Type:
Educational Exhibit
Keywords:
Head and neck, Oncology, CT, PET, Radiation effects, Radiation therapy / Oncology, Cancer
DOI:
10.26044/ranzcr2022/R-0125
Conclusion
The development of ORN has been associated with several risk factors such as poor oral health status, radiation dose, pre-radiotherapy surgery, chemotherapy, alcohol intake and tobacco use.1 Radiation is the main etiologic factor in a dose dependent manner.3 ORN is rare with a conventional radiation dose of less than 60 Gy while rates are higher in those that receive more than 60Gy (12%).3 The use of IMRT has been associated with a lower risk of ORN and lower severity if it develops.3
Management options for ORN are determined by the severity of the disease and often includes both hyperbaric oxygen therapy and surgical resection.3 The use of hyperbaric oxygen therapy has remained controversial, with evidence suggesting limited benefits.3 There is no universal treatment approach for ORN as it is dependent on the institution and experiences of the treating team.3 At our institution, Head and Neck Surgeons along with Oral Maxillofacial Surgeons manage patients with ORN together. MJ was treated surgically with a left mandibulectomy and left fibula free flap.