Surgical treatment of diffused osteoradionecrosis of temporal bone in cases with nasopharyngeal carcinoma after radiotherapy

Abstract

To investigate the effective treatment method of osteoradionecrosis (ORN) of temporal bone in the patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Eight NPC patients (8 ears) with ORN of temporal bone accepted surgical treatment, 2 ears undergoing radical mastoidectomy, 2 ears undergoing extensive radical mastoidectomy, 5 ears undergoing radical mastoidectomy and obliteration with transferring local vascularized fascia flaps. Five of the 8 ears (62.5%) achieved dry ear, including 4 ears undergoing radical mastoidectomy and obliteration with vascularized fascia flaps, and 1 ear undergoing radical mastoidectomy. Two of the 8 ears (25%) still had infection and were not fully epithelized, but without sequestration, including 1 ear undergoing mastoidectomy and obliteration with vascularized fascia flaps, and 1 ear undergoing extensive radical mastoidectomy. One of the 8 ears (12.5%) which had received radical mastoidectomy needed revision surgery because of re-sequestration. The surgical treatment for diffused ORN of temporal bone by radical mastoidectomy and obliteration with local vascularized flaps is effective. The main objective of the surgery is get excellent drainage and prevention of complications.