Purpose

The reconstructive approach and outcomes for patients with Osteoradionecrosis (ORN) of the mandible who have already undergone prior mandibular reconstruction remain undescribed in the literature.

 

Methods

This is a 30-year retrospective analysis of mandibular ORNs on top of a prior same-side mandibular reconstruction, from 994 to 2023.

 

Results

We identified 65 patients with mandibular ORN needing repeat reconstruction. Compared to first-time reconstructions, these patients had more complex defects, more revision surgeries, and worse speech outcomes (Table ). Initial reconstruction type(s) did not affect final reconstruction outcomes (Table 2). In patients undergoing second bone flap reconstructions, outcomes were similar to first-time reconstructions, except for worse speech (Table 3).

 

Conclusions

Second-time mandibular defects due to ORN are more complex but can still be reconstructed using the same approach as the first reconstruction. However, patients should be informed beforehand that speech outcomes are likely inferior to first-time reconstruction .