Porcaro Gianluca, Amosso Ernesto, Mirabelli Luca, Busa Alberto, Carini Fabrizio, Maddalone Marcello
Department of Surgery and Translational Medicine, School of Oral Surgery, University of Milan-Bicocca, Monza, Italy.
J Craniofac Surg. 2015 Oct;26(7):e627-9. doi: 10.1097/SCS.0000000000002136.
Osteoradionecrosis (ORN) of the jaw is a complication of radiation therapy for head and neck cancers. We report a case of ORN of the posterior maxilla treated with Er: YAG laser and a pedicled buccal fat pad (bichat bulla adipose) flap. A 69-year-old man presented complaining of pain on left maxilla. He had received high-dose radiotherapy (90 Gy) for squamous cell carcinoma of the left soft palate 2 years earlier. Clinical and radiographic examinations revealed ORN of the left maxillary molar region and maxillary sinusitis. Daily home care consisted of 0.9% saline irrigation and 0.8% H2O2 gel application. Sequestrectomy and tooth extraction were followed by debridement with Er: YAG laser and repair with a pedicled buccal fat pad flap. Complete resolution of ORN and maxillary sinusitis was established one year postsurgically. The excellent clinical outcome suggests that Er: YAG laser debridement and pedicled buccal fat pad flap are a viable option to treat ORN of the posterior maxilla.
颌骨放射性骨坏死（ORN）是头颈部癌症放射治疗的一种并发症。我们报告一例用铒激光和带蒂颊脂垫瓣治疗的上颌后份ORN病例。一名69岁男性因左侧上颌疼痛就诊。他于2年前因左软腭鳞状细胞癌接受了高剂量放疗（90 Gy）。临床和影像学检查发现左侧上颌磨牙区ORN和上颌窦炎。日常家庭护理包括0.9%盐水冲洗和0.8%过氧化氢凝胶涂抹。在进行死骨切除术和拔牙后，用铒激光清创并用带蒂颊脂垫瓣修复。术后一年ORN和上颌窦炎完全消退。良好的临床结果表明，铒激光清创和带蒂颊脂垫瓣是治疗上颌后份ORN的可行选择。
