{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:40:09Z","timestamp":1780404009022,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"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":[[2021,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Review long\u2010term clinical and quality\u2010of\u2010life outcomes following free flap reconstruction for osteonecrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective multi\u2010institutional review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients included those undergoing free flap reconstructions for osteonecrosis of the head and neck (N = 232). Data included demographics, defect, donor site, radiation history, perioperative management, diet status, recurrence rates, and long\u2010term quality\u2010of\u2010life outcomes. Quality\u2010of\u2010life outcomes were measured using the University of Washington Quality of Life (UW\u2010QOL) survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall flap success rate was 91% (n = 212). Relative to preoperative diet, 15% reported improved diet function at 3\u00a0months following reconstruction and 26% at 5 years. Osteonecrosis recurred in 14% of patients (32\/232); median time to onset was 11\u00a0months. Cancer recurrence occurred in 13% of patients (29\/232); median time to onset was 34\u00a0months. Results from the UW\u2010QOL questionnaire were as follows: no pain (45%), minor or no change in appearance (69%), return to baseline endurance level (37%), no limitations in recreation (40%), no changes in swallowing following reconstruction (28%), minor or no limitations in mastication (29%), minor or no speech difficulties (93%), no changes in shoulder function (84%), normal taste function (19%), normal saliva production (27%), generally excellent mood (44%), and no or minimal anxiety about cancer (94%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The majority of patients maintained or had advancement in diet following reconstruction, with low rates of osteonecrosis or cancer recurrence and above\u2010average scores on UW\u2010QOL survey suggesting good return of function and quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599821990682","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T04:07:39Z","timestamp":1614053259000},"page":"636-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Microvascular Reconstruction of Osteonecrosis: Assessment of Long\u2010term Quality of Life"],"prefix":"10.1002","volume":"165","author":[{"given":"Larissa","family":"Sweeny","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Louisiana State University Health Science Center\u2013New Orleans New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Mayland","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Louisiana State University Health Science Center\u2013New Orleans New Orleans Louisiana 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