Systematic management of osteoradionecrosis in the head and neck
Systematic management of osteoradionecrosis in the head and neck
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DOI：
10.1097/00005537-199908000-00027
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发表时间：
1999-08-01
期刊：
影响因子：
2.6
通讯作者：
Su, JL
中科院分区：
文献类型：
--
作者：
Hao, SP;Chen, HC;Su, JL
目的：放射性骨坏死是放射治疗最严重和最具破坏性的并发症之一。目前尚未确定放射性骨坏死的正确治疗方法。本研究的目的是评估放射性骨坏死系统方法的治疗结果。研究设计：对头颈部放射性骨坏死的系统治疗方法进行了前瞻性研究。方法：1993年7月至1998年6月，采用死骨切除加高压氧治疗的系统方法治疗头颈部放射性骨坏死33例。结果：七人 (21%) 患有复发性癌症。其余26例放射性骨坏死病例控制率为77%（20/26）。结论：尽管进行了积极的根治治疗，但持续性放射性骨坏死仍引起癌症复发的怀疑。广泛性放射性骨坏死伴多发性瘘管、大面积坏死骨暴露或合并骨折，应主要采用根治性死骨切除术和微血管游离皮瓣重建治疗。手术在控制放射性骨坏死方面仍发挥主要作用，高压氧治疗为辅助。
Objectives: Osteoradionecrosis is one of the most serious and devastating complications of radiotherapy. The proper management of osteoradionecrosis is currently undetermined. The objective of this study is to evaluate the treatment results of a systematic approach to osteoradionecrosis. Study Design: A prospective study of a systematic approach to osteoradionecrosis in the head and neck area was undertaken. Methods: From July 1993 to June 1998, 33 cases of osteoradionecrosis in the head and neck area were treated using a systematic approach that combined sequestrectomy and hyperbaric oxygen therapy. Results: Seven (21%) had recurrent cancer. The control rate of the other 26 osteoradionecrosis cases was 77% (20/26). Conclusions: Persistent osteoradionecrosis, despite diligent radical treatment, raises the suspicion of recurrent cancer. Extensive osteoradionecrosis with a multiple discharging fistula, a large area of exposed necrotic bone, or a coexistent fracture should be treated primarily with radical sequestrectomy and microvascular free flap reconstruction. Surgery still plays a major role in controlling osteoradionecrosis, and hyperbaric oxygen therapy is adjuvant.