@hrhwilliam
Hi Mr Olsen,
I last messaged you in Sept 2025 after my diagnosis of osteoradionecrosis. I had an initial local consultation with a recommendation for the Fibular Free Flap procedure but with lots of dire warnings about surgical complications of inability to eat well, speak well, and even the ability to cover the surgical defect due to my previously irradiated and permanently scarred neck.
As I mentioned previously, I’m a retired family doc and decided to do an extensive literature search on other approaches. By God’s grace I learned about Dr Michael Fritz at Cleveland Clinic.
He and his team of ENT and reconstructive surgeons have developed a “rescue” surgery for those with ORN. Initially I thought I would not be a candidate since I had progressed to an actual mandibular fracture but he offered me a “rescue plus” procedure which I underwent in early November. It involves a titanium spanner to stabilize the jaw, bone graft from the iliac crest (hip bone), and a skin and soft tissue free flap that gets placed over the bone and with microvascular attachment to blood vessels in the temple area—and all done from inside the mouth!!
3 days in hospital, soft foods within a week, up and moving immediately, and no need for extensive rehab.
I just got cleared for unrestricted diet. My bone graft is coming along well. The only downside is that I’m not able to get any dental implants to replace the 3 back teeth that are now gone, so chewing only on one side of my mouth. I can live with that!
This may be a good option for those with early stage ORN of the jaw. Unfortunately I don’t think it has caught on with the other medical centers yet but hopefully the numbers will bear out this approach and help avoid the Fibular Free Flap for some.
Enjoy life everyone and persevere!
Dr. Mike