Managing Mandibular Osteoradionecrosis.

Autor: Fritz MA; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Arianpour K; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Liu SW; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Lamarre ED; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Genther DJ; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Ciolek PJ; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Byrne PJ; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA., Prendes BL; Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Sep 27. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1002/ohn.990
Abstrakt: Objective: Mandibular osteoradionecrosis (MORN) is a morbid complication of head and neck radiation therapy. Recent advances in surgical and medical therapies underscore the need for a shift in traditional treatment paradigms and a disease grading system that can guide appropriate management.
Data Sources: Pubmed/MEDLINE.
Review Methods: We conducted a detailed review of publications related to MORN, specifically focusing on its staging and management techniques. Articles meeting inclusion criteria were synthesized into a final narrative review.
Conclusion: There has been a paradigm shift away from hyperbaric oxygen therapy in the management of MORN. Growing evidence for the efficacy of pentoxifylline and tocopherol in early-stage disease and novel surgical techniques to manage moderate and late-stage disease warrant an updated staging stratification which is proposed.
Implications for Practice: This review summarizes the clinical efficacy of established and novel therapeutic modalities currently available in treating MORN, emphasizing the significant advances achieved over the last decade. It introduces a contemporary staging and treatment algorithm which incorporates traditional, evidence-supported surgical and medical management with effective early intervention strategies.
(© 2024 The Author(s). Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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