Meeting abstract

Do We Know Everything about Radioosteonecrosis?

Irina Filpović Zore
Joško Grgurević

Abstract

According to data of the World Health Organisation, malignant diseases, apart from cardiovascular diseases, are the most prevalent diseases of today.
As one form of therapy for malignancy radiation in 63% of patients has the primary task of destroying tumour cells, while minimally damaging the surrounding tissue.
The greatest and most dangerous complication in radiotherapy of the head and neck is without doubt osteoradionecrosis (ORN). It occurs most frequently when the dose of radiation is more than 60 Gy or in the case of patients who receive combined radio and chemo-therapy. ORN occurs in 5-22% of such irradiated patients. ORN can occur spontaneously, although in 60% of cases it occurs as a response to tissue injury, usually after tooth extraction, but also after other manipulations in the oral cavity. Because of the radiation the bone becomes acellular, avascular and hypoxic, and clinically can be interpreted as the occurrence of ulceration, mucous membrane necrosis and exposure of necrotic bone, with pain and eventual paresthesia. Predilective sites are the posterior parts of the mandible. For diagnosis of ORN, apart from a medical examination, orthopantomogram, computerised tomography and magnetic resonance are needed. In the future SPECT (single-photon emission computed tomography) will have an important role.
Clinical indicators in the therapy of ORN are first and foremost a good preventive programme and periradiational care of the patient undergoing radiation, and in the case that changes do occur surgical therapy is needed, therapy with hydrobaric oxygen (HBO), and the use of Marx's protocol. Presentation of numerous examples from our practice shows how many clinical indicators are implemented.

Keywords

Hrčak ID:

2325

URI

https://hrcak.srce.hr/2325

Publication date:

15.12.2004.

Article data in other languages: croatian

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