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Scientific Oral Presentation

Head and Neck Surgery

Temporal Trends in Treatment Modalities for Osteoradionecrosis in Head and Neck Cancer

Sunday, October 18, 2026
3:00 PM - 3:06 PM PT
Location: West Exhibit Hall A, Learning Zone 3

    Presenting Author(s)

  • Allen A. Khudaverdyan, BA

    Medical Student
    NYU Grossman School of Medicine
    New York, NY, United States

    • Co-Author(s)

  • Christie Hung, BA

    Medical Student
    New York University Grossman School of Medicine
    New York, New York, United States

    • Co-Author(s)

  • CH

    Colin Hill, MD

    Assistant Professor, Department of Radiation Oncology
    New York University Grossman School of Medicine, United States

    • Senior Author(s)

  • LM

    Lindsey E. Moses, MD

    Attending Physician
    NYU Langone
    Brooklyn, NY, United States

Disclosure(s):
Allen A. Khudaverdyan, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Lindsey E. Moses, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Osteoradionecrosis (ORN) in head and neck cancer is typically caused by radiation-induced tissue damage. With advancements in radiation techniques, such as intensity-modulated radiation therapy, and studies showing the effectiveness of medications such as pentoxifylline and vitamin E in treating early-stage disease, management recommendations for ORN have shifted over time. We aim to evaluate how treatment practices have evolved in response.

Methods: Patients with a history of mucosal head and neck cancer and diagnosis of ORN were identified using ICD-10 code M27.2 (inflammatory condition of the jaw) between January 1, 2016, and December 17, 2025, in Epic Cosmos, a database that includes >300 million patients from >1800 hospitals and clinics across the United States. Treatment modalities evaluated include appointments with dentists, medical treatment with vitamin E and pentoxifylline, hyperbaric oxygen therapy (HBOT), and surgery (CPT codes: 21025, 21198, 11044, 20969, 15733, 21244, 21245).

Results: A total of 10,598 patients were identified with head and neck cancer and ORN. The rates of dental appointments documented in Epic was 43.9% of patients in 2016 and 44.6% of patients in 2025. Pentoxifylline usage increased from 15.1% of patients in 2016 to 23.0% of patients in 2025. Vitamin E usage also followed a similar trajectory, increasing from 11.4% of patients in 2016, to a peak of 16.4% of patients in 2023, to 14.2% of patients in 2025. While HBOT saw a peak utilization in 2020 at 27.5% of patients, its usage has been steadily declining to 22.9% of patients in 2025. Surgical excision rates have remained steady between 10% and 14% of patients since 2016, while reconstructive surgeries have increased from 5.2% of patients to 8.3% of patients in 2025.

Conclusions: This analysis suggests management of ORN is shifting away from HBOT and towards increased medical management with pentoxifylline and vitamin E, but without a notable reduction in the need for surgical intervention. These analyses highlight the multi-modal treatment modalities for ORN.