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Comparison of Effectiveness of Conservative and Surgical Management of Osteoradionecrosis: A Clinical Study
Amit Rao1, Farouq Afsha Md2, Mrinal M Gawali3
1Department of Oral and Maxillofacial Surgery, Dr HSRSM Dental College and Hospital, Hingoli, Maharashtra, India.
Background:
Osteoradionecrosis (ORN) is a severe complication of radiation therapy in head and neck cancer patients, characterized by necrotic bone exposure, pain, and secondary infections. The optimal treatment approach remains debated between conservative management and surgical intervention.
Methods:
A prospective study was conducted on subjects diagnosed with ORN. Participants were divided into two groups: One receiving conservative management (antibiotics, hyperbaric oxygen therapy, pentoxifylline, and tocopherol) and the other undergoing surgical treatment (sequestrectomy, resection, or free flap reconstruction). Outcomes were assessed based on pain relief, radiographic healing, functional recovery, and recurrence rates.
Results:
A total of 60 subjects were included, with 30 in each group. Pain relief was achieved in 70% of the conservative group versus 90% in the surgical group (P = .03). Complete resolution of ORN occurred in 50% of the conservative group and 83% of the surgical group (P = .01). Surgical intervention was associated with longer hospital stays but superior long-term functional recovery.
Conclusion:
Conservative management is beneficial in early-stage ORN but has a higher recurrence rate. Surgical treatment remains the gold standard for advanced cases. A multidisciplinary approach is crucial for optimizing treatment outcomes.
