{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T15:24:52Z","timestamp":1790954692823,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T00:00:00Z","timestamp":1585008000000},"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":[[2020,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the frequency at which patients with osteocutaneous free flap reconstruction of the head and neck develop long\u2010term complications and identify predisposing perioperative factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A prospectively maintained database of free flaps performed at a single institution over a 10\u2010year period was queried.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single tertiary care referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>In total, 250 osseous or osteocutaneous free flaps (OCFFs) for mandibular or maxillary reconstruction were analyzed. Data were collected on demographics, preoperative therapy, resection location, adjuvant treatment, complications, and subsequent surgeries, and multivariate analysis was performed. Subgroup analysis based on perioperative factors was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up time was 23\u00a0months. In 185 patients with at least 6\u00a0months of follow\u2010up, 17.3% had at least 1 long\u2010term complication, most commonly wound breakdown, fistula or plate extrusion (13.5%), osteoradionecrosis or nonunion (6.5%), and infected hardware (5.9%). Prior chemoradiotherapy and cancer diagnosis predisposed patients to long\u2010term complications. At the 5\u2010year follow\u2010up, 21.7% of patients had experienced a long\u2010term complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010term complications after OCFF occurred in 17% of patients. In this series, a preoperative history of chemoradiation and those undergoing maxillary reconstruction were at high risk for the development of long\u2010term complications and thus warrant diligent follow\u2010up. However, OCFFs can often enjoy long\u2010term viability and survival, even in the case of perioperative complications and salvage surgery.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820912727","type":"journal-article","created":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T04:48:59Z","timestamp":1585025339000},"page":"641-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Long\u2010Term Complications of Osteocutaneous Free Flaps in Head and Neck Reconstruction"],"prefix":"10.1002","volume":"162","author":[{"given":"Brian","family":"Swendseid","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Thomas Jefferson University Hospitals Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayan","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Thomas Jefferson University Hospitals Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Sweeny","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Louisiana State University Health Science Center New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark K.","family":"Wax","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Oregon Health and Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Division of Biostatistics Thomas Jefferson University Hospitals Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Thomas Jefferson University Hospitals Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Krein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; 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