Features and Management of Osteoradionecrosis of the Skull Base A Systematic Review and Meta-Analysis.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-05-09 DOI:10.1002/hed.28186

Ashton Huppert Steed, James Kelbert, Shawn M Stevens, Ameya A Jategaonkar

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引用次数: 0

Abstract

Background: Skull base osteoradionecrosis (SBORN) is a rare but potentially devastating consequence of radiotherapy (RT) for head and neck tumors. This study aims to synthesize existing literature and analyze treatment outcomes among patients with SBORN.

Methods: A systematic literature search was conducted following PRISMA guidelines. Adult patients with SBORN were included. Random effects modeling was used for meta-analysis.

Results: Overall, 29 studies with 593 patients were included. Mean time to presentation of SBORN following RT was 84.3 months. Analysis of treatment modalities revealed 165 patients underwent conservative management, 258 surgery without free flap reconstruction, and 101 surgery with free flap reconstruction. Meta-analysis demonstrated a significantly lower death rate in patients who underwent free tissue transfer, compared to those who were managed conservatively (p < 0.01).

Conclusions: SBORN represents a challenging complication following radiotherapy of head and neck tumors. The consequences can be catastrophic; therefore, prompt identification and treatment are key. The use of vascularized free tissue transfer for patients with significant structural defects from SBORN may improve survivorship compared to conservative treatment measures; however, further research on treatment outcomes is warranted.

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颅底放射性骨坏死的特点和治疗：系统回顾和荟萃分析。

背景：颅底骨放射性坏死（SBORN）是头颈部肿瘤放疗（RT）的一种罕见但具有潜在破坏性的后果。本研究旨在综合现有文献，分析SBORN患者的治疗效果。方法：按照PRISMA指南进行系统的文献检索。纳入了SBORN的成年患者。meta分析采用随机效应模型。结果：总共纳入29项研究，593例患者。放疗后至出现SBORN的平均时间为84.3个月。治疗方式分析：保守治疗165例，游离皮瓣重建258例，游离皮瓣重建101例。荟萃分析显示，与保守治疗的患者相比，接受游离组织移植的患者死亡率显着降低(p)。结论：SBORN是头颈部肿瘤放疗后的一个具有挑战性的并发症。后果可能是灾难性的；因此，及时识别和治疗是关键。与保守治疗措施相比，血管化游离组织移植可改善SBORN严重结构缺陷患者的生存率；然而，对治疗结果的进一步研究是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.