1/16. A simple reconstructive procedure for radiation-induced necrosis of the external auditory canal.Localized necrosis of the bone, cartilage, and soft tissue of the external auditory canal is an uncommon side effect of radiotherapy to the parotid region. Five patients developed late onset skin necrosis of a quadrant of the ear canal secondary to an underlying osteoradionecrosis of the tympanic ring. We report a one-stage procedure to excise the necrotic tissue and replace it with a local rotational flap derived from the post-auricular skin. Otological side effects of radiotherapy are discussed.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/16. osteoradionecrosis of the temporal bone in nasopharyngeal carcinoma after radiotherapy: a case report.osteoradionecrosis of the temporal bone after external-beam radiotherapy for nasopharyngeal carcinoma is not uncommon following a long posttreatment interval. We describe the case of a man who had experienced this complication 13 years after he had undergone such radiotherapy. His condition resolved after removal of dead bone from the external auditory canal, followed by antibiotic therapy and periodic aural toileting.- - - - - - - - - - ranking = 0.16666666666667keywords = canal (Clic here for more details about this article) |
3/16. Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation.Concurrent radionecrosis within the spinal cord and the bone marrow at the same thoracic level was observed 8 years after localized therapeutic irradiation in a patient who had undergone repeated cycles of radiotherapy, glucocorticoid treatment, and chemotherapy for a non-Hodgkin's lymphoma. Mechanisms combining radiotoxic potentialization by glucocorticoids/alkylating agents and delayed radiation-induced vasculitis involving the common arterial pathways to the spinal cord and to the vertebrae were speculated to have acted in a synergistic way.- - - - - - - - - - ranking = 0.059383865407452keywords = spinal (Clic here for more details about this article) |
4/16. Cystic brain necrosis and temporal bone osteoradionecrosis after radiotherapy and surgery in a patient of ear carcinoma.brain cyst formation of temporal lobe induced by radionecrosis in ear carcinoma is rare. A 73-year-old man with basosquamous carcinoma of the left external ear canal received excision of tumor and postoperative radiation therapy in 1992. For osteonecrosis of the left temporal bone, a series treatment including oral and intravenous antibiotics and hyperbaric oxygen therapy was given in following years. Encephalomalasia of the left temporal lobe on brain computed tomography (CT) was noted in 1997. The patient suffered from headache, poor concentration, memory impairment, depressed mood, bad temper, and one 8 x 5 x 3.5 cm cystic lesion of the left temporal lobe with tempomandibular joint defect revealed by brain CT in 2001. Symptoms relieved after stereotactic aspiration of cystic fluid and external drainage (Omaya reservoir) insertion under magnetic resonance image by neurosurgeon. We report the progressive radionecrosis of temporal lobe and cyst formation, which caused the neuropsychological symptoms 10 years after radiotherapy.- - - - - - - - - - ranking = 0.16666666666667keywords = canal (Clic here for more details about this article) |
5/16. CSF otorrhea complicating temporal bone osteoradionecrosis in a patient with nasopharyngeal carcinoma.A 44-year-old Chinese man with a history of nasopharyngeal carcinoma that was treated with radiotherapy presented with fluid in the middle ear. We performed a myringotomy and subsequently made a diagnosis of cerebrospinal fluid (CSF) leakage secondary to osteoradionecrosis of the temporal bone. To the best of our knowledge, this is only the second reported case of an otogenic CSF leak resulting from osteoradionecrosis of the temporal bone. This case highlights the controversial role of myringotomy in the management of CSF otorrhea.- - - - - - - - - - ranking = 0.009897310901242keywords = spinal (Clic here for more details about this article) |
6/16. Salvage treatment of an irradiated, infected lumbosacral wound.A 60-year-old male with lumbosacral multiple myeloma received 5100 cGy of external-beam radiation, thalidomide, and Decadron. He subsequently underwent excision of the epidural tumor, decompressive L4, L5, and S1 laminectomies, and bilateral L4-5 and L5-S1 medial facetectomies. The patient developed osteoradionecrosis, cerebrospinal fluid leak, wound infection, and sepsis. debridement and bilateral V-Y fasciocutaneous advancement flaps failed. Pedicled omental transposition flap through a Petit triangle tunnel was successfully performed. Omental transposition provides a safe option for salvage treatment of irradiated, infected lumbosacral wounds. The plastic and trophic qualities of the omentum make it an excellent choice to fill poorly vascularized wounds. In addition to its immunologic and neoangiogenic properties, the omentum has a dense lymphatic network with tremendous absorptive potential. Its biologic advantages must be weighed against the need for celiotomy and available local options according to circumstances.- - - - - - - - - - ranking = 0.009897310901242keywords = spinal (Clic here for more details about this article) |
7/16. osteoradionecrosis of the cervical spine resulting from radiotherapy for primary head and neck malignancies: operative and nonoperative management. Case report.osteoradionecrosis is a process of dysvascular bone necrosis and fibrous replacement following exposure to high doses of radiation. The poorly vascularized necrotic tissue may cause pain and/or instability, and it cannot resist infection well, which may result in secondary osteomyelitis. When these processes affect the cervical spine, the resulting instability and neurological deficits can be devastating, and immediate reestablishment of spinal stability is paramount. Reconstruction of the cervical spine can be particularly challenging in this subgroup of patients in whom the spine is poorly vascularized after radical surgery, high-dose irradiation, and infection. The authors report three cases of cervical spine osteoradionecrosis following radiotherapy for primary head and neck malignancies. Two patients suffered secondary osteomyelitis, severe spinal deformity, and spinal cord compression. These patients underwent surgery in which a vascularized fibular graft and instrumentation were used to reconstruct the cervical spine; subsequently hyperbaric oxygen (HBO) therapy was instituted. Fusion occurred, spinal stability was restored, and neurological dysfunction resolved at the 2- and 4-year follow-up examinations, respectively. The third patient experienced pain and dysphagia but did not have osteomyelitis, spinal instability, or neurological deficits. He underwent HBO therapy alone, with improved symptoms and imaging findings. Hyperbaric oxygen is an essential part of treatment for osteoradionecrosis and may be sufficient by itself for uncomplicated cases, but surgery is required for patients with spinal instability, spinal cord compression, and/or infection. A vascularized fibular bone graft is a very helpful adjunct in these patients because it adds little morbidity and may increase the rate of spinal fusion.- - - - - - - - - - ranking = 0.079178487209936keywords = spinal (Clic here for more details about this article) |
8/16. CSF otorrhea complicating osteoradionecrosis of the temporal bone.osteoradionecrosis of the temporal bone is a well-recognized complication of radiotherapy for head and neck malignancy. There are two mechanisms by which this condition can produce damage to nearby structures and even result in death. osteoradionecrosis may (1) predispose the patient to an aggressive or chronic infectious process, or (2) cause destruction of tissue by direct necrosis. A review of the literature failed to disclose a cause of CSF otorrhea complicating osteoradionecrosis of the temporal bone. This paper describes a case of skull base osteoradionecrosis, including necrosis of the tympanic membrane, associated with CSF otorrhea. Successful control of this complication was achieved using a translabyrinthine approach to locate the fistula, which originated from the internal auditory canal and was discharging through the middle ear via the oval window. The leak was sealed, the resultant mastoid cavity was obliterated by rotation of a temporalis muscle flap, and the external auditory canal was closed by the Fisch technique.- - - - - - - - - - ranking = 0.33333333333333keywords = canal (Clic here for more details about this article) |
9/16. radiation injury to the temporal bone.osteoradionecrosis of the temporal bone is an unusual sequela of radiation therapy to the head and neck. Symptoms occur many years after the radiation is administered, and progression of the disease is insidious. hearing loss (sensorineural, conductive, or mixed), otalgia, otorrhea, and even gross tissue extrusion herald this condition. Later, intracranial complications such as meningitis, temporal lobe or cerebellar abscess, and cranial neuropathies may occur. Reported here are five cases of this rare malady representing varying degrees of the disease process. They include a case of radiation-induced necrosis of the tympanic ring with persistent squamous debris in the external auditory canal and middle ear. Another case demonstrates the progression of radiation otitis media to mastoiditis with bony sequestration. Further progression of the disease process is seen in a third case that evolved into multiple cranial neuropathies from skull base destruction. Treatment includes systemic antibiotics, local wound care, and debridement in cases of localized tissue involvement. More extensive debridement with removal of sequestrations, abscess drainage, reconstruction with vascularized tissue from regional flaps, and mastoid obliteration may be warranted for severe cases. Hyperbaric oxygen therapy has provided limited benefit.- - - - - - - - - - ranking = 0.16666666666667keywords = canal (Clic here for more details about this article) |
10/16. Fatty replacement of spinal bone marrow due to radiation: demonstration by dual energy quantitative CT and MR imaging.Dual energy CT and quantitative magnetic resonance (MR) imaging were used to evaluate marrow changes due to radiation. The bright signal intensity seen on MR was shown by the two quantitative techniques to be due to a threefold increase in the marrow fat content compared with nonradiated levels and to a normal control. Fat estimates by MR and dual energy CT were in excellent agreement. Single energy CT overestimates the amount of bone loss in the radiation field. Dual energy CT and quantitative MR can be used to correct this error.- - - - - - - - - - ranking = 0.039589243604968keywords = spinal (Clic here for more details about this article) |
| | Next -> |