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.
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http://dx.doi.org/10.1016/j.jcms.2005.05.006 | DOI Listing |
Otolaryngol Head Neck Surg
January 2025
Section of Facial Plastic and Microvascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Objective: Describe the use, indications, and outcomes of iliac crest bone graft (ICBG) with concomitant anterolateral thigh fascia lata (ALTFL) rescue flap for the management of mandibular osteoradionecrosis (ORN).
Study Design: Retrospective chart review.
Setting: Single institution.
Int J Surg
December 2024
Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, P. R. China.
Background: Many studies have compared lip-splitting mandibulotomy (LSM) and lip-mandible preservation (LMP) techniques in oral and oropharyngeal cancer (OOPC) patients with inconsistent conclusions. Evidence-based recommendations for the optimal surgical approach for treating OOPC are lacking.
Methods: The Cochrane Library, Pubmed, Embase, Web of Science, WAN-FANG, CQVIP, and China National Knowledge Infrastructure were systematically searched to identify studies that compared LSM versus LMP for OOPC.
Int J Radiat Oncol Biol Phys
December 2024
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:
Purpose: Osteoradionecrosis (ORN) is a feared complication after head and neck radiation, but the incidence and radiotherapy risk factors for ORN in children are unknown. In this retrospective analysis of a prospectively collected dataset, we evaluated the incidence and factors associated with development of ORN in children treated with proton therapy for head and neck malignancies.
Methods And Materials: We reviewed records from patients treated at a single institution between December 2006 and February 2020 including demographic data, tumor, and treatment details, ORN occurrence, and dosimetry.
Braz Oral Res
December 2024
Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Pathology and Surgery, Belo Horizonte, MG, Brazil.
Radiother Oncol
January 2025
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, Berlin 13353, Germany.
Background And Purpose: With standard radiotherapy protocols after R0 resection of advanced local oral squamous cell carcinoma (OSCC) and primary reconstruction of segmental defects, a high radiation dose is applied to healthy tissue in autologous microvascular free flaps. Considering the potential consequences of flap complications and associated surgeries for patients, data is lacking on whether postoperative radiotherapy (PORT) of the flap volume is indicated at all.
Materials And Methods: Patients with segmental mandibular resection and immediate reconstruction with osseous free flaps due to advanced OSCC between 2012 and 2022 were analyzed retrospectively regarding overall (OS), disease-free survival (DFS), local failure-free survival (LFFS), the need for secondary surgeries as well as flap complications and compared between patients with and without PORT in a matched-pair approach with occurrence of flap complications as a primary endpoint.
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