ORNC\u2010specific definition and reporting standard through comparison with mandibular ORN. This will help generate valuable data, guiding the development of an ORNC\u2010specific treatment protocol and clinical decision\u2010making in managing this debilitating side effect of radiotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1290","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T09:54:47Z","timestamp":1746438887000},"page":"552-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Calvarial Osteoradionecrosis After Treatment of Cutaneous Malignancy: A Systematic Review"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3628-6819","authenticated-orcid":false,"given":"Siyuan","family":"Pang","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Surgery, The Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Concannon","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Drummond","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia"},{"name":"Department of Neurosurgery The Royal Melbourne Hospital Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gearing","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Royal Melbourne Hospital Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxim","family":"Devine","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Tiong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Surgery, The Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Plastic and Reconstructive Surgery Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3857\/roj.2020.00213"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2391(83)90294-X"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.12968\/denu.2022.49.1.64"},{"key":"e_1_2_10_5_1","first-page":"62","article-title":"A review of advanced head and neck osteoradionecrosis","volume":"8","author":"Mayland EJ","year":"2021","journal-title":"Plast Aesthet Res"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ors.12459"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000459"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2016.59.3.192"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1722914"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-7-162"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000644"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_10_13_1","unstructured":"International platform of registered systematic review and meta\u2010analysis protocols. 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