Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제32권5호
  • /
  • Pages.458-463
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  • 2006
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

하악골에 발생한 방사선골괴사증 증례보고 및 문헌고찰

OSTEORADIONECROSIS ON MANDIBLE : A CASE REPORT AND LITERATURE REVIEW

  • 박진혁 (인제대학교 부속 부산백병원 구강악안면외과학교실) ;
  • 신선호 (인제대학교 부속 부산백병원 구강악안면외과학교실) ;
  • 이수운 (인제대학교 부속 부산백병원 구강악안면외과학교실) ;
  • 김우형 (인제대학교 부속 부산백병원 구강악안면외과학교실)
  • Park, Jin-Hyuk (Department of Oral & Maxillofacial Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Shin, Sun-Ho (Department of Oral & Maxillofacial Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Su-Woon (Department of Oral & Maxillofacial Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Woo-Hyung (Department of Oral & Maxillofacial Surgery, Pusan Paik Hospital, College of Medicine, Inje University)
  • 발행 : 2006.10.30
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초록

방사선골괴사증은 발병율이 낮아지고는 있으나 발병시 여전히 치료가 힘든 합병증이다. 방사선골괴사증의 병인 및 치료에 대해서는 논쟁이 계속되고 있으나 그 과정에서 새로운 시도와 개발이 진행되고 있어 고무적이라 할 수 있다. 방사선골괴사증은 치유기전의 문제이며 임의적으로 발병할 수 있어 완전한 예방은 불가능하다. 그러나 앞서 언급한 위험요소들을 주의깊게 인지하고 방사선 치료 전 예방적인 치과치료, 조심스런 발치 및 발치 후 충분한 치유기간, 구강 위생 교육, 예방적 항생제의 사용 등을 철저히 함으로써 발병 위험을 줄일 수 있다. 이 질환은 발병시 자발적으로 치유되지 않으며 보존적 치료로 개선이 되지 않을 시에는 적절한 외과적 개입이 필수적이다. 외과적 개입시에는 방사선골괴사 병소뿐 아니라 환자의 나이, 건강상태 및 환자의 바램, 암종의 예후등도 함께 고려해야 한다. 본 교실에서는 2명의 방사선골괴사증 환자에 대해 비록 장기간의 치료가 시행되었지만 비교적 양호한 치유결과를 얻을 수 있었기에 문헌고찰과 함께 보고하는 바이다.

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.

키워드

참고문헌

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