Heterogeneity of Necrotic Changes between Cortical and Cancellous Bone in Mandibular Osteoradionecrosis: A Histopathological Analysis of Resection Margin after Segmental Mandibulectomy

Background. This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis. Methods. Anteroposterior bone specimens from eleven patients who underwent segmental mandibulec...

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Bibliographic Details
Published in:BioMed research international 2017-01, Vol.2017 (2017), p.1-11
Main Authors: Komori, Takahide, Furudoi, Shungo, Shigeoka, Manabu, Kusumoto, Junya, Wanifuchi, Satoshi, Hashikawa, Kazunobu, Akashi, Masaya, Terashi, Hiroto
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biocompatibility
Biomedical research
Blood vessels
Bones
Canals
Canals (anatomy)
Cancellous bone
Cancellous Bone - pathology
Cancellous Bone - surgery
Complications and side effects
Cortical bone
Female
Fibula
Fibula - pathology
Fibula - surgery
Health aspects
Humans
Male
Mandible
Mandible - pathology
Mandible - surgery
Mandibular Diseases - pathology
Mandibular Diseases - surgery
Mandibular Osteotomy - methods
Margins of Excision
Maxillofacial surgery
Medicine
Middle Aged
Osteonecrosis - pathology
Osteonecrosis - surgery
Osteoradionecrosis
Osteoradionecrosis - pathology
Osteoradionecrosis - surgery
Otolaryngology
Pain
Pathology
Plastic Surgery Procedures - adverse effects
Plastic Surgery Procedures - methods
Radiation therapy
Radiotherapy
Retrospective Studies
Surgery
Trabecular bone
University graduates
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Summary:Background. This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis. Methods. Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals. Results. Ten of eleven (91%) cortices near the inferior border of the mandible at the anterior margins were necrotic. All cancellous bones at the anterior margins were viable. Seven of eleven (64%) cortices near the inferior border of the mandible at the posterior margins were necrotic. Three of eleven (27%) cancellous bones at the posterior margins were necrotic. Conclusion. Necrotic changes are more prevalent in cortices than in cancellous bones in mandibular osteoradionecrosis, probably due to a decrease of periosteal blood supply caused by radiotherapy.
ISSN:2314-6133
2314-6141
DOI:10.1155/2017/3125842