Archives of Head and Neck Surgery
Archives of Head and Neck Surgery
Case Report Head and neck reconstruction

Refractory ORN submitted to resective surgical treatment and free flap musculocutaneous reconstruction

Wilber Edison Bernaola-Paredes, Guilherme Agne, Monica Lucia Rodrigues, Fábio Abreu Alves, Rodrigo Nascimento Lopes

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Osteoradionecrosis (ORN) is one of the most severe complications of radiotherapy in the head, having the greatest impact on patients’ quality of life. Previous studies have shown injury remission and cure rates for refractory osteoradionecrosis, i.e. ORN resistant to conventional treatment, using simultaneous techniques such as superficial debridement, midsize sequestrectomy and resective surgery along with drug therapy and hyperbaric chamber. The present case report describes the results obtained exclusively by a resection surgical approach to ORN and microsurgical reconstruction with musculocutaneous free thigh flap.


osteoradionecrosis; surgical treatment; microsurgical reconstruction; myocutaneous flap; combined therapy


1. Cha YH, Hong N, Rhee Y, Cha IH. Teriparatide therapy for severe, refractory osteoradionecrosis of the jaw. Osteoporos Int. 2018;29(4):987-92. PMid:29249017.

2. Jeyaraj P, Bandyopadhyay TK. Diagnostic features and management strategy of a refractory case of osteoradionecrosis of the mandible: case report and review of literature. J Maxillofac Oral Surg. 2016;15(2):256-67. PMid:27298551.

3. Curi MM, Dib LL, Kowalski LP. Management of refractory osteoradionecrosis of the jaws with surgery and adjunctive hyperbaric oxygen therapy. Int J Oral Maxillofac Surg. 2000;29(6):430-4.

4. Delanian S, Chatel C, Porcher R, Depondt J, Lefaix JL. Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO): a phase II trial. Int J Radiat Oncol Biol Phys. 2011;80(3):832-9. PMid:20638190.

5. Rommel N, Kesting MR, Rohleder NH, Wolff KD, Weitz J. Surgical management of severe osteoradionecrosis of the mandibular bone by using double free flap reconstruction. J Craniomaxillofac Surg. 2018;46(1):148-54. PMid:29174551.

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