Patients with overt mandibular osteoradionecrosis did not benefit from hyperbaric oxygenation.

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PTX-vitamin E boosted by clodronate is an effective treatment of mandibular ORN that induces mucosal and bone healing in a median period of 6 months.

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Postoperative morbidity and functional outcomes are similar after first-line and salvage total glossectomy without laryngectomy. Local tumor control is the main factor influencing survival.

The present series compares results in our head and neck department from primary and salvage surgery for tumors of the tonsillar region from 1978 to 1985. Of 120 consecutively admitted patients, 70 underwent primary surgery followed by irradiation, and 50 underwent salvage surgery after the failure of primary radiotherapy. Follow-up has been continued for the past 6 years. Musculocutaneous flaps were employed in all patients requiring them after the introduction of this reconstructive technique in 1981. The actuarial survival rate after primary surgery was 58% at 3 years and 46% at 5 years. For salvage surgery the figures were 38% and 24%, respectively. This disappointing survival rate in salvage surgery resulted from a higher postoperative mortality (8% versus 1.4% in primary surgery) and from a higher local failure rate (36% versus 14%). The outcome was invariably unfavorable when tonsillar tumors extended into the base of the tongue.

Down-regulation of adhesion molecules has been observed in a number of squamous cell carcinomas (SCC) and is considered to be associated with tumour invasiveness and lymph node metastasis. The present prospective investigation aimed at analyzing the expression patterns of desmosomal markers in oral and pharyngeal SCC and correlations that may exist between these patterns and tumour behaviour. Two constitutive desmosomal molecules, desmoplakin (Dp) and plakoglobin (Pg), were examined in 26 samples of primary carcinoma of the head and neck. The correlation between Dp and Pg expression was only moderate, reflecting functional differences between the two proteins. Whereas decreased Dp and Pg expression was closely associated with distant metastasis formation, reduced Pg expression was correlated to the development of large tumours. There were also variable relationships between the expression of these markers and lymph node invasion, histological differentiation, or survival of the patients. Biochemical analysis of cytoskeletal fractions confirmed the decrease in desmosomal proteins, particularly in tumours which later developed metastases. Down-regulation of Dp and Pg in oral and pharyngeal SCC may represent a reliable marker for extensive tumour growth and the risk of distant metastasis formation, Dp and Pg apparently having metastasis- and tumour-suppressor properties, respectively.