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Curr Treat Options Oncol ; 22(12): 115, 2021 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-34773495

RESUMEN

OPINION STATEMENT: Osteoradionecrosis (ORN) of the mandible is a rare but devastating complication which occurs following radiation therapy for head and neck malignancies. Left untreated, ORN often results in pathologic fracture of the mandible leading to pain, trismus, difficulty eating, and overall poor quality of life. Historically, early intervention relied on hyperbaric oxygen and local debridement. Patients whose disease progressed despite therapy required segmental resection of the mandible with osseous free flap reconstruction, a highly invasive operation. Patients that presented with a moderate disease without pathologic fracture were often doomed to fail non-operative management, ultimately leading to disease progression and fracture. The traditional dichotomous treatment paradigm left a void of options for patients with moderate disease. The ideal intervention for this category of patients would provide renewed vascularity to the diseased tissue bed allowing for the osteogenesis and reestablishment of strong, load-bearing bone. The innovative technique termed the vascularized fascia lata "rescue flap" has proven to be an effective treatment for moderate ORN and will likely transform dated treatment algorithms.


Asunto(s)
Antibacterianos/uso terapéutico , Antioxidantes/uso terapéutico , Conservadores de la Densidad Ósea/uso terapéutico , Oxigenoterapia Hiperbárica , Enfermedades Mandibulares/terapia , Osteorradionecrosis/terapia , Terapia por Ultrasonido , Desbridamiento , Humanos , Enfermedades Mandibulares/prevención & control , Osteotomía Mandibular , Reconstrucción Mandibular , Higiene Bucal , Osteorradionecrosis/prevención & control , Cese del Hábito de Fumar , Extracción Dental
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