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Management of Osteoradionecrosis (ORN) of the Jaw using Nasolabial Flaps (NLF)

Authors: Ahmed AlMajmaie, Ahmed ElMinshawi, Caoimhin O'Higgins, Ellen Desmond, Tom Barry
Publication: Journal of The Irish Head and Neck Society - 2024
Issue: 2 Volume: 2
Published: June, 2024 View PDF

Background: Osteoradionecrosis (ORN) of the jaw presents a challenging complication following oral cancer treatment in which radiotherapy has been a modality. The management of ORN often requires surgical intervention to treat the symptoms of ORN and restore form and function. Nasolabial flaps (NLF) have a viable role in the management of the sequelae of the ORN.

Aim: The aim of this study was to assess the unit’s experience with the use of nasolabial flaps in management of ORN.

Methods: This retrospective study was done by retrieving the patients’ data via medical records and clinical evaluation to involve symptomatic patients with exposed bone post adjuvant radiotherapy in oral cancer patients.

Results: Nine cases with symptomatic ORN received NLF treatment under general anesthesia. No flap failures occurred, with successful mandibular bone coverage. Postoperatively, patients reported improved symptoms (reduced pain, closure of fistulae, and no bone exposure).

Conclusions: Nasolabial flaps represent a valuable tool in the reconstructive armamentarium for addressing ORN. Their reliable vascular supply, versatility in design, and favorable outcomes make them an attractive option for managing these cases. However, careful patient selection, meticulous surgical technique, and attentive postoperative care are essential to optimize outcomes and minimize complications.

Ahmed ElMinshawi1,2, Ellen Desmond1, Caoimhin O’Higgins1, Ahmed AlMajmaie1, Tom Barry1

1 Department of Oral & Maxillofacial Surgery, University Hospital Galway
2 Nasser Institute Hospital for Research and Treatment, Cairo, Egypt 

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