OSTEORADIONECROSIS OF THE ANTERIOR CRANIUM

Osteoradionecrosis occurs in approximately 10% to 15% of patients foll owing radiation therapy for head and neck cancer.(1) In these patients , it is most commonly reported in sites involving the mandible, but it has also been reported in the maxilla, sphenoid, and temporal bones. The majority of these cases are related to some type of trauma such as dental extraction or intraoral biopsies.(2) However, approximately 40 % of these entities occur spontaneously and are felt to be secondary t o cell kill in intermediate tissues such as bone and periosteum.(1) Ou r literature review yielded no previously reported cases of osteoradio necrosis involving the anterior cranium. The following two cases prese nt patients who experienced osteoradionecrosis of their frontal bone f laps following subcranial approaches for tumor resection. Both patient s suffered from carcinomas involving the ethmoid sinuses; one tumor wa s a moderately well-differentiated squamous cell carcinoma, the other a mucinous adenocarcinoma. One patient's radiation therapy consisted o f external beam photons; the other patient received external beam neut rons. Treatment for these patients, as well as possible causative fact ors regarding their osteoradionecrosis, are discussed.