International Journal of Head and Neck Surgery

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VOLUME 2 , ISSUE 1 ( January-April, 2011 ) > List of Articles

REVIEW ARTICLE

Osteoradionecrosis

SS Pagare, Sukhjinder Kaur Khosa

Citation Information : Pagare S, Khosa SK. Osteoradionecrosis. Int J Head Neck Surg 2011; 2 (1):27-32.

DOI: 10.5005/jp-journals-10001-1043

Published Online: 00-04-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Osteoradionecrosis (ORN) is a major complication of surgery or trauma in previously irradiated bone. This condition is often painful, debilitating and may result in significant bone loss. ORN of the mandible is the commonest site in patients who receive radiotherapy for head and neck cancer because of the relatively poor vascularization in this area. Risk factors include the total radiation dose, modality of treatment, fraction size and dose rate, oral hygiene, timing of tooth extractions as well as the continued use of tobacco and alcohol. Conversely, steroid use before or after radiation may have a protective effect related to the inhibition of the initial inflammatory phase of ORN. The management of this side effect is difficult and can result in bone or soft tissue loss, affecting the quality of life. The recommended treatment guidelines are irrigation, antibiotics, hyperbaric oxygen therapy and surgical techniques, including hemimandibulectomy and graft placements.


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