Background. Plate osteosynthesis is a widely used technique in head and neck reconstructive surgery. The objective of this study was to determine whether postoperative chemoradiotherapy, which was recently introduced for high-risk head and neck cancer, affects plate and osteosynthesis related complications. Methods. Fifty-two consecutive patients, who had undergone plate osteosynthesis for mandibular reconstruction between October 2003 and September 2006, were included in the study. The patients were divided into 3 groups: (1) surgery alone (n = 19), (2) surgery with postoperative radiotherapy (n = 14), and (3) surgery with concurrent chemoradiotherapy (n = 19). Outcome measures included any bone or plate related complications. Results. The plate and osteosynthesis related complications occurred in 10.5% of patients in surgery-alone group, 28.6% in surgery with postoperative radiation group, and 63.2% in surgery with postoperative concurrent chemoradiotherapy group. The differences in the complication rates among these 3 groups were statistically significant (p = .003). In univariate analysis, postoperative radiation (p = .007) and concurrent chemotherapy (p = .003) were found to be significantly associated with complications. In multivariate analysis, only concurrent chemotherapy was found to be statistically significant (p = .002) with odds ratio of 7.72. Conclusion. Postoperative concurrent chemoradiotherapy significantly increases plate and osteosynthesis related complications in oral cancer. © 2008 Wiley Periodicals, Inc.
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Ra Sharan, Iyer, Sa, Chatni, S. Sa, Samuel, Jb, Sundaram, K. Rc, Cohen, R. Fbd, Pavithran, Ke, and Kuriakose, M. Aa, “Increased plate and osteosynthesis related complications associated with postoperative concurrent chemoradiotherapy in oral cancer”, Head and Neck, vol. 30, pp. 1422-1430, 2008.