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Osteoradionecrosis

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https://www.readbyqxmd.com/read/28746288/using-a-second-free-fibula-osteocutaneous-flap-after-repeated-mandibulectomy-is-associated-with-a-low-complication-rate-and-acceptable-functional-outcomes
#1
Alexander F Mericli, Mark V Schaverien, Matthew M Hanasono, Peirong Yu, Rene D Largo, Mark T Villa, Greg Reece, Charles E Butler, Patrick B Garvey
BACKGROUND: A significant percentage of patients who undergo segmental mandibulectomy for head and neck cancer will develop a new or recurrent cancer or osteoradionecrosis, necessitating a second mandibulectomy and reconstruction. In this scenario, many surgeons are reluctant to perform a reconstruction with an osseous flap because of the presumed increased morbidity and complexity. The purpose of this study was to evaluate the safety and efficacy of performing a second free fibula flap reconstruction after repeated segmental mandibulectomy...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28733053/dose-volume-correlates-of-mandibular-osteoradionecrosis-in-oropharynx-cancer-patients-receiving-intensity-modulated-radiotherapy-results-from-a-case-matched-comparison
#2
(no author information available yet)
PURPOSE: To determine dosimetric parameters associated with osteoradionecrosis (ORN) in oropharyngeal cancer (OPC) patients in the IMRT era. MATERIAL AND METHODS: Subsequent to institutional review board approval, we identified ORN in OPC patients treated with IMRT from 2002 to 2013. 1:2 case-control matching was implemented. Mandibular dose-volume histograms (DVH) were extracted. Dosimetric parameters were compared using non-parametric stats. Recursive partitioning analysis (RPA) was done to identify DVH correlates of ORN...
July 18, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28709531/bone-margin-analysis-for-osteonecrosis-and-osteomyelitis-of-the-jaws
#3
REVIEW
Mohammed Qaisi, Lindsay Montague
Bone margin analysis in cases of osteomyelitis, osteoradionecrosis, and medication-related osteonecrosis of the jaw is a controversial topic. There is little evidence to guide treatment and the interpretation of bone margin results. This article examines the significance of margin status and any possible effect on progression of the disease process. A review of various treatment adjuncts used for intraoperative margin analysis during removal of affected tissue is provided. Literature on the role of imaging is also discussed with regards to treatment planning for surgical resection...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28708656/osteoradionecrosis-of-the-zygoma
#4
Zhuo-Jue Liu, Xue-Peng Xiong, Yi-Fang Zhao
Osteoradionecrosis occurs in 4.74% to 37.5% of patients following radiation therapy for head and neck cancer. Osteoradionecrosis mostly happens in the mandible but seldom occurs in other maxillofacial bones. Here, the authors reported a rare case of zygomatic osteoradionecrosis which occurred after maxillectomy and then radiotherapy because of maxillary myoepithelial carcinoma. After resection of zygoma sequestrum, the defect was repaired with forehead flap and healed uneventfully.
July 13, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28688679/long-term-toxicities-in-10-year-survivors-of-radiation-treatment-for-head-and-neck-cancer
#5
Yanqun Dong, John A Ridge, Tianyu Li, Miriam N Lango, Thomas M Churilla, Jessica R Bauman, Thomas J Galloway
OBJECTIVES: To characterize the recognized but poorly understood long-term toxicities of radiation therapy (RT) for head and neck cancer (HNC). MATERIALS AND METHODS: We retrospectively evaluated patients treated with curative-intent RT for HNC between 1990 and 2005 at a single institution with systematic multidisciplinary follow-up ≥10years. Long-term toxicities of the upper aerodigestive tract were recorded and assigned to two broad categories: pharyngeal-laryngeal and oral cavity toxicity...
August 2017: Oral Oncology
https://www.readbyqxmd.com/read/28675541/novel-approach-to-maxillary-reconstruction-using-osteocutaneous-free-tissue-transfer-with-a-customized-stent
#6
Vivek R Varma, Yin Yiu, Meade Van Putten, Tiffany L Kessling, Enver Ozer, Amit Agrawal, Theodoros Teknos, Stephen Y Kang, Matthew O Old
BACKGROUND: Computer-guided 3D virtual planning and customized templates are novel and effective methods aiding maxillary reconstruction, particularly during osteocutaneous free tissue transfer of complex defects. However, virtual planning and modelling is often expensive. METHODS: We present a new method to reconstruct complex defects with a surgical stent designed from presurgical casts. We present 2 patients who underwent this technique. Reconstruction in both cases was aided by a surgical stent fashioned preoperatively to approximate the anatomic dimensions of the defect, guiding the shape and orientation of the flap during inset to aid in dental rehabilitation...
July 4, 2017: Head & Neck
https://www.readbyqxmd.com/read/28673362/clinical-outcomes-of-retrograde-intra-arterial-chemotherapy-concurrent-with-radiotherapy-for-elderly-oral-squamous-cell-carcinoma-patients-aged-over-80%C3%A2-years-old
#7
Yuichiro Hayashi, Kenji Mitsudo, Kaname Sakuma, Masaki Iida, Toshinori Iwai, Hideyuki Nakashima, Yoshiyuki Okamoto, Toshiyuki Koizumi, Senri Oguri, Makoto Hirota, Mitomu Kioi, Izumi Koike, Masaharu Hata, Iwai Tohnai
BACKGROUND: The aim of this retrospective observational study was to evaluate toxicities, overall survival, and locoregional control in elderly oral squamous cell carcinoma patients who had undergone retrograde intra-arterial chemotherapy combined with radiotherapy. METHODS: Thirty-one elderly patients over 80 years old with oral squamous cell carcinoma were enrolled in present study. The treatment schedule consisted of intra- arterial chemotherapy (docetaxel, total 60 mg/m(2); cisplatin, total 150 mg/m(2)) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks...
July 3, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28649774/osteoradionecrosis-of-the-jaws-definition-epidemiology-staging-and-clinical-and-radiological-findings-a-concise-review
#8
REVIEW
Aristeidis Chronopoulos, Theodora Zarra, Michael Ehrenfeld, Sven Otto
Osteoradionecrosis (ORN) of the jaws is a pernicious complication of radiation therapy for head and neck tumours. This article aims to provide an update on data related to the definition, epidemiology, staging, and clinical and radiological findings of ORN of the jaws. Using certain keywords, an electronic search was conducted spanning the period from January 1922 to April 2014 to identify the available related investigations. Pooled data were then analysed. ORN is described as exposed irradiated bone that fails to heal over a period of 3 months without evidence of persisting or recurrent tumour...
June 25, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28638295/eagle-syndrome-secondary-to-osteoradionecrosis-of-the-styloid-process
#9
Anna K Bareiss, David Z Cai, Amit S Patel, Brian A Moore
BACKGROUND: Eagle syndrome is a rare condition caused by elongation of the styloid process or ossification of the stylohyoid ligament. The symptomatology can be vague but may include dysphagia, odynophagia, otalgia, foreign body sensation, facial pain, trismus, headache, tinnitus, increased salivation, and/or voice changes. CASE REPORT: We present the case of a 58-year-old male believed to have acquired Eagle syndrome secondary to osteoradionecrosis of the styloid process following radiation therapy used as adjuvant treatment for a surgically resected pT2N1M0 squamous cell carcinoma of the right tonsil...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28615689/nomogram-model-to-predict-postoperative-infection-after-mandibular-osteoradionecrosis-surgery
#10
Zhonglong Liu, Tianguo Dai, Zhonghe Wang, Zhiyuan Zhang, Weiliu Qiu, Yue He
Osteoradionecrosis of the mandible (ORNM) is one of the most dreaded complications of radiotherapy. The poor healing capacity of soft tissue after radiation may lead to surgical failure. The current study was designed to identify prognostic factors for postoperative infection (PPI) and propose corresponding prophylaxis and intervention protocols. A retrospective study was conducted concerning ORNM patients from 2000 to 2015. A risk-stratification score and nomogram model were established to predict the risk of PPI...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28608925/osteoradionecrosis-of-the-mandible-in-patients-with-oropharyngeal-carcinoma-treated-with-intensity-modulated-radiotherapy
#11
Francesca Caparrotti, Shao Hui Huang, Lin Lu, Scott V Bratman, Jolie Ringash, Andrew Bayley, John Cho, Meredith Giuliani, John Kim, John Waldron, Aaron Hansen, Li Tong, Wei Xu, Brian O'Sullivan, Robert Wood, David Goldstein, Andrew Hope
BACKGROUND: Osteoradionecrosis (ORN) of the mandible is a late toxicity affecting patients treated with radiotherapy for head and neck malignancies. To the authors' knowledge, ORN has no standardized grading system and its reporting is based on retrospective findings in heterogeneous patient populations. The rate of ORN in the era of intensity-modulated radiotherapy (IMRT) still is unknown. METHODS: The authors report the incidence of ORN from prospectively collected data regarding 1196 patients who were diagnosed with squamous cell carcinoma of the oropharynx and treated with curative-intent IMRT, with or without concomitant systemic treatment, from January 2005 to December 2014...
June 13, 2017: Cancer
https://www.readbyqxmd.com/read/28606831/relationship-between-dental-status-and-development-of-osteoradionecrosis-of-the-jaw-a-multicenter-retrospective-study
#12
Yuka Kojima, Souichi Yanamoto, Masahiro Umeda, Yumiko Kawashita, Izumi Saito, Takumi Hasegawa, Takahide Komori, Nobuhiro Ueda, Tadaaki Kirita, Shin-Ichi Yamada, Hiroshi Kurita, Yasuko Senga, Yasuyuki Shibuya, Hiroshi Iwai
OBJECTIVE: Osteoradionecrosis of the jaw is a serious late adverse event in patients with head and neck cancer undergoing radiotherapy. The aim of this study is to investigate the relationship between dental status and development of osteoradionecrosis. STUDY DESIGN: Multicenter, retrospective observational study. A total of 392 patients with head and neck cancer who underwent radiotherapy were investigated for correlations between the development of osteoradionecrosis and various factors...
May 4, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28604551/the-periosteal-medial-femoral-condyle-free-flap-a-new-option-for-soft-tissue-reconstruction-of-the-distal-lower-extremity
#13
Noah H Saad, Matthew E Pontell, Brian S Winters, Joseph Daniel, Adam Saad
BACKGROUND: Small (<30 cm) soft tissue defects of the distal leg, foot, and ankle pose a complicated issue with regard to wound healing. Multiple flaps have been proposed for reconstruction of these wounds with varying levels of success. The medial femoral condyle flap is a free bone flap supplied by the descending geniculate artery. It is currently used in the treatment of fracture nonunion, infected bone defects, avascular necrosis, and osteoradionecrosis. This study proposes the use of the periosteal portion of the medial femoral condyle (PMFC) flap for soft tissue reconstruction of the distal leg, foot, and ankle...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28587628/osteoclast-profile-of-medication-related-osteonecrosis-of-the-jaw-secondary-to-bisphosphonate-therapy-a-comparison-with-osteoradionecrosis-and-osteomyelitis
#14
Christian Gross, Manuel Weber, Kay Creutzburg, Patrick Möbius, Raimund Preidl, Kerstin Amann, Falk Wehrhan
BACKGROUND: The medication-related osteonecrosis of the jaw secondary to bisphosphonate therapy [MRONJ (BP)] is characterized by non-healing exposed bone in the maxillofacial region. The pathogenesis of MRONJ (BP) is not fully understood. Giant, hypernucleated, inactive osteoclasts were found in MRONJ (BP) tissues, which indicated that accelerated cell-cell fusion might play a role. Dendritic cell-specific transmembrane protein (DC-STAMP) is associated with the cell-cell fusion of osteoclasts and precursor cells...
June 6, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28549794/intensity-modulated-proton-therapy-and-osteoradionecrosis-in-oropharyngeal-cancer
#15
Wencheng Zhang, Xiaodong Zhang, Pei Yang, Pierre Blanchard, Adam S Garden, Brandon Gunn, C David Fuller, Mark Chambers, Katherine A Hutcheson, Rong Ye, Stephen Y Lai, Mohamed Abdallah Sherif Radwan, X Ron Zhu, Steven J Frank
PURPOSE: We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). METHODS AND MATERIALS: We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test...
May 23, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28542343/bone-marrow-cell-extract-promotes-the-regeneration-of-irradiated-bone
#16
Guillaume Michel, Pauline Blery, Michaël Henoux, Jérôme Guicheux, Pierre Weiss, Sophie Brouard, Olivier Malard, Florent Espitalier
Mandibular osteoradionecrosis is a severe side effect of radiotherapy after the treatment of squamous cell carcinomas of the upper aerodigestive tract. As an alternative to its treatment by micro-anastomosed free-flaps, preclinical tissular engineering studies have been developed. Total bone marrow (TBM) associated with biphasic calcium phosphate (BCP) significantly enhanced bone formation in irradiated bone. One mechanism, explaining how bone marrow cells can help regenerate tissues like this, is the paracrine effect...
2017: PloS One
https://www.readbyqxmd.com/read/28468174/the-strategy-of-delayed-reconstruction-of-the-mandible-in-war-injuries
#17
Firas Taha Ahmed, Marwa Turkey Aljeuary
The most common causes of mandibular defects are ablative surgery of benign or malignant tumors, severe trauma, inflammatory diseases, and osteoradionecrosis. War injuries are another cause for mandibular defect. Reconstruction of the mandible is considered a challenge to the maxillofacial surgeon due to the accompanying functional and cosmetic importance. The object of this article was to show the role of nonvascularized bone graft in the reconstruction of segmental defect of the mandible resulted from projectiles and its snags...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28420035/prospective-series-of-reconstruction-of-complex-composite-mandibulectomy-defects-with-double-island-free-fibula-flap
#18
Edward I Chang, Peirong Yu
BACKGROUND: A double island free fibula (DIFF) flap can be used for reconstruction of through-and-through or complex mandibulectomy defects, but prospective studies are lacking. METHODS: Prospective analysis of all double skin paddle fibula flaps performed from 2010 to 2016. RESULTS: Overall, 16 patients underwent reconstruction with a DIFF flap (average age: 59.1 years). One patient, who underwent a DIFF flap and developed osteoradionecrosis, requiring a second flap...
August 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28419844/triple-cut-computer-aided-design-computer-aided-modeling-more-oncologic-safety-added-to-precise-mandible-modeling
#19
Vittorio Ramella, Alberto Franchi, Stefano Bottosso, Giancarlo Tirelli, Federico Cesare Novati, Zoran Marij Arnež
PURPOSE: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem. MATERIALS AND METHODS: Customized surgical devices with our "triple-cut" concept were used in 5 patients for mandibular reconstruction with free fibula flap (4 after mandibular resection for squamous cell carcinoma and 1 after mandibular osteoradionecrosis)...
March 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28408096/local-treatment-of-a-pharyngocutaneous-fistula-secondary-to-osteoradionecrosis
#20
Olga González-Antolín
Radionecrosis is a late, and difficult to treat,complication of radiotherapy performed on head and neck tumours, and it is difficult to treat. This process causes significant damage, not only in the skin, but also in muscular, nervous, vascular, and bone structures. This, in turn, leads to airway and digestive tract involvement, as well as a functional loss and a cosmetic defect that usually requires reconstructive surgery. Therefore, this process is associated with a significant loss in the quality of life of patients and involves a long hospital stay for treatment, as well as the necessary support measures...
April 10, 2017: Enfermería Clínica
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