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Osteoradionecrosis of the mandible: evaluation of predisposing factors and treatment modalities in clinical material of the Department of Maxillofacial Surgery, Silesian Medical University in Katowice
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Abstract
Material and methods: The clinical records and treatment plans of 13 ORN patients (10 men, 3 women) treated from January 1993 through December 2003 in the Department of Maxillofacial Surgery in Katowice were analysed retrospectively.
Results: Of the 13 patients, 11 were referred for irradiation therapy for oral squamous cell carcinoma, 1 for sarcoma of the mandible, and 1 for histiocytosis. The average duration of radiation therapy, and the clinical diagnosis of ORN was 20 months (range: 1 month to 7 years). In most cases ORN resulted from an injury. Initially all patients were given conservative treatment, which turned out to be effective in 7 cases. In the remaining 6 patients, further ORN progress was observed. Thus, a segmental mandibulectomy or hemi-mandibulectomy with a simultaneous reconstruction with regional flaps was performed.
Conclusions: Mandibular osteoradionecrosis occurs mostly after associated treatment for oral squamous cell carcinoma. Each surgical intervention (such as dental extraction) in the irradiated region is the main risk factor for the development of ORN. In cases with acute and rapid progressive ORN, conservative treatment does not seem to be effective.
Abstract
Material and methods: The clinical records and treatment plans of 13 ORN patients (10 men, 3 women) treated from January 1993 through December 2003 in the Department of Maxillofacial Surgery in Katowice were analysed retrospectively.
Results: Of the 13 patients, 11 were referred for irradiation therapy for oral squamous cell carcinoma, 1 for sarcoma of the mandible, and 1 for histiocytosis. The average duration of radiation therapy, and the clinical diagnosis of ORN was 20 months (range: 1 month to 7 years). In most cases ORN resulted from an injury. Initially all patients were given conservative treatment, which turned out to be effective in 7 cases. In the remaining 6 patients, further ORN progress was observed. Thus, a segmental mandibulectomy or hemi-mandibulectomy with a simultaneous reconstruction with regional flaps was performed.
Conclusions: Mandibular osteoradionecrosis occurs mostly after associated treatment for oral squamous cell carcinoma. Each surgical intervention (such as dental extraction) in the irradiated region is the main risk factor for the development of ORN. In cases with acute and rapid progressive ORN, conservative treatment does not seem to be effective.
Keywords
osteoradionecrosis; mandible; risk factors; treatment


Title
Osteoradionecrosis of the mandible: evaluation of predisposing factors and treatment modalities in clinical material of the Department of Maxillofacial Surgery, Silesian Medical University in Katowice
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
245-251
Published online
2005-01-26
Bibliographic record
Chirurgia Polska 2004;6(4):245-251.
Keywords
osteoradionecrosis
mandible
risk factors
treatment
Authors
Magdalena Jędrusik-Pawłowska
Jan Drugacz
Halina Borgiel-Marek
Iwona Niedzielska
Daria Wziątek-Kuczmik