Delayed tongue necrosis simultaneous with bilateral osteoradionecrosis of the jaw secondary to head and neck irradiation

Publication date: Available online 15 October 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Marcos Martins Curi, Camila Lopes Cardoso, Anthony Benites Condezo, Patrícia Martins Bueno
We present a rare case of massive tongue necrosis simultaneous with bilateral osteoradionecrosis of the jaw in a patient with a previous history of treatment including surgery and post-operative radiotherapy for a retromolar trigone carcinoma that occurred 8 years prior. There is a distinct possibility that the extractions and administration of local anesthesia with vasoconstrictor contributed to the onset of ORN, and together these events may have influenced the blood supply to the tongue. A glossectomy was performed following hyperbaric oxygen therapy. One month after the surgical procedure, the patient responded satisfactorily to the treatment with a significant improvement in speech and oral food intake, as well as a significant decreased in lingual pain. Despite the fact that the simultaneous occurrence of these oral complications is rare, the practitioner must be aware of the factors that instigate osteoradionecrosis and compromise vasculature as well as the clinical signs of tongue necrosis. Additionally, the possibility of tongue necrosis secondary to irradiation of head and neck should be taken into consideration when irradiated patient receives tooth extractions using local anesthetic containing epinephrine.



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