Delaire J, Billet J, Tulasne J F
Rev Stomatol Chir Maxillofac. 1979;80(3):157-65.
Resection of the sections of the mandibular affected by osteoradionecrosis has completely modified the progression and prognosis of this affection by ensuring that the patient does not have to suffer long periods of pain and suppuration, constantly observed when medical treatment is used alone. Unfortunately, these resections are usually extensive and are themselves responsible for functional and esthetic sequelae supported with difficulty by some patients, especially in the case of bilateral or mandibular arch resections. All efforts must be made, therefore, to limit the consequences, and with this in mind it is possible: -- to perform an uninterrupted resection limited to the alveolar area involved, in early cases of mandibular osteoradionecrosis; -- to reconstitute mandibular continuity with a bone graft in more advanced stages; -- to improve the esthetic appearance with skin and subcutaneous grafts whenever this is necessary. Good results can only be obtained if certain anatomical conditions exist and if surgical precautions are adapted to each case.
切除受放射性骨坏死影响的下颌骨部分，通过确保患者不必遭受长时间的疼痛和化脓，彻底改变了这种疾病的病程和预后，而单独采用药物治疗时常常会出现这些症状。不幸的是，这些切除术通常范围广泛，其本身会导致一些患者难以承受的功能和美学后遗症，尤其是在双侧或下颌骨弓切除的情况下。因此，必须尽一切努力限制这些后果，考虑到这一点，有可能做到：——在下颌骨放射性骨坏死的早期病例中，进行仅限于受累牙槽区域的不间断切除；——在病情更严重阶段，用骨移植重建下颌骨的连续性；——必要时，通过皮肤和皮下移植改善美学外观。只有在存在某些解剖条件且手术预防措施适用于每种情况时，才能取得良好的效果。
