Osteoradionecrosis

Osteoradionecrosis is one of the most serious complications arising from head and neck radiation therapy, and so one of the most studied. Mandibular bone is by far the first site concerned, with a few cases reported involving maxilla or temporal bone1'2. Since its description in the 1920s, its incidence, causality, contributing factors and management have been a topic of debate.

Most authors define the entity in terms of clinical parameters in their studies. Incidence reporting for osteoradionecrosis may not be as accurate as for other diseases due to the lack of standard definition. Certain authors define osteoradionecrosis as an bone exposure longer than 3 months3-6. Marx and Johnson7 define it as an area of exposed bone that has failed to show any evidence of healing for at least 6 months. Radiographically, periosteal thickening and lytic destruction are common8. A tumor recurrence must be excluded. Necrosis or irritation of adjacent tissues are common. As necrosis persists, secondary infection, fistula formation or fracture may ensure.

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