When patients have a serious jaw bone problem caused by certain medications, doctors sometimes perform surgery to fix it. After surgery, doctors have traditionally used feeding tubes that go through the nose to help patients eat without disturbing their healing wounds. However, researchers wanted to know if this feeding tube method actually helps wounds heal better. They studied 68 patients and compared those who used feeding tubes to those who ate a clear liquid diet by mouth. Surprisingly, both groups healed equally well, and both groups reported similar quality of life. This suggests that patients might not need the uncomfortable feeding tubes after this type of jaw surgery.

The Quick Take

  • What they studied: Does using a feeding tube through the nose help jaw wounds heal better after surgery for a bone disease caused by certain cancer medications?
  • Who participated: 68 patients who had surgery for medication-related jaw bone death. Researchers compared 36 patients using feeding tubes with 32 patients eating clear liquids by mouth.
  • Key finding: About 61% of feeding tube patients and 63% of regular diet patients had complete wound healing after 14 days. There was no meaningful difference between the two groups in healing speed, healing quality, or how patients felt about their oral health.
  • What it means for you: If you need this type of jaw surgery, you may not need an uncomfortable feeding tube. Eating clear liquids by mouth appears to work just as well. However, always follow your doctor’s specific recommendations, as individual cases may differ.

The Research Details

This was a comparison study where researchers looked back at medical records of 68 patients who had surgery for a serious jaw bone condition called medication-related osteonecrosis of the jaw (MRONJ). This condition happens when certain cancer medications damage the jaw bone. The researchers divided patients into two groups: one group used feeding tubes inserted through the nose (36 patients), and another group ate clear liquids by mouth (32 patients). Both groups were matched as closely as possible so they would be similar in other ways.

The researchers checked how well wounds were healing at specific time points: 1 day, 5 days, and 14 days after surgery. They used three different methods to measure healing: they looked at whether the wound appeared completely healed or not, they used a scoring system called the Early Healing Score, and they used another scale called the Inflammatory Proliferative Remodeling Scale. They also asked patients to fill out a questionnaire about how their oral health affected their daily life and overall well-being.

This type of study is valuable because it looks at real-world outcomes in actual patients rather than in a laboratory setting. By comparing two similar groups receiving different feeding methods, researchers could see if the feeding method itself made a difference in healing.

Understanding whether feeding tubes actually improve healing is important because these tubes are uncomfortable for patients. They can cause irritation in the nose and throat, and many patients dislike using them. If feeding tubes don’t actually help healing, then patients could avoid this discomfort. This research helps doctors make better decisions about what to recommend to patients after surgery.

This study has some strengths and some limitations. A strength is that researchers carefully matched patients in both groups so they would be similar in important ways. They also used multiple methods to measure healing, which gives a more complete picture. However, because this was a retrospective study (looking back at past records rather than planning the study in advance), there could be some bias in how patients were selected for each group. The sample size of 68 patients is moderate—larger studies might give more definitive answers. The study was conducted at what appears to be a specialized medical center, so results might not apply to all hospitals or all patient populations.

What the Results Show

The main finding was that wound healing was nearly identical between the two groups. In the feeding tube group, 61.1% of patients had complete wound healing by day 14, while in the clear liquid diet group, 62.5% had complete healing. This tiny difference of 1.4% is not statistically significant, meaning it could easily be due to chance rather than the feeding method.

When researchers used the Early Healing Score (a detailed measurement of how well wounds were healing), the feeding tube group averaged 18.08 points while the clear liquid group averaged 18.03 points—essentially identical. Similarly, when they used the Inflammatory Proliferative Remodeling Scale (which measures the healing process in detail), the feeding tube group scored 14.36 while the clear liquid group scored 14.66. Again, these differences were not statistically significant.

For quality of life, researchers asked patients about how their oral health affected their daily activities, comfort, and well-being using a standardized questionnaire. There was no meaningful difference between the two groups. This suggests that patients using feeding tubes did not experience worse quality of life than those eating by mouth, and vice versa.

These results were consistent across all three time points measured (days 1, 5, and 14), suggesting that the feeding method did not affect healing at any stage of recovery.

An interesting secondary finding was that patients’ negative feelings about feeding tubes did not translate into worse quality of life scores. Even though feeding tubes are generally disliked, patients using them reported similar satisfaction with their oral health and daily functioning as those eating regular clear liquids. This suggests that while feeding tubes may be uncomfortable, they don’t necessarily make patients feel significantly worse about their overall oral health situation.

Traditionally, doctors have recommended feeding tubes after this type of jaw surgery based on the theory that keeping food away from the surgical site would help it heal better. This study challenges that assumption by showing that a clear liquid diet—which still allows patients to eat and drink by mouth—works just as well. This finding aligns with a broader trend in medicine toward less invasive approaches when they produce equal results. However, more research is needed to confirm these findings in larger groups of patients and at different medical centers.

Several limitations should be considered. First, this was a retrospective study, meaning researchers looked back at past medical records rather than planning the study in advance and randomly assigning patients to groups. This could introduce bias in which patients ended up in which group. Second, the study included only 68 patients, which is a relatively small number. Larger studies might reveal differences that weren’t apparent here. Third, the study was conducted at a single specialized medical center, so results might not apply to all hospitals or all types of patients. Fourth, researchers only followed patients for 14 days after surgery, so we don’t know about longer-term healing or complications. Finally, the study didn’t include information about whether patients actually followed their assigned diet or if some patients switched between methods.

The Bottom Line

Based on this research, patients undergoing surgery for medication-related jaw bone disease may not need a feeding tube after surgery. A clear liquid diet eaten by mouth appears to work just as well for healing and quality of life. However, this recommendation comes with moderate confidence because the study was relatively small and conducted at a single center. Always discuss feeding options with your surgical team, as individual cases may require different approaches based on the extent of surgery, other health conditions, or personal circumstances.

This research is most relevant to patients scheduled for surgery to treat medication-related osteonecrosis of the jaw (MRONJ), which typically occurs in cancer patients taking certain bone-strengthening medications. It’s also important for surgeons and doctors who treat these patients. Patients with other types of jaw surgery or oral surgery might not benefit from these findings, as different procedures may have different healing requirements. If you have questions about whether these findings apply to your situation, discuss them with your surgical team.

Based on this study, you can expect to see clear signs of wound healing within 14 days after surgery, regardless of whether you use a feeding tube or eat clear liquids by mouth. Most patients in both groups showed complete healing by this point. However, complete healing of deeper tissues may take longer, and your doctor will give you specific guidance about when you can return to normal eating and activities.

Want to Apply This Research?

  • Track your wound healing progress by photographing your surgical site at the same time each day (if safe and appropriate) and noting the date. Also track any pain levels, swelling, or signs of infection. Rate your comfort with eating and drinking on a scale of 1-10 daily. This helps you and your doctor monitor recovery objectively.
  • If your doctor approves a clear liquid diet instead of a feeding tube, use the app to plan and track your clear liquid intake throughout the day. Set reminders to eat or drink at regular intervals to ensure adequate nutrition. Log what you consume (broths, juices, gelatin, etc.) and how you feel after eating to identify any foods that irritate your healing wound.
  • Create a daily healing checklist in the app covering: wound appearance (redness, swelling, discharge), pain level, diet tolerance, and overall comfort. Take weekly photos of the surgical site (if appropriate) and upload them to track visible progress. Set weekly check-in reminders to review your healing trajectory and flag any concerning changes to discuss with your doctor.

This research suggests that feeding tubes may not be necessary after certain jaw surgeries, but this does not replace personalized medical advice from your surgical team. Every patient’s situation is unique, and your doctor may recommend a feeding tube based on your specific condition, the extent of your surgery, other health factors, or complications. Always follow your surgeon’s recommendations and discuss any concerns about feeding methods before or after surgery. If you experience signs of infection, severe pain, difficulty swallowing, or other complications, contact your healthcare provider immediately. This information is for educational purposes and should not be used to make medical decisions without consulting your doctor.