CT FINDINGS IN OSTEORADIONECROSIS OF THE MANDIBLE

CT scans of ten patients in whom the diagnosis of mandibular osteoradi onecrosis was proven pathologically or by clinical followup were revie wed. All ten patients had bony abnormalities (cortical interruptions a nd loss of spongiosa trabeculation) on the symptomatic side. These wer e predominantly seen in the body of the mandible (premolar and molar r egion, eight patients), in some of these cases extending into the retr omolar triangle (two patients) or mandibular angle (two patients). In the remaining two patients the abnormalities were in the ramus and ang le. The two patients treated with iridium implantation showed localize d lingual-sided cortical destruction. Three patients had a pathologica l fracture. The cortical destruction was buccal-sided in two and both buccal- and lingual-sided in three of the other five patients. Contral ateral bony abnormalities were present in four patients. Soft tissue t hickening on the symptomatic side was seen in nine patients. As the bo ny abnormalities in mandibular osteoradionecrosis are often associated with a soft tissue mass, CT differentiation from tumor recurrence can be diffficult. The association with cortical defects distant from the position of the original tumor (buccal surface or opposite side of ma ndible) should evoke the possibility of mandibular osteoradionecrosis.