Comparison of Complication Rates for Head and Neck Reconstruction Across Multiple Jaw Pathologies
Austin A. Lignieres, MD1, Edward A. Facundus, MS2, Ron McCall, MS2, Kendall Pitre, BS2, Holman Taylor, BS2, John Phillips, BA2, Adam Fleming, BA1, Ashlie Elver, MD1, Benjamin McIntyre, MD1, Laura S. Humphries, MD1
1. University of Mississippi Medical Center Division of Plastic and Reconstructive Surgery, Jackson, MS
2. University of Mississippi Medical School, Jackson, MS
Background
•Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) have higher complication rates than benign lesions following reconstruction
•Reconstructive surgeries with these disease processes often lead to more severe and chronic problems than those with malignant cancers
•Microsurgical reconstruction is the gold standard following oncologic resection
•Socioeconomic factors have a well-established impact on surgical outcomes
Purpose
(1) Examine complication rates following head and neck (H&N) reconstruction across multiple disease processes
(2) Identify factors that impact complication rates
Methods
•Retrospective review of patients who underwent H&N reconstruction at single institution from 2016-2024
•Jaw pathology types included: Benign Lesions, Malignant Cancers, MRONJ, ORN, Trauma, and Other
•Demographic data including race, age, sex, and social vulnerability index (SVI) quartile were collected
•Chi-square, Fisher exact tests, logistic regression, and ANOVA/post-hoc tests were used to assess significance (p<0.05)
Discussion
•Patients with malignant lesions are 3.2 times more likely to develop post-op complications, while those with traumatic pathologies have significantly lower odds of complications (OR=0.1)
•Male patients had significantly higher odds of post-op complications (OR=2.2)
•The age groups of 50-54 yrs and 70+ yrs had higher likelihood of complications (OR=10.0 and 3.6, respectively)
•SVI quartile 4 patients had significantly higher odds ratio for post-op complications (OR=6), particularly male patients in this quartile (OR=16)
•There were no significant differences in complications by patient race
Future Aims
•Future studies should aim to obtain data from a larger patient population across multiple institutions
•Predictive models that account for both clinical and socioeconomic risk factors could improve perioperative decision making and postoperative care planning
