Cases reported "Osteoradionecrosis"

Filter by keywords:



Filtering documents. Please wait...

11/34. Clinics in diagnostic imaging (85). mandible osteoradionecrosis complicated by infection.

    Mandibular osteoradionecrosis is a rare but well-known complication that may be seen in patients with head and neck tumours following radiation therapy. A 42-year-old man presented with painful soft tissue swelling and a discharging sinus over the right mandible. Radiographs showed osteolytic destruction. Computed tomography confirmed bony destruction and fragmentation, as well as signs of soft tissue infection. The diagnosis of mandible osteoradionecrosis complicated by infection was confirmed by biopsy and surgically. The clinical and imaging features of osteoradionecrosis are highlighted.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

12/34. osteoradionecrosis of the hyoid presenting as a cause of intractable neck pain following radiotherapy and the role of magnetic resonance image scanning to aid diagnosis.

    osteoradionecrosis of the hyoid has been reported rarely in the worldwide literature. We present the case of a 56-year-old gentleman who presented with intractable neck pain, following surgery and radiotherapy for a T(2)N(2c)M(0) tongue base carcinoma, to highlight the need to consider osteoradionecrosis of the hyoid rather than recurrence of the carcinoma as the cause of such symptoms. The previously unreported appearance of osteoradionecrosis of the hyoid on a magnetic resonance image (MRI) scan and the use of this investigation to aid diagnosis is discussed.
- - - - - - - - - -
ranking = 5
keywords = neck
(Clic here for more details about this article)

13/34. False positive fluorine-18 fluorodeoxy-D-glucose positron emission tomography finding caused by osteoradionecrosis in a nasopharyngeal carcinoma patient.

    Nasopharyngeal carcinoma (NPC) is treated by radiotherapy with or without chemotherapy. It is not uncommon to find the residual/recurrent lesion in the skull base area. For patients who had received radiotherapy, it is difficult to differentiate the skull base tumour from post-treatment change in the CT or MRI. (18)F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) provides an alternative diagnostic choice in this situation for head and neck cancer including NPC especially when there is inconclusive CT/MRI finding. This report of an NPC patient who received radiotherapy 18 months previously, describes the misdiagnosis of tumour recurrence at the skull base found in both MRI and FDG PET scan. Histopathological studies showed osteoradionecrosis of the debrided tissue and follow-up PET showed complete regression of the skull base lesion. Therefore, a false positive result in FDG PET caused by osteoradionecrosis was confirmed. To the best of our knowledge, this is the first case report in the literature.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

14/34. DentaScan: a new diagnostic method for evaluating mandibular and maxillary pathology.

    Although computerized tomography (CT) is valuable for evaluating head and neck pathology, it can be suboptimal when evaluating the presence or extent of mandibular and maxillary involvement by tumor, infection, or other pathology. The presence of dental restoration artifact, CT gantry positioning problems, and the inability to obtain cross-sectional images will diminish the accuracy of standard CT images. A program, termed either DentaScan or multiplanar reformation (CT/MPR), eliminates these problems by processing axial CT scan information to obtain true cross-sectional images and panoramic views of the mandible and maxilla. In this study, DentaScan imagery was used in 26 patients whose mandibles or maxillas were affected by tumor, osteomyelitis, or other pathology. CT scanning with multiplanar reformation proved useful in the precise location, assessment, monitoring, and treatment of various pathologies of the mandible and maxilla. Selected case studies illustrate the therapeutic implications and advantages of this new imaging technique.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

15/34. Microvascular free tissue transfer for treatment of osteoradionecrosis of the maxilla.

    head and neck tumors often require radiotherapy as part of the treatment protocol. Although it improves the survival rate in cancer patients, it may cause osteoradionecrosis, especially in the mandible and maxilla. Twelve patients with osteoradionecrosis of the maxilla were treated with microsurgical free tissue transplantations between April of 1996 and August of 2002. There were 10 male and two female patients, with a mean age of 60.2 years. The mean radiotherapy dose was 6674 cGy. The radiation dose could not be traced in three patients because radiotherapy was performed elsewhere. Radical sequestrectomy, soft-tissue debridement, and pathologic proof of no tumor recurrence were performed before microsurgical reconstruction. Free flaps used included the following: anterolateral thigh (n = 7), radial forearm (n = 2), rectus femoris musculocutaneous (n = 2), and supracondylar chimeric (n = 1) flaps. All flaps survived completely and reconstruction succeeded. During a mean 25-month follow-up period, ectropion, plate exposure, and mild infection were encountered in three patients and treated successfully. Radical debridement and obliteration of dead space with well-vascularized tissue are essential for successful treatment of maxillary osteoradionecrosis. The anterolateral thigh flap is most versatile for almost all types of soft-tissue defect reconstruction in the head and neck region.
- - - - - - - - - -
ranking = 2
keywords = neck
(Clic here for more details about this article)

16/34. The development of osteoradionecrosis from sites of periodontal disease activity: report of 3 cases.

    osteoradionecrosis may develop following radiation therapy that involves bone, and most particularly following treatment of cancers within the head and neck. The mandible is at greatest risk of osteoradionecrosis because of the nature of its blood supply and its dense bone configuration. This paper describes 3 cases which demonstrate the development of osteoradionecrosis in the mandible from sites of periodontal disease activity following external beam radiotherapy. The pathogenesis of these events is reviewed, and recommendations for their management are discussed. A proposal for the use of chlorhexidine digluconate and hyperbaric oxygen in the periodontal management of this condition is outlined.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

17/34. Distraction osteogenesis in the irradiated mandible. A case report.

    BACKGROUND: Distraction osteogenesis has been suggested as a relatively simple method of mandibular reconstruction following ablative head and neck surgery. Some authors report good results in irradiated patients while other authors report limitations with this group of patients. PATIENT: In a 72-year-old male an attempt was made to reconstruct the irradiated mandible using distraction osteogenesis. RESULTS: Distraction osteogenesis only resulted in an enlarged soft tissue envelope, while there was no evidence of bone formation in the distraction gap. CONCLUSION: Based on this experience and a search of the literature, it is hypothesized that distraction osteogenesis is only a reliable reconstructive method in irradiated patients if the cumulative dose to the mandibular bone at the distraction site does not exceed a certain maximum still to be defined.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

18/34. Mandibular restoration in the cancer patient: microvascular surgery and implant prostheses.

    This article deals with state of the art reconstruction and rehabilitation of the head and neck cancer patient who requires mandibular resection. The mandible can be reconstructed by microvascular free tissue transfer of bone and soft tissue from distant body sites. The dental units and missing soft tissue contours can be supported by osseointegrated implants placed in the grafted bone. This article discusses the rationale for patient selection and sequencing of this complex and rewarding rehabilitation.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

19/34. osteoradionecrosis of the cervical spine resulting from radiotherapy for primary head and neck malignancies: operative and nonoperative management. Case report.

    osteoradionecrosis is a process of dysvascular bone necrosis and fibrous replacement following exposure to high doses of radiation. The poorly vascularized necrotic tissue may cause pain and/or instability, and it cannot resist infection well, which may result in secondary osteomyelitis. When these processes affect the cervical spine, the resulting instability and neurological deficits can be devastating, and immediate reestablishment of spinal stability is paramount. Reconstruction of the cervical spine can be particularly challenging in this subgroup of patients in whom the spine is poorly vascularized after radical surgery, high-dose irradiation, and infection. The authors report three cases of cervical spine osteoradionecrosis following radiotherapy for primary head and neck malignancies. Two patients suffered secondary osteomyelitis, severe spinal deformity, and spinal cord compression. These patients underwent surgery in which a vascularized fibular graft and instrumentation were used to reconstruct the cervical spine; subsequently hyperbaric oxygen (HBO) therapy was instituted. Fusion occurred, spinal stability was restored, and neurological dysfunction resolved at the 2- and 4-year follow-up examinations, respectively. The third patient experienced pain and dysphagia but did not have osteomyelitis, spinal instability, or neurological deficits. He underwent HBO therapy alone, with improved symptoms and imaging findings. Hyperbaric oxygen is an essential part of treatment for osteoradionecrosis and may be sufficient by itself for uncomplicated cases, but surgery is required for patients with spinal instability, spinal cord compression, and/or infection. A vascularized fibular bone graft is a very helpful adjunct in these patients because it adds little morbidity and may increase the rate of spinal fusion.
- - - - - - - - - -
ranking = 5
keywords = neck
(Clic here for more details about this article)

20/34. Repair of skin covering osteoradionecrosis of the mandible with the fasciocutaneous supraclavicular artery island flap: case report.

    INTRODUCTION: osteoradionecrosis of the mandible is a serious complication following radiotherapy for head and neck cancer. Reconstructive procedures in the head and neck region use a wide range of flaps for defect closure. The methods range from local, mostly myocutaneous flaps and skin grafts to free microsurgical flaps to ensure a satisfactory functional and aesthetic result. Moreover, the donor site defect needs to be closed, with as little as possible functional or aesthetic impairment. PATIENT AND METHOD: A 60-year-old male is presented with a history of squamous cell carcinoma of the left lower lip and chin area in whom the tumour was resected and treated by adjuvant radiotherapy. The follow-up was complicated by chronic inflammation of the left mandibular body as a sequel of radiotherapy; it resulted with partial bone destruction, and soft tissue dehiscence. He was admitted for repair and treatment of the infected mandibular osteoradionecrosis. A supraclavicular artery island flap was used to close the mandibular soft tissue defect. CONCLUSION: The shoulder provides a relatively good skin texture and match to provide cover and lining for defects in the lower part of the face, in combination with minor donor site morbidity.
- - - - - - - - - -
ranking = 2
keywords = neck
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Osteoradionecrosis'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.