Osteoradionecrosis of the jaw (ORNJ)

  • 文章类型: Journal Article
    颌骨放射坏死(ORNJ)是头颈癌(HNC)肿瘤治疗放疗后的一种令人恐惧的并发症。迄今为止,没有明确的证据表明ORNJ手术治疗对受影响患者生活质量(QoL)的影响.然而,了解手术治疗方法的重要性及其对QoL的影响是最佳决策过程中的重要因素,个体化治疗。在这项前瞻性临床研究中,使用标准化问卷(EORTCQLQ-C30,QLQ-HN35,OHIP-14)评估QoL与ORNJ手术治疗前后健康相关QoL(HRQoL)和口腔健康相关QoL(OHQoL)的关系。对有关功能和症状相关投诉的总体QoL评分以及所收集量表的各个领域进行了统计分析。关于年龄的分组,性别,使用KruskalWallis检验比较不同危险因素和ORNJ治疗类型.此外,收集和分析临床和人口统计学患者数据.QoL改善与手术ORNJ的类型和住院时间相关。关于不同的症状,如疼痛,术后获得了更好的QoL评分,吞咽和张开嘴。放射治疗的长期效果仍然明显限制QoL,并随着时间的推移而恶化。
    Osteoradionecrosis of the jaw (ORNJ) is a feared complication following radiation therapy performed for oncological treatment of head and neck cancers (HNC). To date, there is no clear evidence regarding the impact of surgical treatment of ORNJ on the quality of life (QoL) of affected patients. However, understanding the significance of the surgical treatment approach and its effects on QoL is an essential factor in the decision-making process for optimal, individualized therapy. In this prospective clinical study, QoL was assessed in relation to health related QoL (HRQoL) and oral health related QoL (OHQoL) before and after surgical treatment of ORNJ using standardized questionnaires (EORTC QLQ-C30, QLQ-HN35, OHIP-14). The overall QoL scores as well as individual domains of the collected scales regarding functional and symptom-related complaints were statistically analyzed. Subgroups concerning age, gender, different risk factors and type of ORNJ therapy were compared using Kruskal Wallis test. In addition, clinical and demographic patient data were collected and analyzed. QoL improvement correlated with the type of surgical ORNJ and the length of hospitalization. Better QoL scores were achieved post-operatively regarding different symptoms like pain, swallowing and mouth opening. Long-term effects of radiation therapy remained visibly restrictive to QoL and worsen over time.
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  • 文章类型: Journal Article
    Osteoradionecrosis of the jaw (ORNJ) is one of the most devastating and progressive complications of head and neck radiotherapy. It can cause emaciation, deformity, and pathological fractures, resulting in decreased quality of life. The aim of this study was to evaluate the preoperative index and outcomes of treatment for ORNJ. A retrospective study of 252 ORNJ cases treated at one institution between January 2010 and January 2018 was made. The abnormal items from the preoperative examination and follow-up after different treatments were recorded, and the differences between the noteworthy items were compared using univariate and multivariate models. Most ORNJ patients in the middle and late stages had abnormal items, such as hypoproteinaemia, anaemia, and leucocytosis. Partial mandibulectomy with flap reconstruction was significantly more effective than without reconstruction. Advanced ORNJ patients tended to have more abnormal items, which might have a negative influence on treatment. For better outcomes, it is essential and effective to completely remove the necrotic lesion and reconstruct it with a flap. The surgeons should provide sufficient perioperative management and strive for suitable surgical treatment.
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