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目的 探讨下颌骨放射性骨坏死（Osteoradionecrosis of jaws,ORNJ）治疗和外形重建的方案。方法23例因鼻咽癌放疗后引发的下颌骨放射性骨坏死采用局部刮治加高压氧治疗和下颌骨切除后钛板加皮瓣修复两种方法治疗。结果 局部刮治加高压氧对ORNJ治疗无效,有9例症状复发;而切除下颌坏死骨用钛板做支架利用胸大肌皮瓣修复治疗16例,全部有效,随访时间3个月～1年,除1例因排斥反应伤口未愈外,其余15例皆有效。结论 钛板和局部皮瓣或胸大肌皮瓣修复是治疗ORNJ的有效方法。
Objective To investigate the treatment of osteonecrosis of the jaw (ORNJ) and the reconstruction of its shape. Methods Twenty - three cases of radiated osteonecrosis of the mandible induced by radiotherapy of nasopharyngeal carcinoma were treated with local scraping and hyperbaric oxygen therapy and titanium plate plus flaps repairing after mandibular resection. Results Local curettage and hyperbaric oxygen were ineffective in treatment of ORNJ, and 9 cases had recurrent symptoms. Titanium plate was used in the resection of mandibular necrotic bone. Pectoralis major myocutaneous flap was used in 16 cases, all of them were effective. The follow-up time ranged from 3 months to 1 year , Except for 1 case of rejection wound healing, the remaining 15 cases are valid. Conclusion Titanium plate and local skin flap or pectoralis major muscle flap repair is an effective method for the treatment of ORNJ.