Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients—a report of a thirty year retrospective review
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Osteoradionecrosis
Etiology
Mandible (arthropod mouthpart)
Osteoradionecrosis
Free flap reconstruction
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Objective: Osteoradionecrosis (ORN) is a severe and devastating late complication of radiotherapy in patients with head and neck cancer, especially in the mandible. Methods: We report a case of a 47-year-old woman who suffering from osteoradionecrosis and bone exposure 5 yearsafter irradiation therapy for Squamous Cell Carcinoma (SCC) of the tounge. Segmented resection of the mandible was performed followed with reconstruction using plate.Results: ORN can cause pathological fracture of the mandible and should be treat with surgical approach Conclusion: ORN affects the mandible more often than the maxilla or any other bones of head and neck, since it has high density and low blood vasculature so can cause pathological fracture of the mandible. Preventive measures must be evaluated to reducing the risk or severity of ORN
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OBJECTIVE To assess the effectiveness and reliability of free flap transfer for treating the advanced osteoradionecrosis (ORN) of mandible. METHODS Eleven cases of free flap transfer for treating the advanced ORN of mandible from October 1999 to February 2003 were reviewed. Data concerning the operation included site, stage and histology of primary tumor, dosage of radiotherapy, defect description, design of free flap, recipient vessel, free flap survival and complications. RESULTS There were 8 males and 3 females, with age ranged 29-65 years old. Fifteen free flaps were used for reconstructing the defects, 12 were fibula flap, 2 were rectus abdominis myocutaneous flap, and 1 was radial forearm flap. All the free flaps survived completely without partial or total necrosis. The complication rate was 36.4%. All patients had complete resolution of ORN symptoms. No evidence of ORN recurrence was observed in any patient. CONCLUSION Free flap transfer provides a reliable and effective means for treating the advanced ORN of mandible. Free fibula flap is the workhorse flap for reconstruction of mandible.
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Osteoradionecrosis
Mandible (arthropod mouthpart)
Debridement (dental)
Mandibular Diseases
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Osteoradionecrosis
Mandible (arthropod mouthpart)
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Osteoradionecrosis
Mandible (arthropod mouthpart)
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Los Angeles, Calif. From the Division of Plastic Surgery at the UCLA Medical Center. Received for publication November 16, 1982; revised January 7, 1983.
Osteoradionecrosis
Mandible (arthropod mouthpart)
Debridement (dental)
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Osteoradionecrosis (ORN) of the jaws, particularly of the mandible, is a long-term and serious complication of therapeutic radiotherapy for head and neck cancer. The mandible is affected more commonly than any other bones of the head and neck region. The incidence of ORN of mandible is reported to be between 2% and 22%. With the older radiation techniques, the rate of ORN was reported to be between 5% and 15%, whereas with newer techniques such as 3D conformal therapy and intensity modulated radiotherapy the rate of ORN has decreased to 6% or less. We here report a case of mandibular ORN and the literature review discusses the clinical features, pathogenesis, preventive measures, and management of ORN.
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