Volume 18, Number 3, September 2006
| | Free Omental Transfer for Osteoradionecrosis of the Mandible: Objective Sequential Evaluation by Scintigraphy |
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Beng Gwan Teh,1 Wataru Kobayashi,1 Makoto Kobayashi,2 Kuniko Kado,3 Hiroto Kimura1
1Department of Oral and Maxillofacial Surgery, Hirosaki University School of Medicine, Aomori, 2Division of Surgery, Hakodate Goryoukaku Hospital, Hokkaido, and 3Department of Oral Surgery and Dentistry, Misawa City Hospital, Aomori, Japan
Abstract
Objective: To evaluate the effectiveness of free omental transfer for osteoradionecrosis in patients with head and neck cancer.
Patients and Methods: Five patients with osteoradionecrosis of the mandible undergoing free omental transfer were sequentially evaluated postoperatively by orthopantomography and bone scintigraphy. The bone remodelling of the osteoradionecrotic region was evaluated quantitatively 6 months and 1, 2, 3, and 5 years after free omental transfer by calculating the ratio of isotope uptake between the osteoradionecrotic region and the contralateral region.
Results: All patients recovered completely with no signs of osteoradionecrosis, fistulas, or intolerable pain, although 2 patients developed pathological fractures after operation, which were successfully treated by conservative means. Isotope uptake in the osteoradionecrotic region diminished significantly postoperatively and bone remodelling was observed.
Conclusion: Free omental transfer is promising for the management of osteoradionecrosis. The need for segmental resection of the mandible may be avoided.
Key words: Head and neck neoplasms, Omentum, Osteoradionecrosis, Radionuclide imaging
Asian J Oral Maxillofac Surg. 2006;18:180-184
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