Goyal Shikha, Mohanti Bidhu Kalyan
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India.
Indian J Dent. 2015 Apr-Jun;6(2):107-9. doi: 10.4103/0975-962X.154378.
Mandible is the most frequently affected bone during head and neck irradiation. Late changes in the mandible may manifest in the form of reduced bone density, dental caries, loss of spongiosa trabeculations, delayed healing following dental extraction, pathologic fractures, osteoradionecrosis, trismus, growth defects in children or second malignancies. Pathologic fractures of mandibular bone are rare and may be spontaneous or traumatic (following dental extraction). We report the case of a 55-year lady, who had undergone surgery and adjuvant radiotherapy for carcinoma oral tongue T2N0M0 on a cobalt-60 unit and was disease-free. After a follow-up of 8 years post-irradiation, she presented with sudden onset oral pain and inability to open mouth. Pantomogram showed fracture at the junction of body and ramus of the mandible bilaterally.
下颌骨是头颈部放疗中最常受影响的骨骼。下颌骨的晚期变化可能表现为骨密度降低、龋齿、松质骨小梁消失、拔牙后愈合延迟、病理性骨折、放射性骨坏死、牙关紧闭、儿童生长缺陷或第二原发恶性肿瘤。下颌骨病理性骨折罕见，可能为自发性或创伤性（拔牙后）。我们报告一例55岁女性病例，她曾因口腔舌癌T2N0M0在钴-60放疗机上接受手术及辅助放疗，且疾病无复发。放疗后随访8年，她突然出现口腔疼痛且无法张口。全景片显示双侧下颌骨体部与升支交界处骨折。
