Surgical treatment of osteoradionecrosis of the jaw following radiotherapy for oropharyngeal cancer: A retrospective clinical analysis in a single-center

Authors

• Yu Nakai, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Ken-ichiro Sakata, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, JapanFollow
• Kazuhito Yoshikawa, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Taku Maeda, Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
• Tougo Tanabe, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Masayuki Shinohara, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Kenji Imamachi, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Hiroshi Hikasa, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Jun Sato, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Ikuya Miyamoto, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan

Abstract

Background/purpose: Osteoradionecrosis of the jaw (ORNJ) is an intractable disease that develops within the radiation field in patients with head and neck cancer. This study aimed to investigate differences in healing rates among surgical treatments for mandibular ORN that developed after radiotherapy for oropharyngeal cancer.

Materials and methods: We retrospectively evaluated 318 patients who underwent radiotherapy or chemoradiotherapy for oropharyngeal cancer at our institution to determine the incidence of ORNJ. Furthermore, 16 patients (15 males and 1 female) with a mean age of 63.3 years were included in the surgical analysis. Healing was defined as the absence of symptom recurrence for 3 months after surgery. Various factors, including age, sex, use of hyperbaric oxygen therapy, type of surgical treatment, smoking history, alcohol consumption, and nutritional status, were investigated.

Results: Among the 318 patients, 36 developed ORNJ, resulting in an incidence rate of 11.3%. Among the 16 surgically treated patients, primary treatments included sequestrectomy in 8 cases, mandibular marginal resection in 1 case, and segmental resection in 7 cases. The overall healing rate was 50.0% (8/16). Of the 16 cases, 8 required secondary treatment. Most cases initially treated with sequestrectomy required secondary treatment, whereas segmental resection achieved the highest healing rate.

Conclusion: For refractory ORNJ, segmental resection with a vascularized free flap may provide reliable healing by removing necrotic tissue and restoring local blood supply to the ischemic area.

Recommended Citation

Nakai, Yu; Sakata, Ken-ichiro; Yoshikawa, Kazuhito; Maeda, Taku; Tanabe, Tougo; Shinohara, Masayuki; Imamachi, Kenji; Hikasa, Hiroshi; Sato, Jun; and Miyamoto, Ikuya (2026) "Surgical treatment of osteoradionecrosis of the jaw following radiotherapy for oropharyngeal cancer: A retrospective clinical analysis in a single-center," Journal of Dental Sciences: Vol. 21: Iss. 4, Article 37.
Available at: https://jds.ads.org.tw/journal/vol21/iss4/37

Publication Date

2026

Received Date

03 Apr 2026

Final Revision Date

15 Apr 2026