G Schnurbein1, J Wagner2, I Todt2, A Ernst2, R O Seidl2. 1. Klinik für Hals-, Nasen- und Ohrenheilkunde, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Deutschland. gioia.vonschnurbein@ukb.de. 2. Klinik für Hals-, Nasen- und Ohrenheilkunde, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Deutschland.
Abstract
BACKGROUND/ OBJECTIVE: Osteoradionecrosis is a rare, but feared, late complication after radiotherapy of the head and neck region. Its localization to the sternoclavicular joint has rarely been described so far. MATERIALS AND METHODS: Data are from a retrospective study that included all patients admitted to the authors' clinic with osteoradionecrosis of the sternoclavicular joint during the last 5 years. Therapy and outcome were evaluated and compared to the established literature. RESULTS: Over the past 5 years, 2 patients have been treated for pronounced osteoradionecrosis of the sternoclavicular joint. Both patients had received postoperative radiotherapy for tumors of the neck and chest, and presented with lesions involving the clavicle and the sternum. After eliminating the suspicion of recurrent cancer, both radiologic imaging and histopathologic evaluation confirmed an infection. Aggressive debridement with partial claviculectomy, partial sternectomy, and reconstruction using a pectoralis flap lead to the patients' recovery. CONCLUSION: Osteoradionecrosis does not only affect bone, but also the surrounding soft tissue. Due to the changes associated with previous radiotherapy, osteoradionecrosis should always be treated with radical debridement of the infected area, followed by flap reconstruction using unaffected tissue. The prognosis for the patient is then good.
BACKGROUND/ OBJECTIVE:Osteoradionecrosis is a rare, but feared, late complication after radiotherapy of the head and neck region. Its localization to the sternoclavicular joint has rarely been described so far. MATERIALS AND METHODS: Data are from a retrospective study that included all patients admitted to the authors' clinic with osteoradionecrosis of the sternoclavicular joint during the last 5 years. Therapy and outcome were evaluated and compared to the established literature. RESULTS: Over the past 5 years, 2 patients have been treated for pronounced osteoradionecrosis of the sternoclavicular joint. Both patients had received postoperative radiotherapy for tumors of the neck and chest, and presented with lesions involving the clavicle and the sternum. After eliminating the suspicion of recurrent cancer, both radiologic imaging and histopathologic evaluation confirmed an infection. Aggressive debridement with partial claviculectomy, partial sternectomy, and reconstruction using a pectoralis flap lead to the patients' recovery. CONCLUSION:Osteoradionecrosis does not only affect bone, but also the surrounding soft tissue. Due to the changes associated with previous radiotherapy, osteoradionecrosis should always be treated with radical debridement of the infected area, followed by flap reconstruction using unaffected tissue. The prognosis for the patient is then good.
Authors: Merav A Ben-David; Maximiliano Diamante; Jeffrey D Radawski; Karen A Vineberg; Cynthia Stroup; Carol-Anne Murdoch-Kinch; Samuel R Zwetchkenbaum; Avraham Eisbruch Journal: Int J Radiat Oncol Biol Phys Date: 2007-02-22 Impact factor: 7.038
Authors: Kerstin M Stenson; Rangesh Kunnavakkam; Ezra E W Cohen; Louis D Portugal; Elizabeth Blair; Daniel J Haraf; Joseph Salama; Everett E Vokes Journal: Laryngoscope Date: 2010-01 Impact factor: 3.325