Hello @gregdwhipple and welcome to the Head and Neck group. Necrosis can lead to all sorts pains. Hopefully someone here has some ideas as to what might be able to keep the pain at bay. It’s odd that this is happening so far out from treatment rather than as part of the treatment recovery years ago. Maybe keep pestering doctors until a pinpoint of the pain can be determined and dealt with. Our bodies can deal with a lot of issues but pain is often the most difficult to live with.