Osteoradionecrosis
Osteoradionecrosis
Osteoradionecrosis (ORN) is a condition that can occur after radiation therapy to the bones. It happens when the bone tissue dies, and it can lead to pain, infection, and the exposure of bone. ORN can happen in any bone that has been exposed to radiation, but it’s more common in the mandible (lower jawbone) and maxilla (upper jawbone). ORN can occur months or years after radiation therapy, and it’s more likely to happen if you have a history of dental problems or if you smoke. Treatment for ORN includes antibiotics, surgery, and hyperbaric oxygen therapy (HBOT). HBOT is a treatment that involves breathing 100% oxygen in a pressurized chamber. This treatment can help to reduce the risk of infection and promote healing.
Signs and Symptoms
Most people don’t notice symptoms for months or years following radiation treatment. We typically identify the signs following the procedure or any other major procedure performed by head and neck cancer patients.
Certain circumstances increase the likelihood of developing osteoradionecrosis. These include receiving radiation in combination with chemotherapy, smoking while receiving treatment, and the size and location of the cancer being treated.
The symptoms include:
The jaw has a limited range of motion.
Pain that develops when you are at rest
A facial or jaw swelling
Exposition of the mandible, or maxilla. These are the lower and upper jaws.
Complications
Osteoradionecrosis (ORN) is a bone necrosis that can occur as a complication of radiation therapy. It most often affects the mandible (jawbone), but can also occur in other bones. ORN typically develops several months or even years after radiation therapy has been completed. The exact cause of ORN is not fully understood, but it is thought to be due to a combination of tissue hypoxia (lack of oxygen), radiation-induced damage to blood vessels, and inflammatory reactions. Treatment for ORN can be challenging, and may include surgery, hyperbaric oxygen therapy, and/or radiation therapy. In some cases, ORN can lead to significant morbidity and even mortality. As such, it is important for patients who have received radiation therapy to be aware of the potential risks of developing ORN and be in contact with specialists who can explore the possibility of it occurring beforehand.