Late effects of radiation therapy in the head and neck region

The head and neck region is composed of numerous structures, each with an inherent response to radiation that is largely governed by the presence or absence of mucosa, salivary glands, or specialized organs within that site. Irradiated mucocutaneous tissues demonstrate increased vascular permeability that leads to fibrin deposition, subsequent collagen formation, and eventual fibrosis. Irradiated salivary tissue degenerates after relatively small doses, leading to markedly diminished salivary output. This, in turn, effects the teeth by promoting dental decay which, in turn, effects the integrity of the mandible. Details of these changes are presented, including their pathophysiology, clinical syndromes, and potential treatment.