Management of temporal bone osteoradionecrosis: Surgical and adjunctive therapies

Objective: To investigate surgical and adjunctive therapies and associated outcomes in patients with radiotherapy induced temporal bone osteoradionecrosis. Study Design: Retrospective Case Review Setting: Tertiary referral center Patients: Six patients diagnosed with radiotherapy induced ORN of the temporal bone treated at Duke U Medical Center between May 2007 to August 2008. Interventions: The clinical history, therapeutic interventions and disease specific outcomes were retrospectively reviewed for the study patients. All six patients were treated with surgical therapy. Four patients underwent lateral temporal bone resection while two others underwent complete mastoidectomies. One underwent canalplasty with meatoplasty. All six patients underwent tissue transfer to the resection site, 3 with temporalis muscle flaps, 1 with a temporalparietal fascial flap, 1 with rectus free tissue transfer, and 1 with epidermal transfer. Four patients underwent closure of the EAC. Three patients underwent hyperbaric oxygen therapy. All patients underwent prolonged courses of antibiotic therapy. Main Outcome Measures: 1) Patients free from temporal bone necrosis and infection. 2) Complete healing of the primary wound. Mean follow up was 13.5 months.

Duke Scholars

Author David Marcus Kaylie Otology, Neurotology & Skull Base Surgery

Author Debara Lyn Tucci Head and Neck Surgery & Communication Sciences