Maxillofac Plast Reconstr Surg.  2014 Mar;36(2):62-66.

Osteoradionecrosis of Jaw in Head and Neck Cancer Patient Treated with Free Iliac Bone and Umbilical Fat Pad Graft

• Choi Y
• Kim SG
• Moon SY
• Oh JS
• You JS
• Jeong KI
• Lee SS

Abstract

Osteoradionecrosis is one of the most serious complications of patients receiving radiation therapy. It is characterized by hypovascularity, hypocellularity, and hypoxia-inducing necrosis of bone and soft tissue following delayed healing. In this case, a 72-year-old man was referred to the Department of Oral and Maxillofacial Surgery complaining of trismus following extraction three months before first visit. He had a history of right tonsillectomy, radical neck dissection and radiotherapy performed due to right tonsillar cancer seven years prior. After the diagnosis of osteoradionecrosis on right mandibular body and angle, conservative antibiotic therapy was used first, but an orocutaneous fistula gradually formed, and extensive bony destruction and sequestrum were observed. Sequestrectomy, free particulated iliac bone and umbilical fat pad graft were performed via a submandibular approach under general anesthesia. Preoperative regular exams and delicate wound care led to secondary healing of the wound without vascularized free flap reconstruction.

Keyword

Osteoradionecrosis; Head and neck neoplasms; Radiotherapy

MeSH Terms

Adipose Tissue*
Aged
Anesthesia, General
Diagnosis
Fistula
Free Tissue Flaps
Head and Neck Neoplasms*
Humans
Jaw*
Neck Dissection
Necrosis
Osteoradionecrosis*
Radiotherapy
Surgery, Oral
Tonsillar Neoplasms
Tonsillectomy
Transplants*
Trismus
Wounds and Injuries