Multimodal strategy for the management of sphenoid osteoradionecrosis: Preliminary results.
Clivus
chordoma
endoscopic surgery
nasopharyngeal carcinoma
olfactory neuroblastoma
osteoradionecrosis
pentoxifylline‐tocopherol‐clodronate
radiotherapy
skull base
sphenoid
Journal
Laryngoscope investigative otolaryngology
ISSN: 2378-8038
Titre abrégé: Laryngoscope Investig Otolaryngol
Pays: United States
ID NLM: 101684963
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
14
08
2019
revised:
18
11
2019
accepted:
24
12
2019
entrez:
5
3
2020
pubmed:
5
3
2020
medline:
5
3
2020
Statut:
epublish
Résumé
Osteoradionecrosis (ORN) of the sphenoid is a rare but potentially lethal complication that can occur after irradiation of nasopharyngeal and clival malignancies. The objective of this study was to describe a multimodal treatment strategy tailored to the clinical signs and to the radiological extent of the disease, and to report on its preliminary results. Retrospective monocentric study at a tertiary skull base center. Patients treated for a sphenoid ORN from January 2014 to August 2018 were identified and charts were retrospectively reviewed for demographics, histologic tumor type, previous treatments of the tumor, clinical signs at presentation, radiological data, treatment, and outcomes. Sphenoid ORN was treated by a combination of medical therapy, endovascular treatment, and/or surgery. The use of each of these therapeutic modalities was based on the extent of ORN and on the presenting signs. Seven patients were included: four patients underwent endovascular treatment with occlusion of the internal carotid artery, five patients underwent surgical debridement, and covering of the exposed bone by a local flap, seven patients received antibiotics (in combination with pentoxyphilline, tocopherol, and clodronate in one case). Three patients died after progression of the ORN. The global survival rate was 57% (4/7) with a mean follow-up of 24 months. In one case, ORN was treated successfully by medical treatment only, with a combination of antibiotics, pentoxyphilline, tocopherol, and clodronate. This retrospective study describes the results of a management strategy adapted to the extent of the disease in sphenoid ORN and based on medical therapy only, or on a combination of medical therapy, interventional radiology, and/or surgery. 4.
Identifiants
pubmed: 32128426
doi: 10.1002/lio2.345
pii: LIO2345
pmc: PMC7042640
doi:
Types de publication
Journal Article
Langues
eng
Pagination
19-23Informations de copyright
© 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society.
Déclaration de conflit d'intérêts
No conflicts were reported for this work.
Références
Clin Otolaryngol. 2017 Oct;42(5):1100-1104
pubmed: 28306199
Acta Neurochir (Wien). 2016 Dec;158(12):2291-2294
pubmed: 27714466
ANZ J Surg. 2015 Mar;85(3):121-7
pubmed: 25345755
Radiother Oncol. 2004 Nov;73(2):119-31
pubmed: 15542158
Head Neck. 2018 Feb;40(2):369-376
pubmed: 28990255
Laryngoscope. 2006 Sep;116(9):1626-31
pubmed: 16954993
Int J Clin Oncol. 2019 Mar;24(3):248-255
pubmed: 30413913
J Laryngol Otol. 2016 May;130(S2):S97-S103
pubmed: 27841121
Curr Opin Otolaryngol Head Neck Surg. 2016 Apr;24(2):91-7
pubmed: 26900820
Int J Radiat Oncol Biol Phys. 2018 Nov 1;102(3):552-555
pubmed: 29960057
Ann Otol Rhinol Laryngol. 2019 Dec;128(12):1134-1140
pubmed: 31353927
Radiother Oncol. 2015 Jun;115(3):399-406
pubmed: 25987536