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Osteoradionecrosis of the mandible: Study of 104 cases treated by hemimandibulectomy

Published online by Cambridge University Press:  29 June 2007

V. N. Koka
Affiliation:
Paris, France
R. Deo
Affiliation:
Paris, France
A. Lusinchi
Affiliation:
Paris, France
J. Roland
Affiliation:
Paris, France
G. Schwaab*
Affiliation:
Paris, France
*
Dr. G. Schwaab, Chef de Service Department de Chirurgie Cervico Faciale et ORL, Institut Gustave Roussy, Rue Camille Desmoulins, 94805 Villejuif, Cedex, France

Abstract

One hundred and four cases of osteoradionecrosis (ORN) of the mandible following irradiation of head and neck cancer are reported.

Conservative management for ORN failed in all cases. Indications of hemimandibulectomy included intractable pain, severe trismus, pathological fracture, oro-cutaneous fistula and persistent exposure of bone.

Surgical approach was intra-oral in 100 cases and extra-oral in four. Immediate soft tissue reconstructions were carried out in 20 per cent cases. Post-operative complications included minor sepsis (8.6 per cent), major sepsis (2.9 per cent), haemorrhage (2.9 per cent) and fistula (3.8 per cent). Major complications occurred only in patients treated exclusively by external irradiation at doses equal to or higher than 65 Gy.

Relief from pain and trismus was obtained and normal swallowing was established following radical surgery.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1990

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References

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