下颌骨放射性骨坏死切除边缘的组织病理学分析：皮质骨和松质骨之间坏死变化的异质性。
Heterogeneity of Necrotic Changes between Cortical and Cancellous Bone in Mandibular Osteoradionecrosis: A Histopathological Analysis of Resection Margin after Segmental Mandibulectomy.
机构信息
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
Biomed Res Int. 2017;2017:3125842. doi: 10.1155/2017/3125842. Epub 2017 Aug 30.
BACKGROUND
This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis.
METHODS
Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals.
RESULTS
Ten of eleven (91%) cortices near the inferior border of the mandible at the anterior margins were necrotic. All cancellous bones at the anterior margins were viable. Seven of eleven (64%) cortices near the inferior border of the mandible at the posterior margins were necrotic. Three of eleven (27%) cancellous bones at the posterior margins were necrotic.
CONCLUSION
Necrotic changes are more prevalent in cortices than in cancellous bones in mandibular osteoradionecrosis, probably due to a decrease of periosteal blood supply caused by radiotherapy.
背景
本研究旨在分析下颌骨放射性骨坏死行节段性下颌骨切除术切除边缘皮质骨和松质骨之间的坏死变化差异。
方法
对 11 例行节段性下颌骨切除术联合游离腓骨瓣重建术治疗晚期放射性骨坏死的患者的前后骨标本进行组织病理学分析，根据哈氏管内血管的存在来判断骨坏死的存在。
结果
11 例患者中，10 例（91%）下颌骨下缘前缘皮质骨坏死。所有前缘松质骨均存活。11 例患者中，7 例（64%）下颌骨下缘后缘皮质骨坏死。11 例患者中，3 例（27%）后缘松质骨坏死。
结论
放射性骨坏死中，皮质骨的坏死变化比松质骨更常见，这可能是由于放疗导致骨膜血供减少所致。
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