Osteoradionecrosis of the Hyoid Bone: Imaging Findings

Yoo, Ji-Yeon; Rosenthal, David I.; Mitchell, Kevin; Ginsberg, Lawrence E.

doi:10.3174/ajnr.a1892

Cited by 23 publications

(16 citation statements)

References 12 publications

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“…Multiple prior studies have also found the relative unreliability of an elevated SUV in differentiating recurrent tumor from ORN. 11,12,[16][17][18] While recurrent tumor does, in general, demonstrate higher SUV mean and SUV max values compared with ORN, there is significant overlap, which makes differentiating the 2 entities on a case-by-case basis extremely unreliable. This overlap is presumably responsible for previous reports of false-positive results in PET scans attributed to osteoradionecrosis.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9] Patients are often referred for imaging to evaluate the extent of clinically suspected ORN, and, at the same time, to assess potential tumor recurrence. Multiple previous reports have characterized the imaging findings of ORN, [10][11][12][13][14] namely soft-tissue thickening and enhancement, cortical bone erosion, trabecular disorganization, and bone fragmentation. All these findings can be seen in tumor recurrence, however, making the imaging differentiation of these 2 entities quite challenging.…”

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confidence: 99%

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Osteoradionecrosis after Radiation Therapy for Head and Neck Cancer: Differentiation from Recurrent Disease with CT and PET/CT Imaging

Alhilali

Reynolds

Fakhran

2014

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Osteoradionecrosis after Radiation Therapy for Head and Neck Cancer: Differentiation from Recurrent Disease with CT and PET/CT Imaging

Alhilali

Reynolds

Fakhran

2014

AJNR Am J Neuroradiol

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“…It is important to remember that ORN can present clinically similar to recurrent neoplasm 12. Consequently, it is important to include ORN in the differential when working up a patient for suspicion of recurrent neoplasm in the setting of previous RT.…”

Section: Discussionmentioning

confidence: 99%

“…An additional 13 patients have been described in the radiology literature 12. To the best of our knowledge, only one previous case report has documented hyoid ORN presenting with haemoptysis,9 whereas no report has documented management of hyoid ORN with ultrasonic technology.…”

Section: Introductionmentioning

confidence: 99%

Osteoradionecrosis of the hyoid bone – a novel application of the Sonopet ultrasonic aspirator

Gill

Joshi

2014

BMJ Case Reports

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A 66-year-old man with a history of squamous cell carcinoma of the right tonsil presented to the emergency department with two life-threatening episodes of haemoptysis 9 months after completion of chemoradiation. He was evaluated to rule out recurrent malignancy, and was determined to have osteoradionecrosis of his hyoid bone that had led to an oropharyngeal fistula. Given the proximity to branches of the external carotid, he was offered tracheostomy and resection of the protruding necrotic bone with ultrasonic bone aspirator, which was placed down the shaft of the laryngoscope to minimise damage to adjacent structures. He tolerated the procedure well with complete resolution of exposed bone on follow-up laryngoscopy.

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“…Findings of hyoid fragmentation, cortical disruption, and soft tissue or intraosseous air in the post-RT patient should strongly suggest the diagnosis of hyoid ORN. It is important to recognize this entity because the diagnosis may preclude potentially harmful diagnostic intervention and allow more appropriate therapy [38]. The temporal bone has been affected by ORN after irradiation of nasopharyngeal carcinomas [39,40].…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Osteoradionecrosis of the Jaws

Bagán

Scully

Zapater

et al. 2011

Clinic Rev Bone Miner Metab

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Osteoradionecrosis (ORN) is one of the most serious oral complications of head and neck cancer treatment with radiotherapy. There is bone tissue necrosis and failure to heal. The bone becomes devitalized and exposed through the overlying skin or mucosa, without healing for 3 months, without the recurrence of tumor. We review the etiological factors implicated in the ORN and describe the influence of infection, radiation therapy, dental status, and surgery. Finally, we present the currently accepted therapeutics procedures for the management of osteoradionecrosis.Keywords Osteoradionecrosis Á Jaws Á Bone necrosis Osteoradionecrosis (ORN) is one of the most serious oral complications of head and neck cancer treatment. It is characterized by a severe delayed radiation-induced injury, characterized by bone tissue necrosis and failure to heal [1-3], and several definitions have been proposed. One of the most widely accepted is that published by Harris [4]. He describes ORN as an irradiated bone that becomes devitalized and exposed through the overlying skin or mucosa, without healing for 3 months, without the recurrence of tumor. Marx [5] defined ORN as an area greater than 1 cm of exposed bone in a field of irradiation that had failed to show any evidence of healing for at least 6 months.Given the increased use of radiation therapy (RT) and combined chemotherapy-radiation therapy (CRT) regimens in the treatment of head and neck malignancies, it is anticipated that osteoradionecrosis will continue to be an important clinical problem [6], though newer radiotherapy techniques may reduce ORN to a degree, as discussed below.No studies to date have systematically addressed the impact of ORN on either quality of life or cost of care [7]. EpidemiologyIn a retrospective study of 830 patients with head and neck tumors who received radiotherapy between 1969 and 1999, there was an incidence of ORN of 8.2% and a threefold higher incidence in men than in women [8]. In contrast, Cheng et al. [9] in 2006 found the prevalence to be 2.7%.New cancer treatment strategies such as intensity-modulated RT (IMRT) and concomitant CRT have had disappointingly minimal effect on the prevalence of ORN. In a review of 43 articles published between 1990 and 2008, Peterson et al. [7] found that the weighted prevalence for ORN in conventional RT was 7.4%, for IMRT 5.1%, CRT 6.8%, and brachytherapy 5.3%. EtiologyThe cause and pathogenesis of osteoradionecrosis are far more complex than originally believed [6]. Recent theories for the pathogenesis of ORN have proposed that bone

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Osteoradionecrosis of the Hyoid Bone: Imaging Findings

Cited by 23 publications

References 12 publications

Osteoradionecrosis after Radiation Therapy for Head and Neck Cancer: Differentiation from Recurrent Disease with CT and PET/CT Imaging

Osteoradionecrosis after Radiation Therapy for Head and Neck Cancer: Differentiation from Recurrent Disease with CT and PET/CT Imaging

Osteoradionecrosis of the hyoid bone – a novel application of the Sonopet ultrasonic aspirator

Osteoradionecrosis of the Jaws

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