Managing Mandibular Osteoradionecrosis

Overview

Journal Otolaryngol Head Neck Surg

Publisher Wiley

Specialties General Surgery
Otorhinolaryngology

Date 2024 Sep 27

PMID 39327863

Authors

Michael A Fritz

Khashayar Arianpour

Sara W Liu

Eric D Lamarre

Dane J Genther

Peter J Ciolek

Patrick J Byrne

Brandon L Prendes

Affiliations

Soon will be listed here.

Abstract

Objective: Mandibular osteoradionecrosis (MORN) is a morbid complication of head and neck radiation therapy. Recent advances in surgical and medical therapies underscore the need for a shift in traditional treatment paradigms and a disease grading system that can guide appropriate management.

Data Sources: Pubmed/MEDLINE.

Review Methods: We conducted a detailed review of publications related to MORN, specifically focusing on its staging and management techniques. Articles meeting inclusion criteria were synthesized into a final narrative review.

Conclusion: There has been a paradigm shift away from hyperbaric oxygen therapy in the management of MORN. Growing evidence for the efficacy of pentoxifylline and tocopherol in early-stage disease and novel surgical techniques to manage moderate and late-stage disease warrant an updated staging stratification which is proposed.

Implications For Practice: This review summarizes the clinical efficacy of established and novel therapeutic modalities currently available in treating MORN, emphasizing the significant advances achieved over the last decade. It introduces a contemporary staging and treatment algorithm which incorporates traditional, evidence-supported surgical and medical management with effective early intervention strategies.

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