JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 54 No. 3       2008

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Superselective intra-arterial infusion therapy using Seldinger's technique is frequently performed at many institutions to improve treatment outcomes in patients with advanced head and neck cancer. However, complications related to control nerve dysfunction and local toxicity have been reported in association with the use of the one-shot infusion procedure. We report a case of bone necrosis of the mandible after superselective intra-arterial infusion therapy in a 74-year-old woman with carcinoma of the upper gingiva. She received conventional concomitant extrabeam radiotherapy (36 Gy and superselective intra-arterial infusion therapy with CBDCA (300 mg) via the maxillary artery. After superselective intra-arterial infusion chemotherapy, necrosis of the medial pterygoid muscle, extending to the area around the mandible, was recognized. Thereafter, sequestration and a fracture of the mandible developed two times within 1 year after this treatment. Sequestrotomy and intramaxillary fixation for the fracture were performed. Thereafter, both new bone formation and bone remodeling were confirmed. We suspect that this side effect was caused by leakage of CBDCA to the surrounding tissue, moving the catheter to another artery, or spasm of the maxillary artery. Key words: superselective intra-arterial infusion therapy, upper gingival carcinoma, necrosis of the mandible.

| Volver |