Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Head and Neck Surgery

Osteonecrosis of the Head and Neck: Contemporary Management

Tuesday, October 3, 2023
9:45 AM - 10:35 AM East Coast USA Time
Location: Ballroom A1

    Lead Presenter(s)

  • Neal D. Futran, MD, DMD

    Dept chair
    University of Washington Medical Center
    SEATTLE, WA, United States

    • Co-Presenter(s)

  • Emily J. Marchiano, MD

    Assistant Professor of Otolaryngology-HNS
    university of washington
    SEATTLE, WA, United States

Disclosure(s):
Neal D. Futran, MD, DMD: No relevant relationships to disclose.
Emily J. Marchiano, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: Osteonecrosis (ONJ) of the head and neck is a spectrum of bone damaging disease and is preventable in many cases. Although commonly due to adverse sequelae of radiotherapy, bisphosphonate use has been recently implicated as an independent risk factor. Tissue hypoxia, hypovascularity, and hypocellularity occur. Osteoclast function, as well as collagen synthesis and production are impaired, which can lead to a nonhealing wound. ONJ will ultimately develop in up to 10 percent of patients and is a serious and devastating complication. The mandible, larynx, and temporal bone are most often involved. This course will discuss the pathophysiology, diagnosis, and therapeutic modalities (medical and surgical) to prevent and treat ONJ. Hyperbaric oxygen therapy can increase tissue oxygenation, and enhance neovascularization and wound healing. The scientific basis for its use, and its utility with planned debridement, sequestrectomy, and/or resection will be delineated. Optimal reconstructive techniques will be described for each situation. Adjunctive therapies (Vitamin E, Pentoxifylline, Fluoride treatments) and the role of allied professionals, particularly in the area of prevention, will be addressed. Finally, a systematic management scheme to treat this potentially debilitating disease for each site will be provided with an emphasis on early detection and appropriate decision-making.

OUTCOME OBJECTIVE 1: Learn the pathophysiology and diagnosis of osteonecrosis (ONJ) and available therapeutic medical and surgical modalities

OUTCOME OBJECTIVE 2: Identify the appropriate clinical and radiological work up for patients with ONJ

OUTCOME OBJECTIVE 3: Construct a systematic management scheme for prevention and treatment of ONJ of the mandible, maxilla, larynx, and temporal bone.

BACKGROUND STATEMENT: This condition will be seen an evaluated by all otolaryngolgists. It is critical to recognize this condition and the types of presentations. It is important to have at least a basic knowledge of etiology, patient assessment, and treatment options illustrate solutions.