TY - JOUR
T1 - Osteoradionecrosis of the temporal bone
T2 - A case series
AU - Sharon, Jeffrey D.
AU - Khwaja, Shariq S.
AU - Drescher, Andrew
AU - Gay, Hiram
AU - Chole, Richard A.
N1 - Publisher Copyright:
© 2014, Otology & Neurotology, Inc.
PY - 2014
Y1 - 2014
N2 - Objective: To study osteoradionecrosis (ORN) of the temporal bone. Study Design: Retrospective case review. Setting: Academic medical center. Patients: Patients were included who had previously undergone radiation to the head and neck and then developed exposed necrotic bone within the ear canal that persisted at least 3 months. Interventions: Patients were treated with a variety of modalities, including conservative therapy with antibiotic ear drops and in-office debridements, hyperbaric oxygen therapy, and surgery. Main Outcome Measures: To describe the presentation and management of patients with temporal bone osteoradionecrosis. Results: Thirty-three patients with temporal bone osteoradionecrosis were included. The most common site of primary tumor was the parotid gland (n = 11), followed by the nasopharynx (n = 7). The time to development of ORN varied between 1 and 22 years, with mean of 7.9 years. The mean radiation dose was 62.6 Gy to the primary tumor, 53.1 Gy to the affected temporal bone, and 65.2 Gy to the affected tympanic bone. The most common symptoms of ORN were otorrhea (n = 15), hearing loss (n = 13), and otalgia (n = 12). Fifteen patients had bacterial superinfection, most commonly Staphylococcus aureus (n = 9). Conservative therapy was successful at managing symptoms but not in eradicating exposed bone in most patients. Surgery was used for recalcitrant pain, infection, cholesteatoma, cranial neuropa-thies, and intracranial complications. Conclusion: Osteoradionecrosis is a rare complication of radiation to the temporal bone. Management should be aimed at relief of symptoms, eradication of superinfection, and treatment of other commonly present radiation effects like cholesteatoma and hearing loss.
AB - Objective: To study osteoradionecrosis (ORN) of the temporal bone. Study Design: Retrospective case review. Setting: Academic medical center. Patients: Patients were included who had previously undergone radiation to the head and neck and then developed exposed necrotic bone within the ear canal that persisted at least 3 months. Interventions: Patients were treated with a variety of modalities, including conservative therapy with antibiotic ear drops and in-office debridements, hyperbaric oxygen therapy, and surgery. Main Outcome Measures: To describe the presentation and management of patients with temporal bone osteoradionecrosis. Results: Thirty-three patients with temporal bone osteoradionecrosis were included. The most common site of primary tumor was the parotid gland (n = 11), followed by the nasopharynx (n = 7). The time to development of ORN varied between 1 and 22 years, with mean of 7.9 years. The mean radiation dose was 62.6 Gy to the primary tumor, 53.1 Gy to the affected temporal bone, and 65.2 Gy to the affected tympanic bone. The most common symptoms of ORN were otorrhea (n = 15), hearing loss (n = 13), and otalgia (n = 12). Fifteen patients had bacterial superinfection, most commonly Staphylococcus aureus (n = 9). Conservative therapy was successful at managing symptoms but not in eradicating exposed bone in most patients. Surgery was used for recalcitrant pain, infection, cholesteatoma, cranial neuropa-thies, and intracranial complications. Conclusion: Osteoradionecrosis is a rare complication of radiation to the temporal bone. Management should be aimed at relief of symptoms, eradication of superinfection, and treatment of other commonly present radiation effects like cholesteatoma and hearing loss.
KW - Complications of radiation
KW - Late radiation effects
KW - Osteonecrosis
KW - Osteoradionecrosis
KW - Radiation
KW - Temporal bone
KW - Temporal bone osteoradionecrosis
UR - http://www.scopus.com/inward/record.url?scp=85027939415&partnerID=8YFLogxK
U2 - 10.1097/MAO.0000000000000321
DO - 10.1097/MAO.0000000000000321
M3 - Article
C2 - 24914789
AN - SCOPUS:85027939415
SN - 1531-7129
VL - 35
SP - 1207
EP - 1217
JO - Otology and Neurotology
JF - Otology and Neurotology
IS - 7
ER -