Diagnosis and Management of Skull Base Osteoradionecrosis After Radiotherapy for Nasopharyngeal Carcinoma

Abstract

Clinical diagnosis of skull base ORN was based on symptoms, computed tomography, or magnetic resonance imaging and endoscopy. The final confirmation was according to pathologic examination. Surgery had the best effect. Extensive ORN accompanied by radiation brain damage or cranial nerves damage had poor prognosis. Nasopharyngeal bleeding and exhaustion were the main causes of death.

Postradiation nasopharyngeal necrosis in the patients with nasopharyngeal carcinoma

“…It has been reported that patients with NPC who receive 2 courses of radiation are more predisposed to having PRNN. 6,7 In this study, 50% (n ¼ 14) of the patients received 2 courses of radiotherapy to cure the local recurrent/persistent tumors.…”

“…The results of a series study about osteoradionecrosis show that the dosage is highly related with the occurrence of skull base osteoradionecrosis. [7][8][9][10] Of 28 patients studied here, 14 patients received 2 courses of radiotherapy and the accumulating prescribed dose for the nasopharynx was more than 120 Gy. In the patients treated with IMRT, the dose for the nasopharynx was more than 80 Gy.…”

Osteoradionecrosis of the mandible: through a radiologist's eyes

“…The involvement may be classified as extensive and symmetric or localized. 46 Huang et al 46 concluded that histopathological evaluation is very important, as it is difficult to differentiate tumour recurrence from ORN at this site; with the two entities sometimes being co-existent.…”

Endovascular Occlusion of Cervical Internal Carotid Artery Pseudoaneurysm in a Child Treated by N-Butyl Cyanoacrylate: A Rare Case Report

“…Besides that, there can be dysphagia and/or respiratory distress. When the swelling is not visible externally, it may manifest as epistaxis and should alert the clinician for the possibility of a pseudoaneurysm of the cervical carotid artery [11]. …”