D105. Comparison Of Complication Rates for Head and Neck Reconstructive Surgery Between Medication Related Osteonecrosis of the Jaw, Osteoradionecrosis, Benign Lesions, and Malignant Cancers

PURPOSE: Current findings show that medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) have higher postoperative complication rates than benign lesions following reconstruction. Although malignant cancer reconstructive surgeries also face increased complications, MRONJ and ORN often lead to more severe and chronic problems. This study examines complication rates following head and neck (H&N) reconstruction across these disease processes. METHODS: A retrospective chart review identified patients who underwent H&N reconstruction at a single institution from 2016 to 2024. Patients were categorized by disease type: Cancer, Benign Lesion, ORN, MRONJ, or Other. Demographics, including social vulnerability index (SVI) quartile (1st being least vulnerable and 4th being most), and complication data were collected. Mean complication rates were calculated for total, within 30 days post-op, and beyond 30 days post-op. ANOVA and Post-hoc tests were used to assess significance (p<0.05). RESULTS: Out of 121 patients, disease cohorts included: cancer (60.33%, n=73), benign lesions (20.66%, n=25), ORN (3.30%, n=4), MRONJ (5.79%, n=7), and Other (9.92%, n=12). Complication rates beyond 30 days post-op were SVI 1 (39%), SVI 2 (36%), SVI 3 (18%), and SVI 4 (59%) (p=0.014). Significant differences were found between SVI 3 and SVI 4 (p=0.007). CONCLUSION: There were no significant differences in complication rates between disease processes. SVI 4 patients may experience more complications due to poorer living conditions and healthcare access, while SVI 3 patients might have lower complication rates due to loss to follow-up. These findings emphasize the importance of considering patient population factors post-operatively to optimize outcomes.