Osteoradionecrosis

Osteoradionecrosis

Write short note on osteoradionecrosis.
Answer. Osteoradionecrosis is a radiation-induced pathologic process characterized by the chronic and painful infection and necrosis is accompanied by the late sequestration and sometimes permanent deformity.
This is one of the most serious complications of radiation to head and neck seen frequently today because of better treatment modalities and prevention.

Factors Leading to osteoradionecrosis

• Irradiation of an area of previous surgery before adequate healing had taken place.
• Irradiation of lesion in close proximity to bone.
• Prolong oral hygiene and continued use of irritants.
• Poor patient’s corporation in managing irradiated tissues.
• Surgery in irradiated area.
• Failure to prevent trauma to irradiated bony areas.

Pathogenesis

Osteoradionecrosis Clinical Features

• Mandible is more commonly affected as compared to maxilla due to low vascularity. Mostly the posterior region of mandible is affected.
• Presence of trismus, pyrexia and halitosis.
• There is also presence of intermittent swelling with drainage of pus extraorally.
• Pain is severe which continue from weeks to months.
• Persistently draining sinuses are present.
• Bone exposure is the hallmark of osteoradionecrosis.
• As the bone become necrotic due to lack of supply of blood sequestrum is formed.
• Pathological fracture of bone is a common feature.

Osteoradionecrosis Treatment

• Debridement of necrotic tissue should be done along with removal of sequestrum.
• Administration of intravenous antibiotic and hyperbaric oxygen therapy are essential.
• Maintenance of oral hygiene is necessary.