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Osteoradionecrosis

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https://www.readbyqxmd.com/read/28066911/outcomes-of-microvascular-free-tissue-transfer-in-twice-irradiated-patients
#1
Kate Clancy, Sami Melki, Musaddiq Awan, Shawn Li, Pierre Lavertu, Nicole Fowler, Min Yao, Rod Rezaee, Chad A Zender
BACKGROUND: Patients may require microvascular free tissue transfer (MFTT) following re-irradiation for recurrent cancer or radiation complications. The objective of this study was to describe the indications for and outcomes of free flaps performed in twice-radiated patients. METHODS: A retrospective chart review identified the indications for and outcomes of 36 free flaps performed on 29 twice-irradiated patients. RESULTS: The free flap success rate was 92%...
January 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#2
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28056334/immediate-microsurgical-bone-and-nerve-reconstruction-in-the-irradiation-treated-patient-a-case-report
#3
Ramzey Tursun, J Marshall Green
Microsurgical reconstructive techniques have revolutionized the treatment of large head and neck defects. These defects were once forever life altering because of the considerable morbidity to both the form and function of the patient. As time has progressed, microsurgical technique has improved dramatically and has become institutionalized in our training programs. Free flap outcomes in head and neck reconstruction have improved dramatically, and optimization of these outcomes is now key. One overlooked area has been neurosensory reconstruction...
December 11, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28043745/the-efficacy-of-hyperbaric-oxygen-therapy-related-to-the-clinical-stage-of-osteoradionecrosis-of-the-mandible
#4
F J Dieleman, T T T Phan, F J A van den Hoogen, J H A M Kaanders, M A W Merkx
This study aimed to evaluate the success of hyperbaric oxygen therapy (HBOT) and surgery in the treatment of mandibular osteoradionecrosis (ORN) in relation to the extent of the ORN. Twenty-seven patients with ORN were identified from a total of 509 patients with a history of primary oral or base of the tongue cancer; these patients had been treated with radiation therapy with curative intent between 1992 and 2006, with a radiation dose to the mandible of ≥50Gy. The ORN was staged according to the classification of Notani et al...
December 30, 2016: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28034471/pentoxifylline-a-review-of-its-use-in-osteoradionecrosis
#5
REVIEW
A J Lyons, P A Brennan
Pentoxifylline has been used to treat complications related to fibrosis for over 20 years. Formerly used to treat those after radiotherapy such as osteoradionecrosis (ORN), it is now being tried for medication-related osteonecrosis of the jaw (MRONJ), which can occur after prolonged use of bisphosphonates. We review theories on the formation of fibrosis in patients with ORN, discuss the pharmacology of pentoxifylline and vitamin E, and report published outcomes. To our knowledge no prospective randomised controlled trial has investigated the benefits of these agents in cases of ORN, but reported outcomes in many published case series are encouraging...
December 26, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28028129/long-term-outcomes-after-carbon-ion-radiotherapy-for-oral-mucosal-malignant-melanoma
#6
Kensuke Naganawa, Masashi Koto, Ryo Takagi, Azusa Hasegawa, Hiroaki Ikawa, Kazuo Shimozato, Tadashi Kamada, Yoshitaka Okamoto
Oral mucosal malignant melanoma (OMM) is extremely rare and has a poor prognosis. Owing to its rarity, it has not yet been possible to establish an optimal treatment modality. The objective of this study was to evaluate the long-term efficacy of carbon-ion radiotherapy (C-ion RT) for OMM. Between 1997 and 2013, 19 patients with OMM were treated with C-ion RT alone. Patient ages ranged from 44 to 84 years (median, 69 years). Nine men and 10 women were included. OMMs were restaged in accordance with the seventh edition of the tumour/node/metastasis (TNM) Staging System of the International Union Against Cancer...
December 26, 2016: Journal of Radiation Research
https://www.readbyqxmd.com/read/28027781/use-of-pentoxifylline-and-tocopherol-in-radiation-induced-fibrosis-and-fibroatrophy
#7
REVIEW
V Patel, M McGurk
Radiation-induced fibrosis in the head and neck is a well-established pathophysiological process after radiotherapy. Recently pentoxifylline and tocopherol have been proposed as treatments to combat the late complications of radiation-induced fibrosis and a way of dealing with osteoradionecrosis. They both have a long history in the management of radiation-induced fibrosis at other anatomical sites. In this paper we review their use in sites other than the head and neck to illustrate the potential benefit that they offer to our patients...
December 24, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28024727/refining-the-definition-of-mandibular-osteoradionecrosis-in-clinical-trials-the-cancer-research-uk-hopon-trial-hyperbaric-oxygen-for-the-prevention-of-osteoradionecrosis
#8
Richard Shaw, Binyam Tesfaye, Matt Bickerstaff, Paul Silcocks, Christopher Butterworth
INTRODUCTION: Mandibular osteoradionecrosis (ORN) is a common and serious complication of head and neck radiotherapy for which there is little reliable evidence for prevention or treatment. The diagnosis and classification of ORN have been inconsistently and imprecisely defined, even in clinical trials. METHODS: A systematic review of diagnosis and classifications of ORN with specific focus on clinical trials is presented. The most suitable classification was evaluated for consistency using blinded independent review of outcome data (clinical photographs and radiographs) in the HOPON trial...
January 2017: Oral Oncology
https://www.readbyqxmd.com/read/28024723/the-prevalence-and-risk-factors-associated-with-osteoradionecrosis-of-the-jaw-in-oral-and-oropharyngeal-cancer-patients-treated-with-intensity-modulated-radiation-therapy-imrt-the-memorial-sloan-kettering-cancer-center-experience
#9
Adepitan A Owosho, C Jillian Tsai, Ryan S Lee, Haley Freymiller, Arvin Kadempour, Spyridon Varthis, Adi Z Sax, Evan B Rosen, SaeHee K Yom, Joseph Randazzo, Esther Drill, Elyn Riedel, Snehal Patel, Nancy Y Lee, Joseph M Huryn, Cherry L Estilo
OBJECTIVE: To determine the prevalence and correlation of various risk factors [radiation dose, periodontal status, alcohol and smoking] to the development of osteoradionecrosis (ORN). PATIENTS AND METHODS: The records of 1023 patients treated with IMRT for oral cavity cancer (OCC) and oropharyngeal cancer (OPC) between 2004 and 2013 were retrospectively reviewed to identify patients who developed ORN. Fisher exact tests were used to analyze patient characteristics between ORN patients with OCC and OPC...
January 2017: Oral Oncology
https://www.readbyqxmd.com/read/27995119/fibular-flap-for-mandible-reconstruction-in-osteoradionecrosis-of-the-jaw-selection-criteria-of-fibula-flap
#10
Ji-Wan Kim, Jong-Hyun Hwang, Kang-Min Ahn
BACKGROUND: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27993571/delayed-tongue-necrosis-simultaneous-with-bilateral-osteoradionecrosis-of-the-jaw-secondary-to-head-and-neck-irradiation
#11
Marcos Martins Curi, Camila Lopes Cardoso, Anthony Froy Condezo Benites, Patrícia Martins Bueno
We present a rare case of massive tongue necrosis occurring simultaneously with bilateral osteoradionecrosis (ORN) of the jaw in a patient with a history of treatment, including surgery and postoperative radiotherapy, for a retromolar trigone carcinoma 8 years earlier. There is a distinct possibility that the extractions and administration of local anesthesia with a vasoconstrictor contributed to the onset of ORN; together, these events may have influenced the blood supply to the tongue. A glossectomy was performed after hyperbaric oxygen therapy...
October 15, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/27978875/-endoscopic-surgery-and-reconstruction-for-extensive-osteoradionecrosis-of-skull-base-after-radiotherapy-for-nasopharyngeal-carcinoma
#12
Z Chen, Q H Qiu, J B Zhan, Z C Zhu, Y Peng, H Liu
Objective: To investigate the clinical efficacy of endoscopic surgery for extensive osteoradionecrosis (ORN) of skull base in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods: Seventeen patients diagnosed as ORN of skull base after radiotherapy for NPC and underwent endoscopic surgery were retrospectively studied with their clinic data. Results: Based on the CT and endoscopic examination, all patients had large skull base defects with bone defects averaged 7.02 cm(2) (range, 3.60 - 14...
December 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#13
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27861470/-mandibular-osteoradionecrosis-orn-as-a-side-effect-of-head-and-neck-cancer-treatment-factors-that-induce-it
#14
José Francisco Gallegos-Hernández, Alejandro Reyes-Vivanco, Héctor Arias-Ceballos, Gerardo Gabriel Minauro-Muñoz, Alma Lilia Ortiz-Maldonado, Daniel Israel García-Ruiz, Martín Hernández-Sanjuán
INTRODUCTION: Osteoradionecrosis of the mandible is a relatively common complication in patients with head and neck cancer undergoing radiotherapy or concomitant chemoradiotherapy, characterized by exposure of the mandibular bone either in the mouth or in the facial skin, with no improvement with conservative treatment for six months. The risk factors are radiotherapy in head and neck region, lack of dental prophylaxis before treatment and dental extraction. MATERIAL AND METHODS: Retrospective observational study analyzing incidence and etiologic factors of osteoradionecrosis in 250 patients undergoing radiotherapy or combined treatment of cervicofacial area between 2002 and 2010...
November 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27823650/osteoradionecrosis-and-intensity-modulated-radiation-therapy-an-overview
#15
REVIEW
Francesca De Felice, Daniela Musio, Vincenzo Tombolini
Osteoradionecrosis (ORN) is an ongoing topic, especially about its definition, pathogenesis, staging system and management algorithm. But what about its real incidence in intensity modulated radiotherapy (IMRT) era? This paper discusses the mandible in radiation therapy planning as organ at risk and reviews the literature for evidence of radiation damage, discussing likely dose constraints and the use of IMRT to reduce radiation dose to this structure. PubMed search was performed.
November 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27812692/radiotherapy-characteristics-and-outcomes-for-head-and-neck-carcinoma-of-unknown-primary-vs-t1-base-of-tongue-carcinoma
#16
Ali Hosni, Peter R Dixon, Anupam Rishi, Michael Au, Wei Xu, Yuyao Song, Douglas B Chepeha, David P Goldstein, Shao Hui Huang, John Kim, Brian O'Sullivan, John Waldron, Scott V Bratman, John R de Almeida
Importance: Transoral robotic surgery- or transoral laser microsurgery-assisted lingual tonsillectomy may improve the identification rate of hidden base-of-tongue (BOT) carcinoma presenting as head or neck carcinoma of unknown primary (CUP) site. Objective: To evaluate the potential impact of lingual tonsillectomy in CUP site by comparing differences in radiotherapy volumes, dosimetry, and clinical outcomes for CUP site and T1-category BOT carcinoma. Design, Setting, and Participants: Retrospective study of 115 patients treated at a tertiary cancer center between January 1, 2005, and December 31, 2013, that included patients with BOT carcinoma (category T1N1-3M0) and CUP site (category T0N1-3M0) with known p16 status...
December 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27809693/clinical-outcome-and-health-related-quality-of-life-following-microsurgical-reconstruction-in-patients-with-oral-and-oropharyngeal-cancer
#17
Shems Al-Hayder, Jens Jørgen Elberg, Birgitte Charabi
CONCLUSION: Radial forearm free flap (RFFF) and fibula free flap (FFF) provide high safety and reliability with low incidence of free flap failure and an acceptable level of complications and health-related quality-of-life (HRQoL). OBJECTIVES: To determine the clinical outcomes and long-term HRQoL in patients with oral or oropharyngeal cancer following free flap reconstruction. METHODS: A retrospective review of medical records and self-administered HRQoL questionnaires, EORTC QLQ-C30, and -H&N35...
November 4, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27771829/a-retrospective-study-of-osteomyelitis-and-osteonecrosis-of-the-jaws-and-its-etiologic-implication-of-bisphosphonate-in-asians
#18
Sung Ok Hong, Chae-Yoon Lee, Junho Jung, Deog-Yoon Kim, Christian Walter, Yong-Dae Kwon
OBJECTIVE: The objective of this study were to find the annual case trend of inflammatory jawbone diseases and to investigate the impact of medication-related osteonecrosis of the jaws (MRONJ). MATERIAL AND METHODS: A retrospective study of 372 patients diagnosed with inflammatory jawbone condition except for alveolar osteitis from 2007 to 2015 was initiated. History taking and investigation of etiologic factors MRONJ, osteoradionecrosis (ORN), odontogenic infection, foreign body, and trauma were investigated...
October 22, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27747703/a-case-of-peri-implantitis-and-osteoradionecrosis-arising-around-dental-implants-placed-before-radiation-therapy
#19
Yuji Teramoto, Hiroshi Kurita, Takahiro Kamata, Hitoshi Aizawa, Nobuhiko Yoshimura, Humihiro Nishimaki, Kazunobu Takamizawa
A little is known about the effect of radiotherapy on the dental implants that have previously been osseointegrated and charged. Here, we reported a case of osteoradionecrosis which arose around dental implants placed before radiation therapy.
December 2016: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/27734822/the-side-effects-of-head-and-neck-tumors-radiotherapy
#20
REVIEW
Marta Skiba-Tatarska, Marta Kusa-Podkańska, Anna Surtel, Joanna Wysokińska-Miszczuk
Radiotherapy of head and neck tumours causes numerous complications in the oral cavity. The most frequent side effects are: mucositis, osteoradionecrosis, hypogeusia or dysgeusia, xerostomia, dental caries, dentinal hypersensitivity. It is recomended to prevent, reduce or relieve these complications in the oral cavity.
July 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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