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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Diagnostic Features and Management Strategy of a Refractory Case of Osteoradionecrosis of the Mandible: Case Report and Review of Literature</title><author><name sortKey="Jeyaraj, Priya" sort="Jeyaraj, Priya" uniqKey="Jeyaraj P" first="Priya" last="Jeyaraj">Priya Jeyaraj</name><affiliation><nlm:aff id="Aff1">Command Military Dental Centre (Northern Command), Udhampur, Jammu & Kashmir India</nlm:aff></affiliation></author><author><name sortKey="Bandyopadhyay, T K" sort="Bandyopadhyay, T K" uniqKey="Bandyopadhyay T" first="T. K." last="Bandyopadhyay">T. K. Bandyopadhyay</name><affiliation><nlm:aff id="Aff2">Director General Dental Services, Army Dental Corps, New Delhi, India</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27298551</idno><idno type="pmc">4871838</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871838</idno><idno type="RBID">PMC:4871838</idno><idno type="doi">10.1007/s12663-015-0833-y</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000946</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000946</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Diagnostic Features and Management Strategy of a Refractory Case of Osteoradionecrosis of the Mandible: Case Report and Review of Literature</title><author><name sortKey="Jeyaraj, Priya" sort="Jeyaraj, Priya" uniqKey="Jeyaraj P" first="Priya" last="Jeyaraj">Priya Jeyaraj</name><affiliation><nlm:aff id="Aff1">Command Military Dental Centre (Northern Command), Udhampur, Jammu & Kashmir India</nlm:aff></affiliation></author><author><name sortKey="Bandyopadhyay, T K" sort="Bandyopadhyay, T K" uniqKey="Bandyopadhyay T" first="T. K." last="Bandyopadhyay">T. K. Bandyopadhyay</name><affiliation><nlm:aff id="Aff2">Director General Dental Services, Army Dental Corps, New Delhi, India</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Maxillofacial & Oral Surgery</title><idno type="ISSN">0972-8279</idno><idno type="eISSN">0974-942X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Osteoradionecrosis of the jaws produces a considerable amount of esthetic as well as functional deficits seriously affecting quality of life of the patient. Cases are often notoriously difficult to treat and manage owing to associated comorbidities of the patient, post irradiation fibrosis and decreased vascularity at the site, which complicates free tissue flap and graft transfer, that subsequently succumb to failure. Hyperbaric oxygen therapy (HBOT), in which 100 % oxygen is administered by mask under 2.4 atm pressure, in a hyperbaric oxygen chamber, helps by increasing local vascularity.</p></sec><sec><title>Aim and Methods</title><p>It was the aim of this study to show that a particularly refractory, compromised and challenging case of osteoradionecrosis can be managed successfully even without HBOT, by mandibular segmental resection followed by reconstruction using a titanium reconstruction plate enveloped within a pedicled Pectoralis Major Myocutaneous flap.</p></sec><sec><title>Result</title><p>Post operative recovery of the patient was excellent with good functional and esthetic rehabilitation of the patient with and practically nil donor site morbidity.</p></sec><sec><title>Conclusion</title><p>It is important to have a thorough knowledge of the clinical, radiographic, histopathologic, CT and MRI features of osteoradionecrosis of the jaws in order to make a quick and accurate confirmatory diagnosis and to overcome possible diagnostic dilemmas. The strategy of reconstruction of a large mandibular defect using a bridging titanium plate sandwiched by a healthy vascularized myocutaneous flap, following ablative surgery for ORN, has proved to be a safe and reliable option for composite mandibular defects, with gratifying long term functional and cosmetic results.</p></sec></div></front></TEI><pmc article-type="case-report"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Maxillofac Oral Surg</journal-id><journal-id journal-id-type="iso-abbrev">J Maxillofac Oral Surg</journal-id><journal-title-group><journal-title>Journal of Maxillofacial & Oral Surgery</journal-title></journal-title-group><issn pub-type="ppub">0972-8279</issn><issn pub-type="epub">0974-942X</issn><publisher><publisher-name>Springer India</publisher-name><publisher-loc>New Delhi</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27298551</article-id><article-id pub-id-type="pmc">4871838</article-id><article-id pub-id-type="publisher-id">833</article-id><article-id pub-id-type="doi">10.1007/s12663-015-0833-y</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Diagnostic Features and Management Strategy of a Refractory Case of Osteoradionecrosis of the Mandible: Case Report and Review of Literature</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Jeyaraj</surname><given-names>Priya</given-names></name><address><email>jeyarajpriya@yahoo.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Bandyopadhyay</surname><given-names>T. K.</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><aff id="Aff1"><label></label>Command Military Dental Centre (Northern Command), Udhampur, Jammu & Kashmir India</aff><aff id="Aff2"><label></label>Director General Dental Services, Army Dental Corps, New Delhi, India</aff></contrib-group><pub-date pub-type="epub"><day>1</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2016</year></pub-date><volume>15</volume><issue>2</issue><fpage>256</fpage><lpage>267</lpage><history><date date-type="received"><day>30</day><month>11</month><year>2014</year></date><date date-type="accepted"><day>30</day><month>7</month><year>2015</year></date></history><permissions><copyright-statement>© The Association of Oral and Maxillofacial Surgeons of India 2015</copyright-statement></permissions><abstract id="Abs1"><sec><title>Introduction</title><p>Osteoradionecrosis of the jaws produces a considerable amount of esthetic as well as functional deficits seriously affecting quality of life of the patient. Cases are often notoriously difficult to treat and manage owing to associated comorbidities of the patient, post irradiation fibrosis and decreased vascularity at the site, which complicates free tissue flap and graft transfer, that subsequently succumb to failure. Hyperbaric oxygen therapy (HBOT), in which 100 % oxygen is administered by mask under 2.4 atm pressure, in a hyperbaric oxygen chamber, helps by increasing local vascularity.</p></sec><sec><title>Aim and Methods</title><p>It was the aim of this study to show that a particularly refractory, compromised and challenging case of osteoradionecrosis can be managed successfully even without HBOT, by mandibular segmental resection followed by reconstruction using a titanium reconstruction plate enveloped within a pedicled Pectoralis Major Myocutaneous flap.</p></sec><sec><title>Result</title><p>Post operative recovery of the patient was excellent with good functional and esthetic rehabilitation of the patient with and practically nil donor site morbidity.</p></sec><sec><title>Conclusion</title><p>It is important to have a thorough knowledge of the clinical, radiographic, histopathologic, CT and MRI features of osteoradionecrosis of the jaws in order to make a quick and accurate confirmatory diagnosis and to overcome possible diagnostic dilemmas. The strategy of reconstruction of a large mandibular defect using a bridging titanium plate sandwiched by a healthy vascularized myocutaneous flap, following ablative surgery for ORN, has proved to be a safe and reliable option for composite mandibular defects, with gratifying long term functional and cosmetic results.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Osteoradionecrosis (ORN)</kwd><kwd>Hyperbaric oxygen therapy (HBOT)</kwd><kwd>Mandibular reconstruction</kwd><kwd>Titanium reconstruction plate/bar</kwd><kwd>Pectoralis major myocutaneous flap (PMMC)</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Association of Oral and Maxillofacial Surgeons of India 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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