Osteoradionecrosis of the head and neck: a case of a clavicular-tracheal fistula secondary to osteoradionecrosis of the sternoclavicular joint
Radiation therapy is an integral part of treatment for head and neck cancer, but its use is not without complications. We describe the first reported sternoclavicular-tracheal fistula resulting from osteoradionecrosis (ORN) at the medial clavicle. This ORN resulted from definitive radiation therapy for a primary pyriform sinus squamous cell carcinoma. The diagnosis of ORN was made by fiberoptic bronchoscopy. The physiologic damage of ORN is based on a compromised blood supply and altered metabolism of bone formation secondary to effects of ionizing radiation. Treatment requires meticulous hygiene, antibiotics, and debridement as conservative therapy. Radical surgery and reconstruction may be indicated in refractory cases. A thorough preirradiation assessment of patients is mandatory to decrease the incidence of radiation-induced ORN.
- Research Organization:
- Thomas Jefferson Univ. Hospital, Philadelphia, PA (USA)
- OSTI ID:
- 6599121
- Journal Information:
- Ann. Otol., Rhinol., Laryngol.; (United States), Vol. 97
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
HEAD
OSTEORADIONECROSIS
NECK
RADIOINDUCTION
RADIOTHERAPY
SIDE EFFECTS
PATIENTS
RADIATION INJURIES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
DISEASES
INJURIES
LOCAL RADIATION EFFECTS
MEDICINE
NECROSIS
NUCLEAR MEDICINE
PATHOLOGICAL CHANGES
RADIATION EFFECTS
RADIOLOGY
SKELETAL DISEASES
THERAPY
560151* - Radiation Effects on Animals- Man