OSTEORADIONECROSIS

Course overview

TREATMENT OF MALIGNANCIES WITH IONIZING RADIATION HAS SAVED COUNTLESS LIVES IN THE PAST 50 YEARS. HOWEVER, A SMALL PERCENTAGE OF PATIENTS TREATED WITH RADIATION FOR HEAD AND NECK CANCERS WILL DEVELOP OSTEORADIONECROSIS OF THE JAW. PATIENTS WITH OSTEORADIONECROSIS OF THE JAW MAY DEVELOP EXPOSED INTRAORAL MANDIBULAR BONE. MANY OF THESE PATIENTS WILL GO ON TO HEAL SPONTANEOUSLY AND WITHOUT COMPLICATION, BUT OTHERS MAY DEVELOP OSTEOMYELITIS AND EVEN FRACTURES OF THE MANDIBLE. THESE PATIENTS MAY DEVELOP SOFT TISSUE NECROSIS AS A FURTHER COMPLICATION. A NEWER RADIATION TECHNIQUE CALLED INTENSITY-MODULATED RADIATION THERAPY HAS BEEN REPORTED TO RESULT IN A LOWER INCIDENCE OF MANDIBULAR OSTEORADIONECROSIS. HYPERBARIC OXYGEN TREATMENT HAS BECOME A MAINSTAY OF AN INTERPROFESSIONAL TEAM APPROACH TO TREATING OSTEORADIONECROSIS. THIS ACTIVITY DESCRIBES THE PATHOPHYSIOLOGY, EVALUATION, AND MANAGEMENT OF OSTEORADIONECROSIS OF THE JAW AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN ITS MANAGEMENT.