OSTEORADIONECROSIS OF THE MANDIBLE AND ITS TREATMENT

Journal Article · Fri Nov 01 04:00:00 EST 1963 · American Journal of Surgery (U.S.)

DOI:https://doi.org/10.1016/0002-9610(63)90407-0· OSTI ID:4077091

MacDougall, J A; Evans, A M; Lindsay, R K

Various courses of management of patients whose teeth are present and who undergo radiotherapy are discussed. Results are described for the period 1940 to 1949, when radiation for mouth cancer was given by medium voltage x rays and by Ra implants and molds; no preradiation extractions were performed and no radical surgical operations were performed. In a total of 180 patients so treated, in nine osteoradionecrosis developed; and in five cases in edentulous mouths. A comparison is made with results over the following 10 yr. Since 1952 all patients with oral cancer were treated by an external Co/sup 60/ source by single or multiple fields or by Ra implants and molds. During the period 1950 to 1959, 184 patients were treated by radiation; 31 of whom received preradiation dental extractions. Osteoradionecrosis occurred in nine instances, three of which were in edentulous patients. The decreased incidence in this group is attributed to the decreased differential absorption in bone from Co/sup 60/ gamma radiation. It is concluded that treatment of established osteoradionecrosis should be radical, and that pain, trismus, and deformity, progressing to fracture and fistula formation, should not be tolerated in the absence of cancer. The use of antibiotics and other methods to influence infection and pain serve only to prolong the disease. The surgical techniques of hemimandibulectomy, to remove devitalized irradiated areas, are described in detail. (BBB)

• Research Organization: British Columbia Cancer Inst., Vancouver, Can.
• Sponsoring Organization: USDOE
• NSA Number: NSA-18-015921
• OSTI ID: 4077091
• Journal Information: American Journal of Surgery (U.S.), Journal Name: American Journal of Surgery (U.S.) Vol. Vol: 106; ISSN AJSUA
• Country of Publication: Country unknown/Code not available
• Language: English

Related Subjects

ABSORPTION
ANTIBIOTICS
BIOLOGY AND MEDICINE
BONES
COBALT 60
DRUGS
GAMMA RADIATION
INFECTIONS
MAN
RADIATION INJURIES
RADIOTHERAPY
RADIUM
SURGERY
TISSUES
X RADIATION