악골 방사선골괴사증에 관한 임상적 연구

A clinical study of the osteoradionecrosis of the jaw

Osteoradionecrosis(O.R.N.) is a complex metabolic and tissue homeostatic deficiency created by radiation induced tissue injury. We have experienced 10 patients who had complication of osteoradionecrosis in jaw after radiation therapy for treatment of malignant tumor in head and neck area. The following results were obtained: 1. There were 10 of 132 patients who had complication of osteoradionecrosis after radiation therapy for treatment of malignant tumor in head and neck area. 2. Average age at diagnosis was 53.5 years with a range of 22~65 years, and there were 9 males and 1 female. 3. The ratio of involvement of the mandible to that of the maxilla is 4 : 1. 4. The range of therapeutic radiation dose was 5400~24700cGy, and mean dose of radiation was 10212 cGy. 5. There were 3 years 11 months average time of onset with a range of 1year~8years 4months. 6. The representative symtoms of osteoradionecrosis were pain, trismus, fistula formation, pus discharge, swelling, and unhealed extracted socket. 7. Anatomic sites of primary tumor were tonsil, tongue, nasopharynx, floor of mouth and maxilla. 8. Possible predisposing trauma was related to the development of osteoradionecrosis in 5 patients and no predisposing factors could be identified in 5 patients. 9. According to classification of O.R.N. by Marx, there were 4 stage II O.R.N. patients, 6 patients were stage III, and stage 1 was absent. 10. For management, conservative treatment, hyperbaric oxygen therapy, and radical therapy were performed.