1/6. Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity.In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/6. CSF otorrhea complicating osteoradionecrosis of the temporal bone.osteoradionecrosis of the temporal bone is a well-recognized complication of radiotherapy for head and neck malignancy. There are two mechanisms by which this condition can produce damage to nearby structures and even result in death. osteoradionecrosis may (1) predispose the patient to an aggressive or chronic infectious process, or (2) cause destruction of tissue by direct necrosis. A review of the literature failed to disclose a cause of CSF otorrhea complicating osteoradionecrosis of the temporal bone. This paper describes a case of skull base osteoradionecrosis, including necrosis of the tympanic membrane, associated with CSF otorrhea. Successful control of this complication was achieved using a translabyrinthine approach to locate the fistula, which originated from the internal auditory canal and was discharging through the middle ear via the oval window. The leak was sealed, the resultant mastoid cavity was obliterated by rotation of a temporalis muscle flap, and the external auditory canal was closed by the Fisch technique.- - - - - - - - - - ranking = 0.0094302064134309keywords = cavity (Clic here for more details about this article) |
3/6. hemangiopericytoma of the oral cavity: report of case and review of the literature.A case of hemangiopericytoma of the tongue has been described. The literature regarding hemangiopericytoma of the oral cavity has been reviewed; 35 cases have now been reported. There is essentially no difference in clinical behavior, treatment, or recurrence rate reported in the oral cavity and, because of the high recurrence rate and difficulty in predicting the clinical behavior of hemangiopericytoma, long-term follow-up care is important.- - - - - - - - - - ranking = 1.5keywords = oral cavity, cavity (Clic here for more details about this article) |
4/6. The free greater omental flap for treatment of mandibular osteoradionecrosis.osteoradionecrosis can involve the mandible following radical irradiation for treatment of oral cavity cancer. The radionecrosis of the mandible is often associated with severe intractable pain, local or extensive deformity, including pathologic fracture, orocutaneous fistula formation, and frequent loss of function. Treatment has ranged from analgesia and antibiotics to hyperbaric oxygen treatments to local or extensive sequestrectomies with partial or total mandibulectomy and restoration of tissue losses with unirradiated tissue. To our knowledge, this is the first report of the successful use of a free greater omental flap for immediate treatment of mandibular osteoradionecrosis and concomitant reconstruction. We found the omentum to be an excellent vascular bed that rapidly resolved the osteoradionecrosis and pain, promoted healing, and restored mandibular function with minimal discomfort to the patient.- - - - - - - - - - ranking = 0.25keywords = oral cavity, cavity (Clic here for more details about this article) |
5/6. Obliteration of the mastoid in the treatment of tumors of the temporal bone.A retrospective analysis of 29 cases of squamous cell carcinoma of the external and middle ear and 15 cases of glomus jugulare tumors of the middle ear was performed to evaluate the incidence of osteoradionecrosis of the temporal bone following surgery and/or radiotherapy. osteoradionecrosis occurred in 42% (8/19) of cases of squamous cell carcinoma which were treated with radical mastoidectomy, lateral or subtotal temporal bone resection leaving an open cavity and followed by an average of 5,840 rad postoperatively. No osteoradionecrosis, wound breakdown or otorrhea occurred in another group of six patients who were treated by surgical exenteration, total cavity obliteration, and an average of 5,700 rad of postoperative radiotherapy. Thus, cavity obliteration significantly decreased the incidence of these complications (p less than 0.05). In contrast, in 15 patients treated by surgery and postoperative irradiation (average dose = 4,610 rad) for glomus jugulare tumors, no osteoradionecrosis occurred despite use of an open cavity technique.- - - - - - - - - - ranking = 0.037720825653724keywords = cavity (Clic here for more details about this article) |
6/6. The relationship between dental disease and radiation necrosis of the mandible.Preirradiation panoramic radiographs of forty-six dentate patients were examined for the presence of significant dental disease. The occurrence of necrosis of the mandible after these patients received radiation therapy was then determined. Evidence of a positive association between dental disease present before radiation therapy and subsequent necrosis of the mandible was found (p = 0.09), leading to a recommendation that significant disease be eradicated before irradiation of oral tissues. Two cases are reported to illustrate the complications that can arise in dentate patients following radiation to the oral cavity. Considerable suffering results from bone necrosis, which can be reduced by careful and rational dental diagnosis and treatment.- - - - - - - - - - ranking = 0.0094302064134309keywords = cavity (Clic here for more details about this article) |