Osteoradionecrosis of the hyoid bone – a novel application of the Sonopet ultrasonic aspirator

Abstract

A 66-year-old man with a history of squamous cell carcinoma of the right tonsil presented to the emergency department with two life-threatening episodes of haemoptysis 9 months after completion of chemoradiation. He was evaluated to rule out recurrent malignancy, and was determined to have osteoradionecrosis of his hyoid bone that had led to an oropharyngeal fistula. Given the proximity to branches of the external carotid, he was offered tracheostomy and resection of the protruding necrotic bone with ultrasonic bone aspirator, which was placed down the shaft of the laryngoscope to minimise damage to adjacent structures. He tolerated the procedure well with complete resolution of exposed bone on follow-up laryngoscopy.

Osteoradionecrosis beyond the jaws: a mini case series and review of the literature

“…Treatment modalities reported amongst the 11 cases ranged from conservative management including observation and hyperbaric oxygen to surgical resection and reconstruction. One case report demonstrated effective use of an endoscopic ultrasonic bone aspirator for resection of HB‐ORN. Despite the unplanned detachment of the hyoid bone in our reported case, underlying soft tissues achieved complete and spontaneous granulation with no medical or surgical input and no long‐term consequences to the patient.…”

“…Hyoid bone ORN is a rare entity described in only 11 patients within the otolaryngology literature (Table 1) [10][11][12][13][14][15][16][17] . All cases had received RT doses ranging from 60 to 80 Gy for various stages and sites of primary HNC.…”