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Osteoradionecrosis

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https://www.readbyqxmd.com/read/29457320/restoration-of-facial-form-and-lip-competence-in-a-patient-with-a-midfacial-defect
#1
Melani Kapetanakos, Sarah Wisniewski, Marjorie Golden, Joseph Randazzo
Squamous cell carcinoma (SCC) of the head and neck can be treated with a combination of modalities. There is an esthetic and functional compromise with midfacial defects secondary to ablative surgery and adjuvant therapies for SCC. Osteoradionecrosis, tissue contracture, and trismus, are all negative side effects of treatment and can impact a patient's function and possibly their nutrition. In this report, we describe a procedure for fabrication of a prosthesis that provides cosmetic improvement and labial competence to maintain caloric intake...
February 18, 2018: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
https://www.readbyqxmd.com/read/29439883/endoscopic-surgery-for-delayed-sinonasal-complications-of-radiation-therapy-for-nasopharyngeal-carcinoma-a-subjective-outcome
#2
Rachel Shemesh, Eran E Alon, Iris Gluck, Arkadi Yakirevitch
PURPOSE: Delayed sinonasal complications of radiation therapy include choanal stenosis, osteoradionecrosis, chronic sinusitis, and intranasal synechiae. Only sporadic cases on their surgical treatment have been reported, with equivocal results. METHODS AND MATERIALS: We performed a prospective case series of all patients who had been surgically treated for delayed sinonasal complications of radiation therapy in our institution during the past 10 years. The inclusion criteria required ≥6 months of follow-up after surgery...
January 9, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29435836/oral-and-dental-health-in-head-and-neck-cancer-patients
#3
Joel B Epstein, Andrei Barasch
A diagnosis of head and neck cancer (HNC) is typically followed by therapy that is associated with immediate and long-lasting toxic consequences. HNC patients' oral health needs may be complex and are best addressed in multidisciplinary collaborative teams including surgical, medical, and radiation oncologists, dental providers, nutrition, speech/swallow specialists, and physical therapists. Oral health maintenance also requires patient compliance and caregiver support. The role of dental providers begins prior to cancer diagnosis and continues through survivorship...
2018: Cancer Treatment and Research
https://www.readbyqxmd.com/read/29432652/osteonecrosis-of-the-jaws-a-14-year-retrospective-survey-of-hospital-admissions
#4
Kelly McGowan, Saso Ivanovski, Caroline Acton
BACKGROUND: Osteonecrosis of the jaw (ONJ) is a serious complication of both radiation and antiresorptive therapies. This study aimed to determine how many patients have been treated for medication-related osteonecrosis of the jaws (MRONJ) and osteoradionecrosis (ORN), and whether the number of diagnoses has decreased over time with improved awareness and preventative measures. METHODS: Medical records at the Royal Brisbane & Women's Hospital, Gold Coast University Hospital, and Robina Hospital were reviewed to identify patients diagnosed with MRONJ and ORN between January 2003 - May 2017...
February 12, 2018: Australian Dental Journal
https://www.readbyqxmd.com/read/29387398/potential-role-of-post-treatment-follow-up-fdg-pet-ct-to-detect-mandibular-osteoradionecrosis-a-case-report
#5
Masaya Akashi, Satoshi Wanifuchi, Junya Kusumoto, Megumi Kishimoto, Yasumasa Kakei, Kazunobu Hashikawa, Takahide Komori
It was hypothesized that fluorodeoxyglucose (FDG) uptake on post-treatment follow-up positron emission tomography with computed tomography (PET CT; using PET CT to monitor and rule out recurrence and metastasis of head and neck carcinoma) would be useful for detecting and understanding the disease state of osteoradionecrosis (ORN) of the jaw. The present study included 14 patients who developed mandibular ORN following radiation therapy (RT) for head and neck cancer and underwent follow-up PET CT several times following RT...
January 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29360644/parameters-associated-with-mandibular-osteoradionecrosis
#6
William M Mendenhall, Carlos Suárez, Eric M Genden, Remco de Bree, Primož Strojan, Johannes A Langendijk, Antti A Mäkitie, Robert Smee, Avraham Eisbruch, Anne W M Lee, Alessandra Rinaldo, Alfio Ferlito
The objective of this review is to discuss factors related to the risk of osteoradionecrosis (ORN) and how to minimize the likelihood of this complication. A PubMed search for publications pertaining to ORN within the last 3 years was conducted revealing 44 publications. The bibliographies of these publications were reviewed to identify additional references spanning a longer time period. The incidence of ORN is 5% to 10% with a median latency period of 1 to 2 years or less. The likelihood of ORN depends on a number of factors including primary site and extent of disease, dental status, treatment modality, radiotherapy (RT) dose, volume of mandible included in the planning target volume, RT fractionation schedule and technique, and teeth extractions...
January 22, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29326769/osteoradionecrosis-in-subaxial-cervical-spine-a-rare-and-devastating-complication-a-case-report
#7
M Z Rashid, M H Ariffin, S A Rhani, A Baharudin, K Ibrahim
Osteoradionecrosis, a rare complication of radiation therapy, is a slow progression disease which affects the surrounding structures of spinal components. It essentially weakens the soft tissue and bony configuration and can cause nerve impingement or cord compression. We describe a patient who underwent radiotherapy for thyroid cancer and presented with cervical kyphosis with anterolisthesis of C3/C4 and C4/C5 some 32 years later. We explore the role of anterior and posterior fusion, as well as hyperbaric oxygen therapy in promoting healing...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29316962/hopon-hyperbaric-oxygen-for-the-prevention-of-osteoradionecrosis-a-randomised-controlled-trial-of-hyperbaric-oxygen-to-prevent-osteoradionecrosis-of-the-irradiated-mandible-study-protocol-for-a-randomised-controlled-trial
#8
Richard Shaw, Christopher Butterworth, Binyam Tesfaye, Matthew Bickerstaff, Susanna Dodd, Gary Smerdon, Seema Chauhan, Peter Brennan, Keith Webster, James McCaul, Peter Nixon, Anastasios Kanatas, Paul Silcocks
BACKGROUND: Osteoradionecrosis of the mandible is the most common serious complication of radiotherapy for head and neck malignancy. For decades, hyperbaric oxygen has been employed in efforts to prevent those cases of osteoradionecrosis that are precipitated by dental extractions or implant placement. The evidence for using hyperbaric oxygen remains poor and current clinical practice varies greatly. We describe a protocol for a clinical trial to assess the benefit of hyperbaric oxygen in the prevention of osteoradionecrosis during surgery on the irradiated mandible...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29303857/reconstruction-of-a-compound-oromandibular-defect-by-means-of-chimeric-scapular-parascapular-free-flap-assisted-by-virtual-surgical-planning
#9
Josué Hernando, Antonio Aguilar-Salvatierra, Ignacio Osoitz Leizaola-Cardesa, Juan Antonio Rad, Amaya Vicuña, Rafael Gómez, Javier Martín, Gerardo Gómez-Moreno
BACKGROUND: Reconstruction of an oromandibular defect presents a considerable surgical challenge. But since the advent of microvascularized free flap reconstructive surgery, outcomes have improved significantly so that today almost any defect may be reconstructed. Recently, virtual surgical planning has reduced surgical time, the morbidity associated with surgery, and surgical precision. OBJECTIVE: This article reports a complex patient with a composite oromandibular defect...
January 4, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29249017/teriparatide-therapy-for-severe-refractory-osteoradionecrosis-of-the-jaw
#10
Y H Cha, N Hong, Y Rhee, I-H Cha
Although osteoradionecrosis (ORN) is a serious complication of craniofacial radiotherapy, the current management methods remain suboptimal. Teriparatide (TPTD), a recombinant human parathyroid hormone (1-34), has shown beneficial effects on osseous regeneration in medication-related osteonecrosis of the jaw or periodontitis. However, TPTD therapy in irradiated bones has not been indicated yet because of the theoretical risk of osteosarcoma seen in rat models. Hence, we first report here two patients with tongue cancer with late-emerging ORN who were successfully treated with TPTD for 4-6 months with serum calcium and vitamin D supplementation...
December 16, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29224060/differences-between-osteoradionecrosis-and-medication-related-osteonecrosis-of-the-jaw
#11
Masaya Akashi, Satoshi Wanifuchi, Eiji Iwata, Daisuke Takeda, Junya Kusumoto, Shungo Furudoi, Takahide Komori
PURPOSE: The appearance of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) is similar, but clinically important differences between ORN and MRONJ exist. The aim of this study was to compare the clinical data between ORN and MRONJ and to reveal the critical differences between these diseases. METHODS: We retrospectively reviewed the epidemiological data, clinical findings, and treatment in 27 ORN and 61 MRONJ patients. Radiographic signs before the initiation of treatment were also assessed...
December 9, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29174551/surgical-management-of-severe-osteoradionecrosis-of-the-mandibular-bone-by-using-double-free-flap-reconstruction
#12
Niklas Rommel, Marco Rainer Kesting, Nils Hagen Rohleder, Klaus-Dietrich Wolff, Jochen Weitz
PURPOSE: Osteoradionecrosis (ORN) of the jaws represents one of the most severe complications after primary or adjuvant radiation therapy (RT) of large head and neck tumors. In advanced ORN cases, surgical management is generally considered the therapy of choice. However, in several severe ORN patients with extensive bone and soft tissue defects, functional and aesthetic reconstruction represents a huge challenge for any surgeon, with an increased risk of post-operative wound healing disorders...
January 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29172327/head-and-neck-cancer-patients-%C3%A2-information-for-the-general-dental-practitioner
#13
Jennifer Noone, Craig Barclay
Salivary gland damage is the most common adverse effect associated with radiation therapy to the head and neck. A combination of hyposalivation and dietary changes, with a reduced emphasis on oral hygiene practices can contribute to a massive increase in a person’s caries risk status. This can be further complicated by limited mouth opening. To enable optimal dental care for head and neck cancer patients before, during and after radiation therapy, patients must be informed and educated about the potential risks of dental caries and the preventive strategies available...
March 2017: Dental Update
https://www.readbyqxmd.com/read/29157550/imaging-of-radiation-and-medication-related-osteonecrosis
#14
REVIEW
Sanjay M Mallya, Sotirios Tetradis
Osteonecrosis is the devitalization of bone and consequent lytic changes. In the jaws, osteonecrosis is a pathologic consequence of prior radiation therapy (osteoradionecrosis) or certain antiresorptive medications. Herein, we review the pathogenesis and clinical manifestations of these lesions, and describe the spectrum of radiologic findings in these conditions, and highlight the similarities and differences between the imaging appearances of these 2 entities.
January 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29149496/predictive-factors-for-osteoradionecrosis-of-the-jaws-a-retrospective-study
#15
Hans P Sathasivam, Gareth R Davies, Nicholas M Boyd
BACKGROUND: Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ. METHODS: A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors...
November 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/29140591/preventive-effects-of-tonsil-derived-mesenchymal-stem-cells-on-osteoradionecrosis-in-a-rat-model
#16
Hae Sang Park, Jihae Lee, Jin-Woo Kim, Ha Young Kim, Soo Yeon Jung, Sung Min Lee, Chan Hum Park, Han Su Kim
BACKGROUND: The purpose of this study was to investigate the effects of tonsil-derived mesenchymal stem cells (MSCs) on osteoradionecrosis (ORN). METHOD: We generated a mandibular ORN rat model using a combination of 20-Gy single-dose irradiation and tooth extraction. Study groups were negative control (tooth extraction only), ORN group (irradiation, tooth extraction), Matrigel-1 group (Matrigel; BD Biosciences, San Jose, CA; irradiation, Matrigel application immediately after tooth extraction), tonsil-derived MSC-1 group (irradiation, tonsil-derived MSC application immediately after tooth extraction), Matrigel-4 group (irradiation, Matrigel application 4 weeks after tooth extraction), and tonsil-derived MSC-4 group (irradiation, tonsil-derived MSC application 4 weeks after tooth extraction)...
November 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/29140581/comparison-of-long-term-outcomes-between-pull-through-resection-and-mandibular-lip-split-surgery-for-t4a-tongue-floor-of-mouth-cancers
#17
Shih-Jung Cheng, Hui-Hsin Ko, Jang-Jaer Lee, Sang-Heng Kok
BACKGROUND: The purpose of this study was to determine whether the pull-through resection is better than the mandibular lip-split for advanced tongue/floor of mouth (FOM) cancers, which remains inconclusive. METHODS: A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers from 2009 to 2014. Cases with mandibular resection were excluded. The pull-through resection was used when the mouth opening was ≥15 mm; otherwise the mandibular lip-split was used...
January 2018: Head & Neck
https://www.readbyqxmd.com/read/29126490/dental-management-of-patients-who-have-undergone-oral-cancer-therapy
#18
REVIEW
Alessandro Villa, Sunday O Akintoye
Oral cancer therapies are associated with orofacial complications that could result in dose-limiting cancer treatment and consequent suboptimal tumor control. Oral cancer treatment complications include oral mucositis, salivary gland hypofunction, odontogenic infections, pain, dermatitis, neurotoxicity, soft tissue fibrosis, trismus, osteoradionecrosis, and potential cancer recurrence. These complications significantly affect cancer survivorship, quality of life, and psychosocial status. Effective dental management of patients with oral cancer involves the coordination of care among several health care professionals before, during, and after cancer therapy...
January 2018: Dental Clinics of North America
https://www.readbyqxmd.com/read/29126489/dental-treatment-planning-for-the-patient-with-oral-cancer
#19
REVIEW
Lauren E Levi, Rajesh V Lalla
Oral cancer therapy is associated with a multitude of head and neck sequelae that includes, but is not limited to, hyposalivation, increased risk for dental caries, osteoradionecrosis of the jaw, radiation fibrosis syndrome, mucositis, chemotherapy-induced neuropathy, dysgeusia, dysphagia, mucosal lesions, trismus, and infections. Preparing a comprehensive treatment plan for patients undergoing cancer therapy is essential to help minimize their risks for developing these oral and dental complications. In addition, dentists must take into account a patient's ongoing oncologic therapy for those patients who present to the dentist while concurrently receiving cancer treatment...
January 2018: Dental Clinics of North America
https://www.readbyqxmd.com/read/29123273/in-vivo-imaging-of-the-microvasculature-of-the-soft-tissue-margins-of-osteonecrotic-jaw-lesions
#20
P Bastos, V Patel, F Festy, N Hosny, R J Cook
Introduction Given the increasing incidence of medication-related jaw osteonecrosis, and recognition of the mucosal blood supply's importance, we have developed a non-invasive Real Time Optical Vascular Imaging (RTOVI) instrument. Imaging the red blood cells within the sub-mucosal capillary networks demonstrates the microcirculatory anatomy. We report a small trial, demonstrating the technique's viability, examining mucosal microcirculatory changes adjacent to osteonecrotic lesions.Aims Imaging the microvasculature of soft tissue margins of patients' exposed necrotic bone lesions in situ was intended to provide unique observational as well as quantitative data, using an image analysis routine, based on ImageJ software...
November 10, 2017: British Dental Journal
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