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Osteoradionecrosis

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https://www.readbyqxmd.com/read/28990255/role-of-surgery-in-the-treatment-of-osteoradionecrosis-and-its-complications-after-radiotherapy-for-nasopharyngeal-carcinoma
#1
Wen Bo Huang, Stanley Thian Sze Wong, Jimmy Yu Wai Chan
BACKGROUND: The purpose of this study was to review the efficacy of surgery for patients with osteoradionecrosis (ORN) after radiotherapy for nasopharyngeal carcinoma (NPC). METHODS: Between 2000 and 2016, we identified 162 patients with skull base ORN, among which 58 patients required surgery. A retrospective medical chart review was performed and the indications and results of surgical interventions were recorded. RESULTS: All surgeries were performed for the treatment of secondary complications of ORN, including central nervous system (CNS) infection (48...
October 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28961429/synchronous-reconstruction-of-a-total-mandibulectomy-defect-with-a-single-fibula-osteocutaneous-free-flap
#2
Ramzey Tursun, J Marshall Green, Daniel Winokur, Andre Ledoux
Osteoradionecrosis (ORN) is a well-known and usually late complication of radiation therapy in the treatment of head and neck cancer. Although the therapy can be life extending, it also produces tissue toxicity in ipsilateral and contralateral tissues in an acute and chronic fashion. In the most severe cases of ORN, such as the one presented in this report, bilateral disease results in the need for total mandibulectomy and creates a tremendous reconstructive challenge. The advent of microvascular surgery and free tissue transfer has caused an evolution of the management protocol for severe ORN cases...
September 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28951870/heterogeneity-of-necrotic-changes-between-cortical-and-cancellous-bone-in-mandibular-osteoradionecrosis-a-histopathological-analysis-of-resection-margin-after-segmental-mandibulectomy
#3
Masaya Akashi, Kazunobu Hashikawa, Satoshi Wanifuchi, Junya Kusumoto, Manabu Shigeoka, Shungo Furudoi, Hiroto Terashi, Takahide Komori
BACKGROUND: This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis. METHODS: Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28929077/late-temporal-lobe-extensive-osteoradionecrosis-post-radiation-for-nasopharyngeal-carcinoma-case-series
#4
Chian Ling Tang, Ramesh Kumar, Charng Jeng Toh, Shahizon Azura, Geok Chin Tan, Balwant Singh Gendeh
Osteoradionecrosis is one of the most serious complications of radiotherapy for nasopharyngeal carcinoma. We report three cases of osteoradionecrosis in temporal lobe who presented differently few years after completion of radiotherapy. Cranial magnetic resonance image showed lesions in temporal lobe either unilateral or bilateral with mass effect. One of the cases even showed disease progression few years after the initial diagnosis of osteoradionecrosis. Diagnosis of osteoradionecrosis for all three patients was confirmed by biopsy...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28911982/upper-aerodigestive-tract-cancer-and-oral-health-status-before-radiotherapy-a-cross-sectional-study-of-154-patients
#5
A Raskin, M Ruquet, L Weiss-Pelletier, J Mancini, O Boulogne, J Michel, N Fakhry, J M Foletti, C Chossegros, R Giorgi
OBJECTIVES: We aimed to determine primarily the oral health status of patients with upper aerodigestive tract cancer before radiotherapy, and secondarily the prevalence of risk factors for poor oral status. METHODS: A cross-sectional study was conducted in Marseille University hospital. Assessment criteria were the Decay, Missing and Filled (DMF) Index and periodontal status. RESULTS: One hundred and fifty-four patients, mean age 60.9years, were included...
September 12, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28882499/secondary-surgical-management-of-osteoradionecrosis-using-three-dimensional-isodose-curve-visualization-a-report-of-three-cases
#6
J Kraeima, R J H M Steenbakkers, F K L Spijkervet, J L N Roodenburg, M J H Witjes
Osteoradionecrosis is defined as bone death secondary to radiotherapy. There is a relationship between the radiation dose received and the occurrence of osteoradionecrosis of the jaws, with the risk increasing above a dose of 60Gy. In cases of class III mandibular osteoradionecrosis, a segmental resection can be indicated. Current practice is to completely remove the affected bone up to the point where the bone looks healthy and is bleeding. Exact resection planning and the use of guided surgery based on imaging of the bone changes have not been reported so far...
September 4, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28865083/radiation-induced-changes-in-the-microstructure-of-epithelial-cells-of-the-oral-mucosa-a-comparative-light-and-electron-microscopic-study
#7
Pekka J Asikainen, Hannah Dekker, Ellinoora Sirviö, Jopi Mikkonen, Engelbert A J M Schulten, Elisabeth Bloemena, Arto Koistinen, Chris M Ten Bruggenkate, Arja M Kullaa
OBJECTIVES: The microplicae is a typical structure of the epithelial cell surface of the oral mucosa. The cell surface is potentially of great significance, as it provides the underlying basis for the protective function of the salivary pellicle. The aim of this study is to investigate whether radiation therapy affects the surface morphology of the superficial cells of the human oral mucosa in patients who have received radiotherapy for oral cancer. MATERIAL AND METHODS: Oral mucosal tissue samples from 91 patients were collected during dental implant surgery or ablative surgery...
September 2, 2017: Journal of Oral Pathology & Medicine
https://www.readbyqxmd.com/read/28862391/dental-extractions-for-preradiation-dental-clearance-and-incidence-of-osteoradionecrosis-in-patients-with-nasopharyngeal-carcinoma-treated-with-intensity-modulated-radiotherapy
#8
Yoong L See Toh, Yoke L Soong, Yi X Chim, Li T Tan, Weng K Lye, Khim H Teoh
AIM: The aims of the present retrospective study were to evaluate the outcomes of dental extractions in nasopharyngeal carcinoma patients who had undergone dental clearance pre- and post-radiotherapy (RT) with intensity-modulated RT, and to report on the incidence and timing of osteoradionecrosis (ORN) in these patients. METHODS: A total of 231 patients were seen pre-, mid-, and postradiation therapy. Information on patient demographics, smoking history, staging, treatment modalities, dental extraction indications, and number and site of dental extractions was gathered...
September 1, 2017: Journal of Investigative and Clinical Dentistry
https://www.readbyqxmd.com/read/28851495/intensity-modulated-radiotherapy-in-head-and-neck-cancer-an-update-for-oral-and-maxillofacial-surgeons
#9
REVIEW
P A Brennan, K L Bradley, M Brands
Intensity-modulated radiation therapy (IMRT), a relatively new method of delivering radiotherapy, can precisely target a point within a specific tumour and reduce the dose to nearby anatomical structures. This is particularly important in the head and neck where radiotherapy can easily and irreparably damage the salivary glands, spinal cord, and eyes, and where, with increasingly better outcomes and survival, late complications of conventional radiotherapy (including osteoradionecrosis of the cervical spine) can be difficult to manage...
August 26, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28843593/surgical-management-of-temporal-bone-osteoradionecrosis-single-surgeon-experience-of-47-cases
#10
Sameep Kadakia, Arvind Badhey, Jared Inman, Moustafa Mourad, Yadranko Ducic
PURPOSE: To report the outcomes of 47 patients with temporal bone osteoradionecrosis treated primarily with surgical resection in order to analyze whether flap type and hyperbaric oxygen use affect wound breakdown. MATERIALS AND METHODS: Between January 1998 and January 2016, 47 patients were treated for temporal bone osteoradionecrosis with surgery. Some patients were also treated with hyperbaric oxygen. Resection of grossly necrotic temporal bone was followed by immediate reconstruction with local, regional, or free flaps...
July 23, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28797468/incidence-of-and-risk-factors-for-mandibular-osteoradionecrosis-in-patients-with-oral-cavity-and-oropharynx-cancers
#11
Dominic H Moon, Sung Ho Moon, Kyle Wang, Mark C Weissler, Trevor G Hackman, Adam M Zanation, Brian D Thorp, Samip N Patel, Jose P Zevallos, Lawrence B Marks, Bhishamjit S Chera
OBJECTIVES: To evaluate the incidence of, and risk factors associated with, mandibular osteoradionecrosis (MORN) following radiation therapy (RT) for oral cavity and oropharyngeal cancers. MATERIALS AND METHODS: Patient and treatment records of 252 consecutive patients with oral cavity or oropharynx cancers treated with RT by a single radiation oncologist at a high volume academic institution from August 2009 to December 2015 were retrospectively reviewed. A Cox regression model was used to assess factors associated with the development of MORN...
September 2017: Oral Oncology
https://www.readbyqxmd.com/read/28759822/treatment-of-late-sequelae-after-radiotherapy-for-head-and-neck-cancer
#12
REVIEW
Primož Strojan, Katherine A Hutcheson, Avraham Eisbruch, Jonathan J Beitler, Johannes A Langendijk, Anne W M Lee, June Corry, William M Mendenhall, Robert Smee, Alessandra Rinaldo, Alfio Ferlito
Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications...
September 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28750685/osteoradionecrosis-of-the-hyoid-bone-after-intra-arterial-chemoradiotherapy-for-oropharyngeal-cancer-mr-imaging-findings
#13
Hiromitsu Hatakeyama, Noriyuki Fujima, Kazuhiko Tsuchiya, Kenji Mizoguchi, Takatsugu Mizumachi, Tomohiro Sakashita, Satoshi Kano, Akihiro Homma, Satoshi Fukuda
BACKGROUND: Osteoradionecrosis (ORN) of the hyoid bone sometimes induces severe front neck infection and can cause laryngeal stenosis and carotid rupture. Although ORN of the hyoid bone is known to be a complication of chemoradiotherapy for head and neck cancer, there has been no basis for its evaluation. Our purpose is to present the clinical and MR imaging features of ORN of the hyoid bone. METHODS: The study group comprised patients with advanced oropharyngeal cancer treated with targeted intra-arterial cisplatin infusion with concomitant radiotherapy...
July 27, 2017: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
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
#14
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
#15
(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...
August 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
#16
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
#17
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.
September 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
#18
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
#19
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
#20
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
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