Abstract
BACKGROUND: In patients with medication-related osteonecrosis of the jaw (MRONJ), the use of nasogastric tubes (NGTs) after surgery is recommended to allow adequate nutrition without food interfering with oral wound healing. However, NGT therapy is often perceived as irritating and rejected by some patients. This study evaluates the effect of NGT feeding on oral wound healing and patients' oral health-related quality of life (OHRQoL) after surgical treatment of MRONJ. METHODS: We assessed early wound healing in 68 patients after Surgery for MRONJ. Postoperative comparison was made between patients with NGT feeding and a matched control group receiving an oral clear liquid diet. At 14 days postoperatively, the healing of the surgical site was morphologically classified as "complete" or "incomplete". The Early Healing Score (EHS) and the Inflammatory Proliferative Remodeling (IPR) Scale were examined on Days 1, 5 and 14 after surgery. The German version of the Oral Health Impact Profile-14 (OHIP-G 14) was used to assess OHRQoL. RESULTS: No significant difference was observed in the rate of complete wound healing in patients receiving NGT feeding (61.1%) compared to patients receiving an oral clear liquid diet (62.5%) at 14 days postoperatively. The mean total EHS and the IPR Scale were not significantly different between patients on NGT feeding (EHS: 18.08 ± 5.35, IPR Scale: 14.36 ± 3.08) and patients on an oral clear liquid diet (EHS: 18.03 ± 5.26, IPR Scale: 14.66 ± 3.24). Furthermore, there was no significant difference in the mean OHIP-G 14 total score regardless of NGT therapy or consumption of an oral clear liquid diet. CONCLUSIONS: The results indicate that postoperative NGT feeding has no beneficial effect on wound healing after surgical treatment of MRONJ. It can be assumed that NGT feeding can be replaced by an oral clear liquid diet after surgery for MRONJ without compromising oral wound healing. Additionally, our data suggest that there is no difference in OHRQoL between patients treated with an NGT and those treated with an oral clear liquid diet. Therefore, patients' negative perceptions of NGTs do not appear to affect OHRQoL. TRIAL REGISTRATION: The trial was retrospectively registered with the German Clinical Trials Register on February 26, 2024 (DRKS00033706).