Osteoradionecrosis of the Mandible—Resection Aided by Measurement of Partial Pressure of Oxygen (pO 2): A Technical Report

Abstract

p s part of the treatment for malignant tumor condiions in the oral and maxillofacial region, ionizing adiation is applied alone or in combination with adical tumor resection. The reduction in the vascuarization induced by radiation makes the bone much ore susceptible to infection, so that it can develop nfected osteoradionecrosis spontaneously or followng surgical procedures. Treating osteoradionecrosis is still a challenge for ral and maxillofacial surgeons. Delineation of the esection boundaries in the mandible on the basis of isible bleeding is merely a qualitative criterion, not a uantitative one, and therefore inexact. Conseuently, it is desirable to obtain definitive measureents with an instrument to limit the extent of the esection. Partial pressure of oxygen (pO2) measureent with the Eppendorf fine needle probe provides quantitative parameter for the current oxygen suply in the tissue. The aim of this case presentation is o show that this method is suitable for defining the recise limits of the resection of bone in a case of steoradionecrosis. Marx was able to show in a clinical-pathological tudy that hypovascularization, cell reduction, and a ypoxic state developed in the irradiated mandible. It as not been possible to measure the extent of the ypoxia objectively thus far. Our own studies have recently confirmed that poarographically aided measurement of pO2 to ascerain the oxygenation status of the mandible is practi-