[Diagnosis and treatment on osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma].

OBJECTIVE

To investigate the diagnosis and management on osteoradionecrosis (ORN) of skull base in the patients with nasopharyngeal carcinoma (NPC) after radiotherapy.

METHODS

All patients (n = 15) diagnosed as NPC and ORN of skull base were studied on the clinical data, diagnosis and therapy.

RESULTS

All the patients were found with foul odor, headache, bleeding and exposed necrotic bone. 9 patients were treated by surgery, among them 2 patients died of temporal lobe radionecrosis, and the survival time of remaining 7 patients was 2 to 7 years. 5 patients with extensive ORN and 1 patient with local ORN were treated by conservative methods, among them 3 died of nasopharyngeal bleeding and 1 died of respiratory and heart failure, survival time of the remaining 2 patients was 3 to 5 years.

CONCLUSIONS

ORN can be diagnosed by clinical characteristics, CT or MR, and endoscopic findings. Surgery is the best choice for ORN. The patients with extensive ORN or radiation-induced cranial neuropathy had poor prognosis. The most common causes of death were nasopharyngeal bleeding and exhaustion.