The Missed Diagnosis of Sigmund Freud’s Maxilla Osteoradionecrosis
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Osteoradionecrosis
Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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Osteoradionecrosis
Mandible (arthropod mouthpart)
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Osteoradionecrosis is a common and severe complication after radiotherapy of head and neck cancer,and it is difficult for clinicians to deal with.The development of osteoradionecrosis is slow and can persist for a long time,and the pathogenesis of osteoradionecrosis is not clear.There is no uniform standard for the treatment of ORN.This review focused on the research advances in the definition,pathogenesis,risk factors,prevention and treatment of osteoradionecrosis.
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早期舌がんの放射線治療に伴う下顎骨壊死の発生を抜歯処置との関連で検討した。国立がんセンター中央病防で1975年から1990年の間に早期舌がんに対し組織内照射治療を受けた114人のうち21人 (18.4%) に放射線性下顎骨壊死が発生した。下顎骨壊死の発生率は, 放射線治療前抜歯群 (20.9%), 非抜歯群 (16.9%) で有意な差は認めなかった。つまり, 放射線性骨壊死を回避するための治療前抜歯は, 下顎骨壊死発生の減少に有効とは言えなかった。しかし治療前抜歯群での下顎骨壊死は非抜歯群に比べ治療後早期 (2年以内) に発生する傾向があることが示唆された。下顎骨の被爆線量を軽減するためのスベーサーは, 下顎骨壊死発生を回避するのに有効で, 舌がん組織内照射治療において不可欠な装置であると考えられた。
Osteoradionecrosis
Dental extraction
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Osteoradionecrosis is one of the most serious and devastating complications of radiotherapy. The proper management of osteoradionecrosis is currently undetermined. The objective of this study is to evaluate the treatment results of a systematic approach to osteoradionecrosis.A prospective study of a systematic approach to osteoradionecrosis in the head and neck area was undertaken.From July 1993 to June 1998, 33 cases of osteoradionecrosis in the head and neck area were treated using a systematic approach that combined sequestrectomy and hyperbaric oxygen therapy.Seven (21%) had recurrent cancer. The control rate of the other 26 osteoradionecrosis cases was 77% (20/26).Persistent osteoradionecrosis, despite diligent radical treatment, raises the suspicion of recurrent cancer. Extensive osteoradionecrosis with a multiple discharging fistula, a large area of exposed necrotic bone, or a coexistent fracture should be treated primarily with radical sequestrectomy and microvascular free flap reconstruction. Surgery still plays a major role in controlling osteoradionecrosis, and hyperbaric oxygen therapy is adjuvant.
Osteoradionecrosis
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Osteoradionecrosis
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Osteoradionecrosis
Quality of evidence
Dental extraction
Evidence-Based Medicine
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Osteoradionecrosis
Etiology
Mandible (arthropod mouthpart)
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Osteoradionecrosis
Mandibular Diseases
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