Ahmed Salmaan, Gupta Nakul, Hamilton Jackson D, Garden Adam S, Gidley Paul W, Ginsberg Lawrence E
From the *Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX; †Department of Diagnostic and Interventional Imaging, The University of Texas Medical School at Houston, Houston, TX; ‡Department of Radiation Oncology, and §Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX.
J Comput Assist Tomogr. 2014 Sep-Oct;38(5):662-6. doi: 10.1097/RCT.0000000000000096.
The goal of this study was to describe computed tomographic findings in patients with clinically proven temporal bone (TB) osteoradionecrosis (ORN) (TB-ORN).
Computed tomographic scans of 20 patients were retrospectively evaluated for bony and soft tissue abnormalities. Clinical severity was graded based on level of therapy administered: mild (observation), moderate (antibiotics/hyperbaric oxygen), or severe (surgery).
Radiation dose to the primary tumor ranged from 30 to 75.6 Gy. Time to onset of ORN from completion of radiation therapy was 2 to 22 years (median, 7 years).
exposed bone, 20 of the 20 patients; otorrhea, 17 of the 20 patients; hearing loss, 11 of the 20 patients; otalgia, 10 of the 20 patients; facial nerve paralysis, 2 of the 20 patients; gait imbalance, 2 of the 20 patients. Computed tomographic findings: external auditory canal erosions, 18 of the 20 patients; mastoid effusion, 18 of the 20 patients; mastoid bony coalescence, 5 of the 20 patients; enhancing soft tissue, 6 of the 20 patients; soft tissue gas, 6 of the 20 patients; temporomandibular joint/condylar erosion, 3 of the 20 patients.Three patients developed an abscess.
Mastoid effusion and external auditory canal erosions are commonly seen with TB-ORN. Clinically moderate or severe cases of TB-ORN are more likely to demonstrate enhancing soft tissue (P = 0.002), soft tissue gas (P = 0.002), and temporomandibular joint involvement (P = 0.07).
本研究的目的是描述经临床证实的颞骨（TB）放射性骨坏死（ORN）（TB-ORN）患者的计算机断层扫描结果。
回顾性评估20例患者的计算机断层扫描，以观察骨和软组织异常情况。根据所给予的治疗水平对临床严重程度进行分级：轻度（观察）、中度（抗生素/高压氧）或重度（手术）。
原发肿瘤的辐射剂量为30至75.6 Gy。从放疗结束到ORN发病的时间为2至22年（中位数为7年）。
20例患者中有20例出现暴露骨；20例患者中有17例出现耳漏；20例患者中有11例出现听力损失；20例患者中有10例出现耳痛；20例患者中有2例出现面神经麻痹；20例患者中有2例出现步态失衡。计算机断层扫描结果：20例患者中有18例出现外耳道侵蚀；20例患者中有18例出现乳突积液；20例患者中有5例出现乳突骨融合；20例患者中有6例出现软组织强化；20例患者中有6例出现软组织积气；20例患者中有3例出现颞下颌关节/髁突侵蚀。3例患者发生脓肿。
乳突积液和外耳道侵蚀在TB-ORN中常见。临床中度或重度TB-ORN病例更可能出现软组织强化（P = 0.002）、软组织积气（P = 0.002）和颞下颌关节受累（P = 0.07）。
