Refractory Case of Osteoradionecrosis of the Mandible

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Refractory Case of Osteoradionecrosis of the Mandible

Osteoradionecrosis of the jaws produces a considerable amount of esthetic as well as functional deficits, seriously affecting quality of life of the patient. Hyperbaric Oxygen Therapy (HBOT), in which 100% Oxygen is administered by mask under 2.4 Atm pressure, in a Hyperbaric oxygen chamber, helps by increasing local vascularity. Study was done to show that a particularly refractory, compromised and challenging case of osteoradionecrosis can be managed successfully even without HBOT, by mandibular segmental resection followed by reconstruction using a titanium reconstruction plate enveloped within a pedicled Pectoralis Major Myocutaneous flap.

Post-operative recovery of the patient was excellent with good functional and esthetic rehabilitation of the patient with and practically nil donor site morbidity. It is important to have a thorough knowledge of the clinical, radiographic, histopathological, CT and MRI features of osteoradionecrosis of the jaws in order to make a quick and accurate confirmatory diagnosis and to overcome possible diagnostic dilemmas. The strategy of reconstruction of a large mandibular defect using a bridging titanium plate sandwiched by a healthy vascularized Myocutaneous flap, following ablative surgery for ORN, has proved to be a safe and reliable option for composite mandibular defects, with gratifying long term functional and cosmetic results.

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