J Korean Assoc Maxillofac Plast Reconstr Surg.  2004 Mar;26(2):195-203.

SURGICAL MANAGEMENT OF OSTEORADIONECROSIS OF THE MANDIBLE

• Lee KH
• Kim KW
• Lee EY
• Park HJ
• Kang JY
• Choi HW

Abstract

The radiation therapy can be used effectively for a small lesion with no metastatic lesion or preoperatively to decrease the primary lesion or postoperatively when the possibility of occult cancer cells are exist. But there are many complications following radiation therapy such as mucositis, multiple cervical caries, xerostomia with the salivary gland atrophy and osteoradionecrosis with the poor blood supply to bone, and even a pathologic fracture of the mandible. Osteoradionecrosis is one of severe complications of radiation therapy. Treatment of osteoradionecrosis compromised 1) avoidance of local physical and biological irritant 2) wound irrigation 3) antibiotics and analgesics 4) superficial sequestrectomy 5) hyperbaric oxygen therapy 6) resection and reconstructive therapy 7) supportive therapy for systemic condition. Because of the cumulative effect of radiation therapy, osteoradionecrosis should be managed as conservatively as possible. Surgical management is considered when any conservative treatments were not effective for a long time and symptoms aggravated. We report 2 cases of osteoradionecrosis which were not controlled by conservative treatment such as wound irrigation, antibiotics. We eventually performed surgical managements of osteoradionecrosis successfully.

Keyword

Osteoradionecrosis of Mandible; Surgical management

MeSH Terms

Analgesics
Anti-Bacterial Agents
Atrophy
Fractures, Spontaneous
Hyperbaric Oxygenation
Mandible*
Mucositis
Osteoradionecrosis*
Root Caries
Salivary Glands
Wounds and Injuries
Xerostomia
Analgesics
Anti-Bacterial Agents