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Home
Managing Mandibular Osteoradionecrosis.

Home
Managing Mandibular Osteoradionecrosis.

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Managing Mandibular Osteoradionecrosis.

Michael A Fritz¹, Khashayar Arianpour¹, Sara W Liu¹

¹Division of Facial Plastic and Microvascular Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|September 27, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Mandibular osteoradionecrosis (MORN) management is shifting away from hyperbaric oxygen. New evidence supports pentoxifylline and tocopherol for early MORN, with advanced surgical options for later stages.

Keywords:

free flap head and neck jaw mandible microsurgery osteoradionecrosis reconstruction rescue flap staging

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Area of Science:

Oncology
Oral and Maxillofacial Surgery
Radiation Oncology

Background:

Mandibular osteoradionecrosis (MORN) is a severe complication following head and neck radiation therapy.
Traditional treatment paradigms for MORN require re-evaluation due to recent therapeutic advancements.

Purpose of the Study:

To review current MORN staging and management techniques.
To propose an updated staging system guiding appropriate MORN treatment.
To highlight a paradigm shift in MORN management.

Main Methods:

A comprehensive literature review was conducted using PubMed/MEDLINE.
Publications focusing on MORN staging and management were synthesized.
A narrative review approach was employed.

Main Results:

A significant shift away from hyperbaric oxygen therapy in MORN management is evident.
Pentoxifylline and tocopherol show efficacy in early-stage MORN.
Novel surgical techniques are emerging for moderate and late-stage MORN.

Conclusions:

An updated MORN staging stratification is proposed, reflecting current therapeutic evidence.
Contemporary MORN treatment algorithms integrate traditional and novel medical and surgical approaches.
Early intervention strategies are crucial for effective MORN management.