HYPERBARIC-OXYGEN TREATMENT OF OSTEORADIONECROSIS OF THE MANDIBLE WITH REPEATED PATHOLOGICAL FRACTURE - REPORT OF A CASE

Treatment of patients with osteoradionecrosis of the mandible with a p athologic fracture consists in a most a cases of a continuity resectio n of the mandible. This leads to functional and esthetic problems that can only be solved by often extensive surgery. In this case report we present a 38-year-old woman who developed osteoradionecrosis of the m andible with a pathologic fracture 1 1/2 years after combined surgical and radiation therapy of an adenocarcinoma of the right parotid gland . The patient had a subcondylar pathologic fracture together with oste olysis in the right mandibular body, normally an indication for partia l resection of the mandible. Because of the absence of denuded bone, f istulation, and the poor quality of the surrounding soft tissues, a mo re conservative approach was chosen. Treatment consisted of hyperbaric oxygen and dental extractions with alveolectomy with the patient unde r local anesthesia. During follow-up, a second pathologic fracture occ urred in the region of the right first and second molar. No additional treatment was given. Six and one-half years after the initial treatme nt and 5 1/2 years after the last fracture, the patient is free of com plaints, the fractures have healed and both esthetic and functional re sults are good.