A review of advanced head and neck osteoradionecrosis

Mayland, Erica; Sweeny, Larissa

doi:10.20517/2347-9264.2021.38

PAR 2021

DOI: 10.20517/2347-9264.2021.38

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A review of advanced head and neck osteoradionecrosis

Erica Mayland¹,

Larissa Sweeny²

Abstract: Osteoradionecrosis (ORN) of the head and neck can be a devastating complication following radiation therapy. ORN is associated with pain, chronic infection, and non-healing wounds. Radiation fibrosis, chronic infection, fistula formation, and necrotic tissues can make treatment challenging. The following review article is a narrative on the management of advanced head and ORN.

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2024

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Cited by 2 publications

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Presentation and Optimal Management of Anterior and Central Skull Base Osteoradionecrosis: Systematic Review and Meta‐Analysis

Shah,

Wu,

Sindwani

et al. 2024

The Laryngoscope

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ObjectiveTo conduct a systematic review and meta‐analysis to compare the efficacy of conservative treatment versus surgical debridement versus debridement followed by vascularized tissue coverage to provide evidence‐based guidance on the management of osteoradionecrosis of the anterior and central skull base.Data SourcesPubMed, Embase, and Cochrane Library.Review MethodsSystematic review and data sources including PubMed, Embase, and Cochrane Library were accessed using PRISMA guidelines. Meta‐analysis was performed on treatment type and resolution of osteoradionecrosis.ResultsA total of 13 articles met the inclusion criteria. Patients were categorized into conservative medical treatment versus surgical treatment. Conservative treatment included patients undergoing hyperbaric oxygen therapy, antibiotics, pentoxifylline‐tocopherol‐clodronate, or a combination of the three. Eight out of 197 patients treated with conservative therapy had resolution of symptoms (4.1%) while 135 of 188 patients treated with surgical intervention had resolution of symptoms (71.8%). Of these, 104 patients (91.2%) in the vascularized tissue group experienced resolution of symptoms.ConclusionSurgery was superior to medical treatment alone in the resolution of skull base osteoradionecrosis. Vascularized surgical treatment fared significantly better when compared with both surgical debridement only and/or medical treatment. Our findings suggest that surgical treatment should be considered earlier in patients with skull base osteoradionecrosis to prevent severe or fatal sequelae.Level of EvidenceNA Laryngoscope, 2024

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Presentation and Optimal Management of Anterior and Central Skull Base Osteoradionecrosis: Systematic Review and Meta‐Analysis

Shah,

Wu,

Sindwani

et al. 2024

The Laryngoscope

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show abstract

Fentanyl versus Dexmedetomidine Infusion in Head and Neck Free Flap Surgery for Comparison of Hemodynamic Parameters and Anaesthetic Requirements: A Randomised Controlled Trial

Bista,

Goswami,

Rewari

et al. 2024

Indian J Otolaryngol Head Neck Surg

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A review of advanced head and neck osteoradionecrosis

Cited by 2 publications

References 38 publications

Presentation and Optimal Management of Anterior and Central Skull Base Osteoradionecrosis: Systematic Review and Meta‐Analysis

Presentation and Optimal Management of Anterior and Central Skull Base Osteoradionecrosis: Systematic Review and Meta‐Analysis

Fentanyl versus Dexmedetomidine Infusion in Head and Neck Free Flap Surgery for Comparison of Hemodynamic Parameters and Anaesthetic Requirements: A Randomised Controlled Trial

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