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Carbon Dioxide Laser Sequestrectomy for Osteoradionecrosis: A Case Series.

Jesse R Qualliotine1, Andrew Yousef1, Ryan K Orosco1,2

  • 1Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, La Jolla, California, USA.

Photobiomodulation, Photomedicine, and Laser Surgery
|February 13, 2023
PubMed
Summary

A novel carbon dioxide (CO2) laser sequestrectomy technique effectively treated osteoradionecrosis (ORN) of the jaw in five patients. This clinic-based approach resolved pain and achieved mucosal coverage, offering a promising new treatment for ORN.

Keywords:
CO2 laserhead and neck neoplasmsin-clinic procedurenovel treatment approachosteoradionecrosis

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Oncology
  • Laser Medicine

Background:

  • Osteoradionecrosis (ORN) of the jaw is a severe complication following radiotherapy for head and neck cancers.
  • Current treatments for early-stage ORN, including curettage and mechanical bone removal, have limited success.
  • There is a critical need for innovative therapeutic strategies for managing ORN of the jaw.

Purpose of the Study:

  • To present a novel, clinic-based sequestrectomy technique utilizing a carbon dioxide (CO2) laser for treating ORN of the jaw.
  • To evaluate the efficacy and durability of CO2 laser sequestrectomy in patients with early-to-intermediate stage ORN.
  • To explore the potential of this minimally invasive approach as an alternative to traditional surgical methods.

Main Methods:

  • A series of five cases involving patients with early-to-intermediate stage ORN of the jaw were treated.
  • A CO2 laser was employed for sequestrectomy in an office-based setting.
  • Treatments were performed on exposed bone lesions located in the mandibular gingiva, maxillary gingiva, and hard palate.

Main Results:

  • All five patients experienced complete resolution of ORN-related pain.
  • Complete mucosal coverage over the previously exposed bone was achieved in all cases.
  • Durable results were observed, with follow-up ranging from 7 to 19 months, and patients required one to two laser treatment sessions.

Conclusions:

  • CO2 laser sequestrectomy demonstrates encouraging results for managing ORN of the jaw.
  • This novel, office-based intervention offers a potentially effective and durable treatment option.
  • Further investigation in larger prospective studies and in conditions like medication-related osteonecrosis of the jaw is warranted.