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Head and Neck Surgery

Stepwise Approach to Treating and Preventing Osteoradionecrosis

Tuesday, October 3, 2023
9:15 AM - 10:15 AM East Coast USA Time
Location: 202BC

    Panelist(s)

  • Chad A. Zender, MD, FACS

    Professor, Director Head and Neck Surgery
    Department of Otolaryngology- Head and Neck Surgery, University of Cincinnati
    Cincinnati, OH, United States

  • Matthew O. Old, MD

    Professor and Director, Otolaryngology Head and Neck Surgery
    The Ohio State University
    Columbus, OH, United States

  • Marita S. Teng, MD

    Professor
    Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai
    New York, NY, United States

    • Moderator(s)

  • Alice Tang, MD

    Assistant Professor
    University of Cincinnati MedicalCenter/College of Medicine
    Cincinnati, OH, United States

Disclosure(s):
Chad A. Zender, MD, FACS: No relevant relationships to disclose.
Matthew O. Old, MD: No relevant relationships to disclose.
Alice Tang, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: Osteoradionecrosis (ORN) and soft tissue necrosis is the cause of significant morbidity in head and neck cancer survivors. An evidence-based approach of the treatment of ORN continues to evolve with both surgical and non-surgical management. For advanced ORN, the gold-standard treatment is surgical resection of the hypoxic and hypovascular necrotic bone with immediate reconstruction with vascularized tissue into the irradiated fields. However, there are special considerations for this type of intervention given that previously irradiated and/or operated environments offer unique challenges. Similarly, soft tissue necrosis after radiation can be a diagnostic challenge, as tumor recurrence is always a consideration. Recognizing when to treat can also be problematic as it is difficult to determine if and when these ulcers will heal without surgical intervention with vascularized tissue. Experts will review the evidence and share their personal experience of operating in these distinct conditions. Additionally, this session will also evaluate and review the conservative management options and review recently published protocols for early ORN. This educational panel will highlight the challenges of recognizing and treating radiation-induced complications in head and neck cancer.

OUTCOME OBJECTIVE 1: Prevention and Treatment of Early Osteoradionecrosis: An update on non-surgical treatment of osteoradionecrosis and soft tissue necrosis

OUTCOME OBJECTIVE 2: Special considerations in the surgical treatment of osteoradionecrosis of the mandible

OUTCOME OBJECTIVE 3: Surgical technique and considerations when treating osteoradionecrosis and soft tissue necrosis with free tissue transfer

BACKGROUND STATEMENT: This panel reviews up-to-date evidence based practice to prevent ORN and also for conservative medical management after diagnosis for the general ENT that may see this in the community. We will also review surgical techniques for the microvascular trained surgeons in the audience.