The conservative management of osteoradionecrosis of the mandible with ultrasound therapy.
A regimen of ultrasound with local debridement and metronidazole has proved to be an effective and practicable treatment for osteoradionecrosis, achieving healing in 10/21 (48%) cases without the need for surgery or sophisticated technology. Nine further patients were successfully treated by covering the preserved mandible with a local intra-oral flap. Only 2 patients required mandibular resection with reconstruction. An ultrasound programme of 1 watt/cm2, 3 mega Hz. pulsed 1:4, 15 min a day for 60 days would seem to be optimum. However, a range of dosage needs to be further explored for inducing neovascularity and neocellularity in the irradiated tissues.
Harris
M
M
Joint Department of Maxillofacial Surgery and Oral Medicine, Eastman Dental Hospital, London.
D001918:Brachytherapy / Q000009:adverse effects; D002506:Cephalexin / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008795:Metronidazole / Q000627:therapeutic use; D010025:Osteoradionecrosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D013524:Surgical Flaps / Q000379:methods; D014464:Ultrasonic Therapy; D014945:Wound Healing
D008795:Metronidazole; D002506:Cephalexin