{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:17:51Z","timestamp":1768443471603,"version":"3.49.0"},"reference-count":67,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the microbiologic characteristics, antibiotic resistance patterns, and clinical predictors of reconstruction in patients with osteoradionecrosis of the jaw (ORNJ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary care academic medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty\u2010four adult patients treated for ORNJ between January 2023 and August 2024 were included. Clinical and microbiologic data were extracted from the electronic health record. Culture results, antibiotic resistance profiles, and reconstructive outcomes were analyzed. Logistic regression was used to identify predictors of autologous reconstruction, Gram\u2010negative infection, and Actinomyces isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 84 patients (median age 63.3), 73.8% had cultures obtained, and 92.9% received antibiotics. Bacterial species were isolated in 58.2% of 134 cultures, with\n                      <jats:italic>Actinomyces<\/jats:italic>\n                      (23.9%) and\n                      <jats:italic>Streptococcus anginosus<\/jats:italic>\n                      (7.5%) most frequent. Gram\u2010negative organisms were identified in 22.6% and independently predicted autologous reconstruction (odds ratio [OR]\u2009=\u200914.81; 95% confidence interval [CI]: 2.59\u201084.67;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0025). Fistula presence was significantly associated with Gram\u2010negative infection (OR\u2009=\u20096.57; 95% CI: 1.76\u201024.47;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.005). High resistance was observed to ampicillin (47.1%) and cefazolin (35.3%), while gentamicin showed the highest susceptibility (75.9%). Posterior mandibular involvement and pathologic fracture were associated with reduced odds of reconstruction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ORNJ exhibits a polymicrobial and antibiotic\u2010resistant profile. Gram\u2010negative infection is a key predictor of the need for autologous reconstruction and may reflect more severe disease. These findings support the use of culture\u2010directed therapy and highlight the importance of integrating microbiologic and anatomic factors in ORNJ management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70044","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:58:03Z","timestamp":1760446683000},"page":"152-162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post\u2010Radiation Microbiological Changes in Osteoradionecrosis: Investigating the Microbial Landscape"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5680-0513","authenticated-orcid":false,"given":"Grace Anne","family":"Longfellow","sequence":"first","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0129-8421","authenticated-orcid":false,"given":"Makayla R.","family":"Matthews","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle J.","family":"Adams","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren M.","family":"Cook","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria I.","family":"Fonesca","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8190-0091","authenticated-orcid":false,"given":"Ezer H.","family":"Benaim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology &amp; Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3791-3252","authenticated-orcid":false,"given":"Jason","family":"Tasoulas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology &amp; Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-2398","authenticated-orcid":false,"given":"Trevor","family":"Hackman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology &amp; Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1624-7422","authenticated-orcid":false,"given":"Christopher Blake","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology &amp; 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