{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:28:18Z","timestamp":1769128098504,"version":"3.49.0"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,8,1]],"date-time":"2009-08-01T00:00:00Z","timestamp":1249084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To examine outcomes of vascularized bone flap reconstruction of end\u2010stage osteoradionecrosis of the mandible.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN<\/jats:title><jats:p>Case series with planned data collection.<\/jats:p><\/jats:sec><jats:sec><jats:title>SETTING<\/jats:title><jats:p>Tertiary care academic hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>SUBJECTS<\/jats:title><jats:p>Patients with end\u2010stage radiation\u2010induced osteoradionecrosis (ORN) refractory to conservative therapy with wound complications including chronic infections, fistula formation, and pathologic fracture were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Outcomes of 33 patients were prospectively collected and analyzed, making this the largest series on this subject in the literature and the only one with planned data collection. Data on preoperative variables including radiation dose, sub\u2010site location, treatment date, and prior therapy, along with intraoperative issues and postoperative outcomes, were tracked and are presented. ORN was seen to develop in a bimodal distribution based on the timing of interval surgical intervention. The extent of local soft tissue injury often required the use of contralateral recipient vessels. Local wound complication rates were higher than that seen in primary reconstructions.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Successful reconstruction was achieved in all of the patients in this series. Long\u2010term resolution of infectious complication and disease resolution was seen in 91 percent of the patients in this series.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2009.03.013","type":"journal-article","created":{"date-parts":[[2009,7,29]],"date-time":"2009-07-29T09:17:07Z","timestamp":1248859027000},"page":"196-201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Analysis of Outcomes of Vascularized Flap Reconstruction in Patients with Advanced Mandibular Osteoradionecrosis"],"prefix":"10.1002","volume":"141","author":[{"given":"Daniel S.","family":"Alam","sequence":"first","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic Foundation Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Nuara","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic Foundation Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Christian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2007.05.021"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200205000-00014"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000152424.91250.A5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bdj.2007.1065"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10171"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199908000-00027"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(83)80005-6"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20538"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.09.006"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.129.1.72"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1121"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(08)80414-8"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2009.03.013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.otohns.2009.03.013","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2009.03.013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:30:18Z","timestamp":1760963418000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.otohns.2009.03.013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,8]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2009,8]]}},"alternative-id":["10.1016\/j.otohns.2009.03.013"],"URL":"https:\/\/doi.org\/10.1016\/j.otohns.2009.03.013","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,8]]},"assertion":[{"value":"2008-09-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-03-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}