Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, U.S.A.
Otol Neurotol. 2010 Jun;31(4):656-9.
To assess the incidence of osteoradionecrosis (ORN) of the temporal bone after surgery with radiotherapy for malignant parotid tumors.
A tertiary care, academic medical center.
All patients who underwent surgical resection with postoperative radiotherapy (RT) for a malignant parotid tumor between July 1988 and July 2007.
A retrospective chart analysis to determine the extent of surgery, the RT parameters, and the incidence of ORN of the temporal bone.
The incidence of ORN in 3 subgroups of patients.
The 221 patients with malignant parotid tumors who underwent surgical resection with postoperative RT were divided into groups 1, parotidectomy only; 2, parotidectomy with mastoidectomy; and 3, parotidectomy with subtotal petrosectomy. The overall incidence of temporal bone ORN in group 1 was 2 (2%) of 106; in group 2, 8 (13%) of 64; and in group 3, 0 (0%) of 51.
The incidence of temporal bone ORN is higher after mastoidectomy for facial nerve identification or resection in patients undergoing parotidectomy with postoperative radiotherapy. Oversew of the ear canal with mastoid obliteration should be considered in this subgroup of patients to avoid this long-term complication of radiotherapy used in the treatment of malignant parotid tumors.
评估因恶性腮腺肿瘤行放射治疗术后并发颞骨放射性骨坏死（ORN）的发生率。
三级护理，学术医疗中心。
1988 年 7 月至 2007 年 7 月期间，所有因恶性腮腺肿瘤而行手术切除加术后放射治疗（RT）的患者。
回顾性图表分析以确定手术范围、RT 参数以及颞骨 ORN 的发生率。
3 组患者 ORN 的发生率。
221 例因恶性腮腺肿瘤而行手术切除加术后 RT 的患者被分为 3 组：1 组为腮腺切除术；2 组为腮腺切除术加乳突切除术；3 组为腮腺切除术加次全颞骨切除术。第 1 组中颞骨 ORN 的总发生率为 2（2%）/106；第 2 组为 8（13%）/64；第 3 组为 0（0%）/51。
对于因面神经识别或切除而行腮腺切除术并接受术后放疗的患者，行乳突切除术会增加颞骨 ORN 的发生率。对于该亚组患者，应考虑用乳突填塞来缝合耳道，以避免因治疗恶性腮腺肿瘤而使用放疗带来的这种长期并发症。
