Osteo Radio Necrosis Of The Jaw

I guess you've done the research on this, but if not here's what I know, it is usually graded in stages. When it gets to the late stages a jaw resection is unfortunately pretty much all they can do. At that point the bone has no blood flow and is dead. I am sure the doctors have weighed all the options and have staged it correctly, but ask them any questions and voice any concern you have. I wish the best for you both.

Good Luck!

Joe 

Yes, I had Osteo radio necrosis of the jaw 7 yrs ago. It was quite an ordeal. I had a hard time getting the infection under control and went through all the antibiotics it seems. I spent 2 weeks in  the hospital and had a trach for a short time because the infection spread under my tongue and it swelled. I had some minor surgeries to clean up the area and scrap off dead bone. My surgeon was patient and I went to a naturopathic Dr. who helped me with a bone building program. In addition the surgeon sent me for 6 weeks of hyperbaric oxygen. In the end the bone started to regenerate and I did not have to have the bone removed. It is still doing OK but I am very careful and have my teeth cleaned every 2-3 months to watch out for infection. I am sure everything I did helped but the hyperbaric oxygen is very improtant.

Hope this helps you.

Nora

Thankyou, my husaband is scheduled for surgery on Tuesday, he had hyperbaric in the past but it was not sucessful.

We are scared to death. All you can do is take it one day at a time.

thanks again

Hello,

I had squamous cell carcinoma of the base of the tongue treated with chemo and 7 weeks radiation (over 250 shots in total) last year. The tumour appears to be in remission but I have had significant and lasting side effects from the radiation.

I have a chronic necrosis of the mandible one the side where the radiation enetered. Periodically it flares up causing pain and requires antibiosis and pain relief. I also have a worsening trismus of the jaw to the point where I can hardly open my mouth wide enough to get a grape in. Forcing my jaw open beyond a certain pain causes pain.

Has anyone experienced this problem and how was it treated?

George 

Hi George.  My boyfriend completed radiation and chemotherapy last June for the same kind of cancer that you had, and has just discovered that he now has necrosis of the jaw.  He is going to see an oral surgeon, hopefully, by next week.  He also seems to be having trouble opening his mouth very wide.  When did you complete your treatments and were they concurrent or consecutive?

Thank you. 

JJ

On 9/25/2008 Georgie at Nidri wrote:

Hello,

I had squamous cell carcinoma of the base of the tongue treated with chemo and 7 weeks radiation (over 250 shots in total) last year. The tumour appears to be in remission but I have had significant and lasting side effects from the radiation.

I have a chronic necrosis of the mandible one the side where the radiation enetered. Periodically it flares up causing pain and requires antibiosis and pain relief. I also have a worsening trismus of the jaw to the point where I can hardly open my mouth wide enough to get a grape in. Forcing my jaw open beyond a certain pain causes pain.

Has anyone experienced this problem and how was it treated?

George 

 

 

Hi Joanne,

Yes the treatments were concurrent. I had cisplastin once a week and radiation 5 times weekly (except public holidays when I had a double dose on one of the following weekdays).

I saw my facio-maxillary surgeon last week and he agreed  further action was needed. A staged approach is considered starting with curetting out the sequestrum of necrotic bone, packing with some slow release iodine pack and hoping this will cause granulation (healing) over the defect.

 He is not a believer in hyperbaric oxygen and there are few facilities for it in the UK but he asked me to review the literature and if I felt it would be useful he could include that as part of the protocol. I have done and there is only one proper (randomised blinded) study, a Belgian one in which no benefits were found. As it would involve lengthy travel and time commitment I am not going for hyperbarics.

I will keep you advised as to progress.

As far as the opening of the mouth (trismus) he was not in the least concerned and it was my ENT surgeon that has referred me to a speech therapist for appropriate physiotherapy solutions - basically opening my mouth by increasing amounts every day. It is caused by fibrosis of the muscles  which close the jaw.

Let me know how you get on,

With kind regards

George