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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

Beauvillain de Montreuil, G., Billet, J., Bonnet, J., Gordeff, A., Lagent, F. (1982). Les ostéradionécrosesand mandibulaires limitées. Traitement chirurgical conservateur précoce. Annales d'Otolaryngologie (Paris), 104: 579585.Google Scholar
Beumer, J., Harrison, R., Sanders, B., Kurrasch, M. (1984) Osteoradionecrosis: predisposing factors and outcome of therapy. Head and Neck Surgery, 6: 819827.CrossRefGoogle ScholarPubMed
Demard, F., Abbes, M., Cronier, C., Valliconi, J. (1975) L'oxygénothérapie hyperbare dans le radionécroses pelvibuccales. In: Cancers du Plancher de la Bouche. Cernea, P.Masson: Paris, p148152.Google Scholar
Dolezal, R. F., Baker, J. R., Krausse, C. J. (1982) Treatment of the patients with extensive osteoradionecrosis. Archives of Otolaryngology, 108: 179183.CrossRefGoogle Scholar
Ewing, J. (1926) Radiation osteitis. Acta Radiologica, 6: 339342.Google Scholar
Freestone, J. T., Look, F., Clauder, S. L. (1973) Intra-oral mandibular resections for osteoradionecrosis. Journal of Oral Surgery, 31: 861864.Google Scholar
Guttenberg, S. A. (1974) Osteoradionecrosis of the jaw. American Journal of Surgery, 127: 326332.CrossRefGoogle ScholarPubMed
Hart, G. B., Mainous, E. G. (1976) The treatment of radionecrosis with hyperbaric oxygen. Cancer, 37: 25802585.3.0.CO;2-H>CrossRefGoogle Scholar
Harvey, A. Z., Ruthcarr, (1982) Salvage of the exposed irradiated mandible. Plastic and Reconstructive Surgery, 72: 648653.Google Scholar
Marchetta, F. C., Sako, K., Holyoke, E. D. (1967) Treatment of osteoradionecrosis by intra-oral excision of mandible. Surgery, Gynecology and Obstetrics, 125: 10031008.Google Scholar
Marx, R. E., Johnson, R. P. (1987) Studies in radiobiology of osteoradionecrosis and their clinical significance. Oral Surgery Oral Medicine Oral Pathology, 164: 379390.CrossRefGoogle Scholar
Obwegeser, H., Sailer, H. F. (1978) Experience with intra-oral resection and immediate reconstruction in cases of radio-osteomyelitis of the mandible. Journal of Maxillo-Facial Surgery, 6: 257265.CrossRefGoogle Scholar
Rankow, R. M., Weisman, B. (1971) Osteoradionecrosis of the mandible. Annual of Otology, Rhinology and Laryngology, 80: 603611.CrossRefGoogle ScholarPubMed