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Management of Osteoradionecrosis of the Mandible in Patients with Oral and Oropharyngeal Cancers

Other Title
구강 및 구인두암 환자의 하악골에 발새한 방사선골괴사의 치료
Authors
정, 연훈; 이, 한국; 강, 성석; 최, 은창; 김, 귀언; 변, 성규; 차, 인호
Citation
Taehan Ibi Inhukwa Hakhoe chi, 43(10):1109-1115, 2000
Journal Title
Taehan Ibi Inhukwa Hakhoe chi; Journal of the Korean Otolaryngological Society; 대한이비인후과학회지
ISSN
1225-035X
Abstract
Background and Objectives : Osteoradionecrosis (ORN) of the mandible is one of the most serious

complications following radiotherapy for oral and oropharyngeal cancer. However, the predisposing

factors and clinical course of ORN are variable and its proper management is currently

undetermined. The objective of this study is to review our ORN cases and evaluate the treatment

methods.

Patients and methods : We retrospectively reviewed 57 cases of oral and orpharyngeal cancers,

where patients received combined surgery and radiotherapy from 1990 to 1998. Osteoradionecrosis

occurred in 5 cases, and we evaluated the predisposing factors, clinical course and results of

treatments. Four patients were treated with radical sequestrectomy and open reduction of

mandible., Of these four patients, three received the combined treatment with hyperbaric

oxygen(HBO) therapy, and one received the conservative treatment.

Results : four ORN cases occurred at the lateral mandibulotomy site and one case arose at the

opposite mandibular body unrelated to osteotomy. The interval between ORN and radiotherapy was

so variable as 3 to 140 months. Four patients were successfully treated with the combined

surgical and HBO therapies(3 cases) or with the conservative treatment (1 case). The remaining

case could not be controlled by surgical treatment without HBO.

Conclusion : Osteoradionecrosis usually occurred at lateral mandibulotomy sites, especially

combined with sagittal partial mandibulectomies. We recommend that lateral mandibulotomies

should, whenever possible, be avoided if the radiotherapy is planned postoperativiely. And the

patients who received radiotherapy at the mandible should be observed for osteoradionecrosis for

long time. Our treatment results suggest that a combined surgery with HBO therapy can be a

primary treatment modality for ORN.
Keywords
하악골방사선골괴사구강암구인두암고압산소치료OsteoradionecrosisOral and oropharyngeal cancerHyperbaric oxygen therapyMandible
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Journal Papers > School of Medicine / Graduate School of Medicine > Otolaryngology
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