[Current treatment of osteoradionecrosis]

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Oncology

Context:

• Osteoradionecrosis (ORN) of the mandible is a debilitating complication following radiotherapy.
• Conventional treatments often involve extensive hemimandibulectomy, leading to significant functional and aesthetic deficits.
• There is a need for less invasive and more effective ORN management strategies.

Purpose:

• To present a refined surgical approach for managing osteoradionecrosis of the mandible.
• To evaluate the efficacy of preserving mandibular continuity and utilizing distant vascularized flaps.
• To assess the impact of these flaps on tissue vitality and bone regeneration.

Summary:

• A new surgical method for ORN of the mandible is proposed, focusing on excising only infected and necrotic bone while maintaining mandibular integrity.
• The remaining bone is covered with a distant, well-vascularized flap, which provides mechanical support and enhances tissue viability.
• The study reports on five cases using this method and six cases where immediate repair with osteo-musculo-cutaneous flaps was performed after bone resection.

Impact:

• This technique potentially reduces the extent of bone resection required for ORN treatment.
• The use of vascularized flaps promotes improved healing and vitality of the compromised mandibular bone.
• This approach offers a promising alternative for ORN management, aiming to preserve mandibular function and aesthetics.