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<p>50-year-old male with prior radiotherapy for left tonsillar carcinoma presented with trismus, dysphagia, and mandibular pain. Imaging revealed advanced osteoradionecrosis (ORN) with a pathological mandibular fracture and a pharyngeal fistula. Hyperbaric oxygen therapy was contraindicated due to pulmonary fibrosis. Surgical management included wide local excision, en bloc segmental resection of the left mandible, and reconstruction using a pectoralis major myocutaneous (PMMC) flap. The flap was tunneled through a subplatysmal plane and wrapped around the defect. This case highlights the challenges of managing ORN and demonstrates the effectiveness of PMMC flap reconstruction in extensive composite mandibular defects.</p>

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Management of an Osteoradionecrosis of Mandible with Pharyngeal Fistula of Anterior Neck: A Case Report

  • 期刊论文

  • 发表日期：

    2025年9月12日

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  • Rajarshi Banerjee,
  • Indranil Ghosh,
  • Mayukh Misra,
  • Sudipta Sahu,
  • Pushan Maity,
  • Chirantan Maity

摘要

50-year-old male with prior radiotherapy for left tonsillar carcinoma presented with trismus, dysphagia, and mandibular pain. Imaging revealed advanced osteoradionecrosis (ORN) with a pathological mandibular fracture and a pharyngeal fistula. Hyperbaric oxygen therapy was contraindicated due to pulmonary fibrosis. Surgical management included wide local excision, en bloc segmental resection of the left mandible, and reconstruction using a pectoralis major myocutaneous (PMMC) flap. The flap was tunneled through a subplatysmal plane and wrapped around the defect. This case highlights the challenges of managing ORN and demonstrates the effectiveness of PMMC flap reconstruction in extensive composite mandibular defects.