Semin Plast Surg 2020; 34(02): 106-113
DOI: 10.1055/s-0040-1709144
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Osteoradionecrosis of the Maxilla: Conservative Management and Reconstructive Considerations

Tom Shokri
1  Department of Otolaryngology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
,
Weitao Wang
2  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
,
Aurora Vincent
2  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
,
Jason E. Cohn
3  Department of Otolaryngology–Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
,
Sameep Kadakia
4  Department of Plastic and Reconstructive Surgery, Wright State University, Dayton, Ohio
,
Yadranko Ducic
2  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
06 May 2020 (online)

Abstract

The implementation of radiotherapy in the multimodal treatment of advanced head and neck cancer has greatly improved survival rates. In some patients, however, this benefit comes at the potential expense of the tissue surrounding the primary site of malignancy. Osteoradionecrosis (ORN) of the facial bones, in particular the maxilla, is a debilitating complication of radiation therapy. Exposure to ionizing radiation results in devitalization of underlying bone with necrosis of adjacent soft tissue. Controversy surrounding appropriate early intervention in ORN persists and no consensus for clinical treatment has been established. In the present article, we review the pathophysiology of maxillary ORN and discuss the role of both conservative medical therapy and reconstruction.