Maxillary osteonecrosis after radiotherapy for nasopharyngeal carcinoma

A case of extensive osteoradionecrosis of the posterior maxillae, pterygoid plates and floor of the sphenoid sinuses is reported. The patient received more than one full course of radical radiotherapy for nasopharyngeal carcinoma. Although there was complete remission of the tumour, she suffered from repeated episodes of gum bleeding which was found to be due to oroantral fistulas and severe dental decay. The large fraction dose and total dose, severe dental caries and xerostomia are the most likely contributory causes to this unusual complication in our patient.