Biopsies in the diagnosis of osteoradionecrosis or cancer recurrence

3^rd Annual World Dentists Summit & 4^th International Conference on Dental Research and Dental Treatments

November 29, 2022 | Webinar

Dr. Sabir Choudhury

Royal Preston Hospital, United Kingdom

Scientific Tracks Abstracts: Oral Health Case Re

Abstract :

Osteoradionecrosis (ORN) is a well known complication following head and neck radiotherapy. The diagnosis of ORN and exclusion of recurrent cancer can be challenging. Whilst investigations from radiographs to CT and MRI scans can be helpful it is important to appreciate that they are not conclusive. Normally with any concerning lesion the next step would be histopathological analysis through a biopsy. The difficulty is that in cases of ORN localised trauma from a biopsy can aggravate ORN and worsen patient outcomes. However there is the concern that the lesion could contain cancer. So what is the criteria for biopsy in these patients? A literature review was undertaken to understand the current guidance in the use of biopsies in diagnosing osteoradionecrosis or cancer recurrence. A comprehensive search from databases of Medline, The Cochrane library, Pubmed and Sciencedirect was completed for published papers between 1990-2022, in the English language and human studies. Keywords for osteoradionecrosis, biopsy, jaws and cancer were used. From 532 papers, only 16 papers were included in the study. Multiple authors strongly recommended biopsies in their routine evaluation of suspected ORN. It was deemed a necessary diagnostic step in order to confirm or exclude recurrent cancer. Studies show up to one-fifth of lesions previously diagnosed as ORN were confirmed as containing cancer from their biopsy. However some authors disapproved of biopsies due to concern of causing localised trauma and exacerbating ORN. Some suggested that biopsies were not beneficial as there was evidence of them failing to identify cancer and they can also delay major treatment. Currently there is limited guidance for clinicians and there are contrasting views on the use of biopsies in diagnosing osteoradionecrosis or cancer recurrence. It is clear that more research and clarification is needed in this area.

Biography :

Sabir Choudhury is junior clinical fellow who works in oral and maxillofacial surgery. He has many years of experience of working in many di�erent NHS hospital units across the United Kingdom. He is regularly involved in managing OMFS emergencies and traumatic injuries, head and neck oncology reconstructive surgery, as well as the running of outpatient clinics which cover biopsies to surgical dental extractions. He has a keen interest in dento-alveolar surgery and has a keen eye on constructing methods of improving healthcare and patient outcomes.