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首页> 外文期刊>Journal of Surgical Oncology >Identification of predisposing factors for osteonecrosis of the jaw after marginal mandibulectomy in the surgical management of oral squamous cell carcinoma
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Identification of predisposing factors for osteonecrosis of the jaw after marginal mandibulectomy in the surgical management of oral squamous cell carcinoma

机译：在口腔鳞状细胞癌外科手术管理中颌骨切除术后颌骨骨折的概述概述

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Background The aim of this study is to evaluate osteonecrosis of the jaw (ONJ) with the extent of marginal mandibulectomy. Methods Between January 2006 and December 2012, 3087 patients undergoing ablative resection were consecutively enrolled. Among them, 345 cases undergoing marginal mandibulectomy were retrospectively reviewed. Results The occurrence of ONJ was 5.51% and associated with body mass index, overall stage, diabetes, concomitant mandibulotomy, and radiotherapy ( P ?=?0.023, 0.033, 0.009, 0.016, and 0.006, respectively). As for bone parameters based on radiological measurements after marginal mandibulectomy, resected bone height, remaining bone height to original bone height ratio, and resected bone height to original bone height ratio were associated with ONJ. In multivariate logistic analyses, concomitant mandibulotomy, radiotherapy, diabetes, resected bone height of 14.5?mm, resected bone height to original bone height ratio of 49.5%, and remaining bone height to original bone height ratio of 53.5% indicated higher risks for ONJ (adjusted HR: 4.345, 4.152, 4.079, 3.402, 3.541, and 3.211; P ?=?0.018, 0.013, 0.009, 0.021, 0.018, and 0.043, respectively). Conclusions This study demonstrated the predisposing factors and parameters associated with ONJ with marginal mandibulectomy; more caution is necessitated in performing marginal mandibulectomy in patients with multiple risks to prevent ONJ.
机译：背景本研究的目的是评估下颌骨骨坏死（ONJ）与下颌骨边缘切除的程度。方法2006年1月至2012年12月，连续入选3087例接受消融切除术的患者。对其中345例进行了回顾性分析。结果ONJ的发生率为5.51%，与体重指数、总分期、糖尿病、下颌骨联合切开术和放疗有关（P？=0.023、0.033、0.009、0.016和0.006）。至于基于边缘下颌骨切除术后放射学测量的骨参数，切除骨高度、剩余骨高度与原始骨高度之比以及切除骨高度与原始骨高度之比与ONJ相关。在多变量logistic分析中，同时行下颌骨切开术、放疗、糖尿病、切除的骨高度>；14.5?mm，切除骨高度与原始骨高度之比；49.5%，剩余骨高与原始骨高之比为；53.5%的人表示ONJ的风险更高（调整后的HR分别为4.345、4.152、4.079、3.402、3.541和3.211；P？=0.018、0.013、0.009、0.021、0.018和0.043）。结论本研究证实了下颌骨边缘切除术后ONJ的易感因素和相关参数；在对有多种风险的患者进行下颌边缘切除术以预防ONJ时需要更加谨慎。

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