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Osteoradionecrosis

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https://www.readbyqxmd.com/read/28542343/bone-marrow-cell-extract-promotes-the-regeneration-of-irradiated-bone
#1
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
#2
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
#3
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...
April 18, 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
#4
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
#5
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
https://www.readbyqxmd.com/read/28396234/intraoral-vacuum-assisted-closure-therapy-a-pilot-study-in-medication-related-osteonecrosis-of-the-jaw
#6
Johannes Laimer, Otto Steinmassl, Martin Hechenberger, Michael Rasse, Rajmond Pikula, Emanuel Bruckmoser
PURPOSE: For approximately 2 decades, vacuum-assisted closure (VAC) therapy has been widely used for the management of complex wounds and soft tissue defects on the external surface of the body. As yet, this technique has not been studied for intraoral wound management. Therefore, this study evaluated the feasibility, safety, and effectiveness of intraoral VAC therapy in patients with medication-related osteonecrosis of the jaw (MRONJ). PATIENTS AND METHODS: After successful construction of an intraoral device providing sufficient airtight sealing, individually manufactured appliances were used in a prospective clinical trial of 3 patients using the VAC therapy system...
March 18, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28370713/risk-factors-for-and-the-role-of-dental-extractions-in-osteoradionecrosis-of-the-jaws-a-national-based-cohort-study
#7
Ti-Hao Wang, Chia-Jen Liu, Tze-Fan Chao, Tzeng-Ji Chen, Yu-Wen Hu
BACKGROUND: The purpose of this study was to investigate the risk factors, especially the use of certain drugs and the dental procedures, for osteoradionecrosis of the jaw (ORNJ) in patients with head and neck cancer undergoing irradiation as their primary treatment. METHODS: The cohort was composed of 23,527 patients with head and neck cancer. Cox proportional hazard models were used for risk factors analysis. RESULTS: The overall incidence of ORNJ is 3...
March 28, 2017: Head & Neck
https://www.readbyqxmd.com/read/28365078/macrophage-and-osteoclast-polarization-in-bisphosphonate-associated-necrosis-and-osteoradionecrosis
#8
Falk Wehrhan, Patrick Moebius, Kerstin Amann, Jutta Ries, Raimund Preidl, Friedrich W Neukam, Manuel Weber
PURPOSE: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a complication of antiresorptive therapy with nitrogen-containing bisphosphonates (BP). With various suggestions as to pathogenesis, the etiology of BRONJ is not sufficiently understood. Osteoclasts and their precursors, that is, macrophages, are the main target cells of BP. BP can repolarize regeneration- and healing-associated M2 macrophages towards the tissue destructive M1-type. The current study aims to elucidate differences in macrophage and osteoclast polarization in BRONJ, osteoradionecrosis (ORN) and healthy control specimens...
March 1, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28363372/surgical-management-of-the-radiated-chest-wall-and-its-complications
#9
REVIEW
Dan J Raz, Sharon L Clancy, Loretta J Erhunmwunsee
Radiation to the chest wall is common before resection of tumors. Osteoradionecrosis can occur after radiation treatment. Radical resection and reconstruction can be lifesaving. Soft tissue coverage using myocutaneous or omental flaps is determined by the quality of soft tissue available and the status of the vascular pedicle supplying available myocutaneous flaps. Radiation-induced sarcomas of the chest wall occur most commonly after radiation therapy for breast cancer. Although angiosarcomas are the most common radiation-induced sarcomas, osteosarcoma, myosarcomas, rhabdomyosarcoma, and undifferentiated sarcomas also occur...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28351585/proposal-for-a-new-risk-classification-system-for-nasopharyngeal-carcinoma-patients-with-post-radiation-nasopharyngeal-necrosis
#10
Qi Yang, Xiong Zou, Rui You, You-Ping Liu, Yuan Han, Yi-Nuan Zhang, Ling Guo, Hai-Qiang Mai, Chuan-Miao Xie, Li Li, Ming-Huang Hong, Ming-Yuan Chen
PURPOSE: To analyze the clinical outcomes of nasopharyngeal carcinoma (NPC) patients with post-radiation nasopharyngeal necrosis (PRNN) and construct a new risk classification system for predicting survival of PRNN. METHODS: A total of 276 patients with PRNN were consecutively enrolled. Complete magnetic resonance (MR) images of the nasopharynx and neck were available for all patients and were used to assess nasopharyngeal necrosis status. After 2010, patients with PRNN were initially treated by radical endoscopic necrectomy followed by reconstruction with nasal flap (ENNF)...
April 2017: Oral Oncology
https://www.readbyqxmd.com/read/28351583/candidate-apoptotic-and-dna-repair-gene-approach-confirms-involvement-of-ercc1-ercc5-tp53-and-mdm2-in-radiation-induced-toxicity-in-head-and-neck-cancer
#11
D Borchiellini, M C Etienne-Grimaldi, R J Bensadoun, K Benezery, O Dassonville, G Poissonnet, L Llorca, N Ebran, P Formento, Y Château, J Thariat, G Milano
INTRODUCTION: Single nucleotide polymorphisms (SNPs) of DNA repair and apoptosis genes have been associated with outcome in head and neck squamous cell carcinoma (HNSCC) patients receiving radiotherapy (RT). Our goal was to conduct a candidate gene study in HNSCC patients receiving RT or chemoRT. METHODS: 122 non-resectable HNSCC patients undergoing RT (N=38) or chemoRT (N=84) between 1992 and 2006 were retrospectively analyzed. ERCC1 Lys259Thr (rs735482), ERCC2 Lys751Gln (rs13181), ERCC5 His46His C>T (rs1047768), XRCC1 Arg399Gln (rs25487), TP53 Arg72Pro (rs1042522) and MDM2 309T>G (rs2279744) were analyzed on tumor DNA...
April 2017: Oral Oncology
https://www.readbyqxmd.com/read/28343674/two-stage-implant-placement-technique-for-the-management-of-irradiated-jaws-an-animal-study
#12
Moustafa N Aboushelib, Mohamed A Arnaout, Mohamed H Elsafi, Youssef M Kassem
STATEMENT OF PROBLEM: Radiotherapy results in diminished bone remodeling capacity and an elevated risk of osteoradionecrosis, which can negatively influence the survival rate of dental implants. Patients receiving radiotherapy are advised not to receive dental implants during or soon after completing their radiotherapy. PURPOSE: The purpose of this animal study was to investigate a 2-stage implant placement technique designed to diminish applied trauma on irradiated bone...
March 23, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28336321/the-histological-and-histomorphometric-changes-in-the-mandible-after-radiotherapy-an-animal-model
#13
Lucas J Poort, Johan H B Ludlage, Nienke Lie, Roland A Böckmann, Jim C E Odekerken, Frank J Hoebers, Peter A W H Kessler
PURPOSE: Approximately 5% of irradiated head and neck cancer patients develop osteoradionecrosis of the mandible. The current non-surgical treatment options for osteoradionecrosis have limited effects and are based on a small number of studies. Therefore, we aimed to enhance the understanding of the pathophysiology of osteoradionecrosis by investigating changes induced by external irradiation in mini-pigs. METHODS: Sixteen Göttingen mini-pigs were divided into four groups for the application in two fractions with total equivalent radiation dosages of 25, 50, 70 Gray, and one group served as control...
February 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28326215/osteoradionecrosis-of-the-temporal-bone-leading-to-cerebellar-abscess
#14
Thomas B Layton
Squamous cell carcinoma of the temporal bone is a rare and destructive malignancy and represents both diagnostic and therapeutic challenge. The complex regional anatomy of the temporal bone requires equally intricate surgical techniques to adequately resect the tumour mass during surgical excision. Adjuvant radiotherapy is offered to patients with advanced disease and has been showed to confer a survival benefit in carefully selected patients. One feared complication of radiotherapy is osteoradionecrosis and is a major obstacle faced in the treatment of head and neck cancers...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28318917/radiological-changes-with-magnetic-resonance-imaging-and-computed-tomography-after-irradiating-minipig-mandibles-the-role-of-t2-spir-mixed-signal-intensities-in-the-detection-of-osteoradionecrosis
#15
Lucas J Poort, Alida A Postma, Annika A R Stadler, Roland A Böckmann, Frank J Hoebers, Peter A W H Kessler
PURPOSE: Radiotherapy in the head and neck can induce several radiologically detectable changes in bone, osteoradionecrosis (ORN) among them. The purpose is to investigate radiological changes in mandibular bone after irradiation with various doses with and without surgery and to determine imaging characteristics of radiotherapy and ORN in an animal model. MATERIALS AND METHODS: Sixteen Göttingen minipigs were divided into groups and were irradiated with two fractions with equivalent doses of 0, 25, 50 and 70 Gray...
May 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28306199/surgical-management-of-extensive-osteoradionecrosis-in-nasopharyngeal-carcinoma-patients-with-the-maxillary-swing-approach-and-free-muscular-flaps
#16
LETTER
N Y Choi, H J Kim, C H Baek
No abstract text is available yet for this article.
March 17, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28291570/refining-the-indications-for-scapula-tip-in-mandibular-reconstruction
#17
M W Ho, J S Brown, R J Shaw
Mandibular reconstruction in osteoradionecrosis or salvage surgery can often be complicated by the lack of suitable recipient vessels in the ipsilateral neck and the associated requirement for significant extraoral skin reconstruction. The scapula tip with its long vascular pedicle and option of a chimeric soft tissue component offers a versatile reconstructive solution in such cases. This article reports four consecutive cases of mandibular reconstruction with poor ipsilateral vascular options and additional soft tissue requirements in which the scapula tip was justified and preferred...
March 10, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28258895/re-evaluation-of-ipsilateral-radiation-for-t1-t2n0-n2b-tonsil-carcinoma-at-the-princess-margaret-hospital-in-the-human-papillomavirus-era-25%C3%A2-years-later
#18
Shao Hui Huang, John Waldron, Scott V Bratman, Jie Su, John Kim, Andrew Bayley, John Cho, Meredith Giuliani, Andrew Hope, Jolie Ringash, Aaron Hansen, John R de Almeida, David Goldstein, Bayardo Perez-Ordonez, Ilan Weinreb, Li Tong, Wei Xu, Brian O'Sullivan
PURPOSE: To report the outcome of ipsilateral radiation therapy (RT) in human papillomavirus (HPV)-positive (HPV+) patients and HPV-negative (HPV-) patients with T1-T2N0-N2b tonsillar cancer treated 25 years after our initial historical cohort. METHODS AND MATERIALS: Patients with T1-T2N0-N2b tonsillar cancer who received ipsilateral RT or bilateral RT between 1999 and 2014 were reviewed. Overall survival (OS), local control (LC), regional control (RC), and grade 3 to 4 late toxicity (LT) were compared between ipsilateral RT and bilateral RT within HPV+ and HPV- patients, separately...
January 9, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28249651/symptom-burden-and-dysphagia-associated-with-osteoradionecrosis-in-long-term-oropharynx-cancer-survivors-a-cohort-analysis
#19
Angela T T Wong, Stephen Y Lai, G Brandon Gunn, Beth M Beadle, Clifton D Fuller, Martha P Barrow, Theresa M Hofstede, Mark S Chambers, Erich M Sturgis, Abdallah Sherif Radwan Mohamed, Jan S Lewin, Katherine A Hutcheson
OBJECTIVE: The purpose is to examine the relationship between mandibular osteoradionecrosis (ORN) and chronic dysphagia in long-term oropharynx cancer (OPC) survivors, and to determine the perceived symptom burden associated with ORN. MATERIALS AND METHODS: Medical records of 349 OPC patients treated with bilateral IMRT and systemic therapy were reviewed. ORN was graded using a published 4-point classification schema. Patients were considered to have chronic dysphagia if they had aspiration pneumonia, stricture or aspiration detected by fluoroscopy or endoscopy, and/or feeding tube dependence in long-term follow-up ⩾1year following radiotherapy...
March 2017: Oral Oncology
https://www.readbyqxmd.com/read/28241807/clinical-registry-of-dental-outcomes-in-head-and-neck-cancer-patients-orarad-rationale-methods-and-recruitment-considerations
#20
Rajesh V Lalla, Leslie Long-Simpson, James S Hodges, Nathaniel Treister, Thomas Sollecito, Brian Schmidt, Lauren L Patton, Michael T Brennan
BACKGROUND: Most head and neck (H&N) cancer patients receive high-dose external beam radiation therapy (RT), often in combination with surgery and/or chemotherapy. Unfortunately, high-dose RT has significant adverse effects on the oral and maxillofacial tissues, some of which persist for the life of the patient. However, dental management of these patients is based largely on individual and expert opinion, as few studies have followed patients prospectively to determine factors that predict adverse oral sequelae...
February 27, 2017: BMC Oral Health
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