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Osteoradionecrosis

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https://www.readbyqxmd.com/read/28209748/the-use-of-hyperbaric-oxygen-for-the-prevention-and-management-of-osteoradionecrosis-of-the-jaw-a-dana-farber-brigham-and-women-s-cancer-center-multidisciplinary-guideline
#1
REVIEW
Ahmed Sultan, Glenn J Hanna, Danielle N Margalit, Nicole Chau, Laura A Goguen, Francisco M Marty, Guilherme Rabinowits, Jonathan D Schoenfeld, Stephen T Sonis, Tom Thomas, Roy B Tishler, Nathaniel S Treister, Alessandro Villa, Sook-Bin Woo, Robert Haddad, Hani Mawardi
BACKGROUND: Osteoradionecrosis of the jaw (ORN) is an infrequent yet potentially devastating complication of radiation therapy to the head and neck region. Treatment options include antimicrobial therapy, local sequestrectomy, resection, and the use of hyperbaric oxygen (HBO). Published data on ORN are difficult to compare because of the lack of a universally accepted classification and staging system, and the literature on the use of HBO to either prevent or successfully manage ORN is controversial and inconclusive...
February 16, 2017: Oncologist
https://www.readbyqxmd.com/read/28186845/image-findings-of-bisphosphonate-related-osteonecrosis-of-jaws-comparing-with-osteoradionecrosis
#2
Kenichi Obinata, Shinichi Shirai, Hitoshi Ito, Motoyasu Nakamura, Marco Carrozzo, Iain Macleod, Andrew Carr, Yutaka Yamazaki, Kanchu Tei
OBJECTIVES: The aim of this study was to evaluate image characteristics of bisphosphonate related osteonecrosis of the jaws (BRONJ) and compare these with osteoradionecrosis (ORN). METHODS: Thirty-four patients with BRONJ and 16 patients with ORN were included in this study. We investigated the computed tomography (CT) and Dental Panoramic Radiograph (DPR) images for osteolysis, osteosclerosis, sequesteration, periosteal reaction, pathological fracture, and spread of soft tissue inflammation around the jaws...
February 10, 2017: Dento Maxillo Facial Radiology
https://www.readbyqxmd.com/read/28184080/the-financial-burden-for-the-surgical-management-of-osteoradionecrosis
#3
V Patel, L Ormondroyd, A Lyons, M McGurk
Osteoradionecrosis (ORN) remains a difficult clinical problem. In large refractory cases surgery appears to be the only option but it does not guarantee a cure and is expensive. Cost analysis of 31 patients who had resection with or without reconstruction of their mandible was £892,357. The largest cost was in-patient stay, which accounted for 62% of the total. This article explores in detail the expenditure associated with major ORN surgery and its subsequent implications.
February 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28141179/pedicled-temporalis-muscle-flap-stuffing-after-a-lateral-temporal-bone-resection-for-treating-mastoid-osteoradionecrosis
#4
Junming Chen, Feng Lin, Zhen Liu, Youjun Yu, Yuejian Wang
Objective The aim of this study was to compare the outcomes of lateral temporal bone resection and pedicled temporalis muscle flap stuffing with external auditory canal closure with those of canal wall down mastoidectomy for the treatment of mastoid osteoradionecrosis. Study Design Prospective nonrandomized case-control clinical study. Setting Department of Otolaryngology of the First People's Hospital of Foshan. Subjects and Methods Seventy-seven postirradiation nasopharyngeal carcinoma patients with mastoid osteoradionecrosis were included...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28124630/cost-analysis-of-osteoradionecrosis
#5
L Park, N Lilic, B Addison, R Patel
OBJECTIVE: Osteoradionecrosis is a significant complication of head and neck cancer treatment, and its most severe form (grade III) necessitates radical surgery. This study aimed to compare the cost of free-flap reconstructive surgery for grade III osteoradionecrosis and similar non-osteoradionecrosis cases in order to assess the cost burden of osteoradionecrosis treatment. METHODS: All patients who underwent free-flap reconstructive surgery for osteoradionecrosis between July 2004 and July 2010 at Auckland City Hospital (19 patients) were identified, and relevant data were collected retrospectively...
January 26, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28116973/human-adipose-derived-mesenchymal-stem-cells-for-osseous-rehabilitation-of-induced-osteoradionecrosis
#6
Jeffrey R Janus, Ryan S Jackson, Katherine A Lees, Stephen G Voss, Zachary C Wilson, Nicholas B Remmes, Michael G Keeney, Joaquin J Garcia, Serban San Marina
Objective Human adipose-derived mesenchymal stem cells (ADSCs) were used to rehabilitate bone damaged by osteoradionecrosis (ORN) in an established animal model. Study Design Prospective animal study. Setting Academic department laboratory. Subjects and Methods After institutional review board and Institutional Animal Care and Use Committee approval, 24 athymic nude rats were divided into 5 groups: 4 groups irradiated (20 Gy) by brachytherapy catheter placed at the left hemimandible and 1 mock irradiation control (n = 4)...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28116418/-establishment-and-assessment-of-tibial-osteoradionecrosis-in-rats
#7
Wei Han, Yong Zhou, Yi-Qun Wu, Zhi-Yong Wang, Lei Zhang, Duo-Hong Zou, Kai Zhang, Yuan-Yin Wang, Jia-Cai He, Zhi-Yuan Zhang
PURPOSE: To establish a rat tibial osteoradionecrosis model and assess the model by observing clinical manifestation and histopathological examinations. METHODS: The right tibia of 6 Sprague Dawley (SD) rats (weighing 200-250 g) was irradiated by a linear accelerator (single fraction 15 Gy, total dose 60 Gy) every second week for four times. Hair and cutaneous changes of the irradiated region were observed one, two, three and four weeks after irradiation, respectively...
October 2016: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
https://www.readbyqxmd.com/read/28095728/dental-prophylaxis-and-osteoradionecrosis
#8
C T Chang, S P Liu, C H Muo, C H Tsai, Y F Huang
The aim of this study was to investigate the association of different dental prophylactic modalities and osteoradionecrosis (ORN) and determine the risk of ORN under different timing periods of scaling, with the use chlorhexidine mouth rinse after surgery and with different strategies of fluoride gel application in head and neck cancer (HNC) participants. A cohort of 18,231 HNC participants, including 941 ORN patients and 17,290 matched control cases, were enrolled from a Longitudinal Health Insurance Database for Catastrophic Illness Patients (LHID-CIP) in Taiwan...
January 1, 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28091874/the-influence-of-dental-treatment-on-the-development-of-osteoradionecrosis-after-radiotherapy-by-modern-irradiation-techniques
#9
Ramona Schweyen, Andreas Stang, Andreas Wienke, Alexander Eckert, Thomas Kuhnt, Jeremias Hey
OBJECTIVES: The aim of this study was to analyze the influence of dental treatment on the development of osteoradionecrosis (ORN) of the jaw. METHODS: This study included the data of 776 patients who underwent 3D-CRT or IMRT because of head and neck cancer. Sex, dental status before and after radiotherapy (RT), tumor site, bone surgery during tumor operation, concomitant chemotherapy, and the development of an advanced ORN were documented for each patient. The patients' dentitions before and after RT were classified into four groups with regard to the number and localization of the remaining teeth...
January 13, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28066911/outcomes-of-microvascular-free-tissue-transfer-in-twice-irradiated-patients
#10
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
#11
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-irradiated-patient-a-case-report
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
February 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
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