Postradiation nasopharyngeal necrosis is an important late effect of radiotherapy that affects prognosis in patients with nasopharyngeal carcinoma.In the present study,we reviewed the clinical and imaging features of ...Postradiation nasopharyngeal necrosis is an important late effect of radiotherapy that affects prognosis in patients with nasopharyngeal carcinoma.In the present study,we reviewed the clinical and imaging features of 67 patients with pathologically diagnosed postradiation nasopharyngeal necrosis who were treated at Sun Yat-sen University Cancer Center between June 2006 and January 2010.Their clinical manifestations,endoscopic findings,and imaging features were analyzed.Early nasopharyngeal necrosis was limited to a local site in the nasopharyngeal region,and the tissue defect was not obvious,whereas deep parapharyngeal ulcer or signs of osteoradionecrosis in the basilar region was observed in serious cases.Those with osteoradionecrosis and/or exposed carotid artery had a high mortality.In conclusion,Postradiation nasopharyngeal necrosis has characteristic magnetic resonance imaging appearances,which associate well with clinical findings,but pathologic examination is essential to make the diagnosis.展开更多
下颌骨放射性骨坏死(osteoradionecrosis of the mandible,ORNM)是头颈部癌放射治疗后一种常见的并发症。近年来,三维适形和调强放疗新技术已明显减少了下颌骨的放射剂量,加上病因学预防措施包括严格的口腔护理,已使ORNM发生率明显减少...下颌骨放射性骨坏死(osteoradionecrosis of the mandible,ORNM)是头颈部癌放射治疗后一种常见的并发症。近年来,三维适形和调强放疗新技术已明显减少了下颌骨的放射剂量,加上病因学预防措施包括严格的口腔护理,已使ORNM发生率明显减少。此无论对提高放疗患者的生存质量,还是节省医疗资源和医疗开支意义十分重大。本文述评下降ORNM相关研究进展,讨论ORNM的预防新概念,为临床放射治疗头颈部癌减少ORNM提供新策略。展开更多
目的 :探讨游离腓骨肌-皮-筋膜复合瓣在修复下颌骨放射性骨坏死(osteoradionecrosis of the jaws,ORNJ)术后软、硬组织缺损的应用价值。方法:选择2014年3月—2017年7月间,中山大学孙逸仙纪念医院口腔颌面外科40例下颌骨ORNJ患者,所有病...目的 :探讨游离腓骨肌-皮-筋膜复合瓣在修复下颌骨放射性骨坏死(osteoradionecrosis of the jaws,ORNJ)术后软、硬组织缺损的应用价值。方法:选择2014年3月—2017年7月间,中山大学孙逸仙纪念医院口腔颌面外科40例下颌骨ORNJ患者,所有病例原发肿瘤均为鼻咽癌,排除鼻咽癌复发。以游离腓骨肌-皮-筋膜复合瓣重建放射性下颌骨坏死手术切除后的骨缺损,以皮岛修复皮肤软组织缺损,以筋膜修复口内黏膜缺损并充填软组织缺损的空腔,记录腓骨截骨、组织瓣存活情况,供区、受区并发症,术后开口度和余留牙咬合情况,对颌面部外形和功能进行评价。结果:随访3~6个月,游离腓骨肌-皮-筋膜复合瓣重建下颌骨缺损均获成功。下颌骨截骨长度5.5~16.0 cm,切取腓骨长度7.5~17.0 cm。无1例发生严重供区或受区并发症,所有病例外形恢复良好,开口度1.0~3.5 cm,余留牙咬合正常。结论:游离腓骨肌-皮-筋膜复合瓣能很好地即刻重建放射性下颌骨坏死术后颌面部软、硬组织缺损,降低手术并发症,值得临床推广应用。展开更多
文摘Postradiation nasopharyngeal necrosis is an important late effect of radiotherapy that affects prognosis in patients with nasopharyngeal carcinoma.In the present study,we reviewed the clinical and imaging features of 67 patients with pathologically diagnosed postradiation nasopharyngeal necrosis who were treated at Sun Yat-sen University Cancer Center between June 2006 and January 2010.Their clinical manifestations,endoscopic findings,and imaging features were analyzed.Early nasopharyngeal necrosis was limited to a local site in the nasopharyngeal region,and the tissue defect was not obvious,whereas deep parapharyngeal ulcer or signs of osteoradionecrosis in the basilar region was observed in serious cases.Those with osteoradionecrosis and/or exposed carotid artery had a high mortality.In conclusion,Postradiation nasopharyngeal necrosis has characteristic magnetic resonance imaging appearances,which associate well with clinical findings,but pathologic examination is essential to make the diagnosis.
文摘下颌骨放射性骨坏死(osteoradionecrosis of the mandible,ORNM)是头颈部癌放射治疗后一种常见的并发症。近年来,三维适形和调强放疗新技术已明显减少了下颌骨的放射剂量,加上病因学预防措施包括严格的口腔护理,已使ORNM发生率明显减少。此无论对提高放疗患者的生存质量,还是节省医疗资源和医疗开支意义十分重大。本文述评下降ORNM相关研究进展,讨论ORNM的预防新概念,为临床放射治疗头颈部癌减少ORNM提供新策略。
文摘目的 :探讨游离腓骨肌-皮-筋膜复合瓣在修复下颌骨放射性骨坏死(osteoradionecrosis of the jaws,ORNJ)术后软、硬组织缺损的应用价值。方法:选择2014年3月—2017年7月间,中山大学孙逸仙纪念医院口腔颌面外科40例下颌骨ORNJ患者,所有病例原发肿瘤均为鼻咽癌,排除鼻咽癌复发。以游离腓骨肌-皮-筋膜复合瓣重建放射性下颌骨坏死手术切除后的骨缺损,以皮岛修复皮肤软组织缺损,以筋膜修复口内黏膜缺损并充填软组织缺损的空腔,记录腓骨截骨、组织瓣存活情况,供区、受区并发症,术后开口度和余留牙咬合情况,对颌面部外形和功能进行评价。结果:随访3~6个月,游离腓骨肌-皮-筋膜复合瓣重建下颌骨缺损均获成功。下颌骨截骨长度5.5~16.0 cm,切取腓骨长度7.5~17.0 cm。无1例发生严重供区或受区并发症,所有病例外形恢复良好,开口度1.0~3.5 cm,余留牙咬合正常。结论:游离腓骨肌-皮-筋膜复合瓣能很好地即刻重建放射性下颌骨坏死术后颌面部软、硬组织缺损,降低手术并发症,值得临床推广应用。
