© Thieme Medical Publishers
Reconstruction of a Nasopharyngeal Defect from Cervical Spine Osteoradionecrosis
11 March 2010 (online)
Osteoradionecrosis of the cervical spine is a rare complication of radiation treatment of head and neck tumors that requires a multidisciplinary approach to management and reconstruction. The case of a 57-year-old man with osteoradionecrosis of the cervical spine secondary to radiation for metastatic hepatocellular carcinoma is presented. Operative debridement of the necrotic bone was performed and the nasopharyngeal soft tissue defect was reconstructed with a radial forearm free flap. The management and reconstruction options for osteoradionecrosis of the cervical spine are discussed.
Head and neck - reconstruction - microvascular - nasopharynx - osteoradionecrosis - cervical spine
- 1 Marx R E. Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg. 1983; 41 283-288
- 2 Teng M S, Futran N D. Osteoradionecrosis of the mandible. Curr Opin Otolaryngol Head Neck Surg. 2005; 13 217-221
- 3 Wong J R, Wood R E, McLean M. Conservative management of osteoradionecrosis. Oral Surg Oral Med Oral Pathol. 1997; 84 16-21
- 4 Marx R E, Ames J R. The use of hyperbaric oxygen therapy in bony reconstruction of the irradiated and tissue-deficient patient. J Oral Maxillofac Surg. 1982; 40 412-420
- 5 Donovan D J, Huynh T V, Purdom E B, Johnson R E, Sniezek J C. Osteoradionecrosis of the cervical spine resulting from radiotherapy for primary head and neck malignancies: operative and nonoperative management. Case report. J Neurosurg Spine. 2005; 3 159-164
- 6 Ng R L, Beahm E, Clayman G L, Hassenbusch S J, Miller M J. Simultaneous reconstruction of the posterior pharyngeal wall and cervical spine with a free vascularized fibula osteocutaneous flap. Plast Reconstr Surg. 2002; 109 1361-1365
- 7 Khoo M L, Soo K C, Gullane P J et al.. Resurfacing of the nasopharynx after nasopharyngectomy using a free radial forearm flap. Head Neck. 2001; 23 916-922
Daniel G Deschler, M.D.
Massachusetts Eye and Ear Infirmary
243 Charles Street, Boston, MA 02114