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Osteoradionecrosis

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https://www.readbyqxmd.com/read/28615689/nomogram-model-to-predict-postoperative-infection-after-mandibular-osteoradionecrosis-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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