Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radiotherapy

Abstract

: Conservative management should be limited to early-onset ORN after brachytherapy with or without a low dose of external irradiation. Marginal mandibulectomy is appropriate for the late-onset ORN after brachytherapy with or without low-dose external irradiation. Segmental mandibulectomy is required for late-onset ORN after a high dose of external irradiation.

Osteoradionecrosis Complicating Mandibulotomy

“…All devascularized bone must be resected, and ideally, blood supply to the tissue must be optimized. It has been proposed that the time interval between the completion of radiation therapy and the onset of osteoradionecrosis helps to dictate aggressiveness of surgical management, 12 but the amount of bone to be resected is strictly a clinical decision and is based on the presence of brightly bleeding edges of the remaining bone.…”

Doble injerto microvascularizado de peroné para reconstrucción bilateral mandibular por osteorradionecrosis

“…Fracturas patológicas o fístulas persistentes son claros indicadores para un abordaje quirúrgico más radical 1,8 .…”

Maxillary osteoradionecrosis – review of published literature: incidence, classification, risk factors, physiopathology and prevention

“…Wong best defines it, in 1997 as a slow-healing radiation-induced ischemic necrosis of variable extent occurring in the absence of local primary tumor necrosis, recurrence, or metastatic disease 2 . Clinically ORN starts with an asymptomatic small mucosal breakdown exposing the overlying bone, but it may evolve to a very painful, debilitating situation 3,4 . The management of ORN is controversial varying from the more conservative to the more aggressive treatment [5][6][7][8] .…”