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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Osteoradionecrosis (ORN)
Synonyms
- Radiation osteitis, radiation necrosis, irradiation osteomyelitis, avascular bone necrosis
Definitions
- Radiation-induced injury to temporal bone
- Localized (more common): Limited to external auditory canal (EAC)
- Diffuse: Involves mastoid septations and middle ear cavity (MEC), possibly skull base
- Radiation-induced injury to temporal bone
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Herr MW et al: Radiation necrosis of the lateral skull base and temporal bone. Semin Plast Surg. 34(4):265-71, 2020
- Yuhan BT et al: Osteoradionecrosis of the temporal bone: an evidence-based approach. Otol Neurotol. 39(9):1172-83, 2018
- Lambert EM et al: Effects of radiation on the temporal bone in patients with head and neck cancer. Head Neck. 38(9):1428-35, 2016
- Glicksman JT et al: Pentoxifylline-tocopherol-clodronate combination: a novel treatment for osteoradionecrosis of the temporal bone. Head Neck. 37(12):E191-3, 2015
- Kammeijer Q et al: Treatment outcomes of temporal bone osteoradionecrosis. Otolaryngol Head Neck Surg. 152(4):718-23, 2015
- Lee EW et al: Osteoradionecrosis of the temporal bone. Ear Nose Throat J. 94(1):18-9, 2015
- Phillips DJ et al: Radiation-induced necrosis of the temporal bone: diagnosis and Management. Otol Neurotol. 36(8):1374-7, 2015
- Ahmed S et al: CT findings in temporal bone osteoradionecrosis. J Comput Assist Tomogr. 38(5):662-6, 2014
- Sharon JD et al: Osteoradionecrosis of the temporal bone: a case series. Otol Neurotol. 35(7):1207-17, 2014
- Delanian S et al: Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO): a phase II trial. Int J Radiat Oncol Biol Phys. 80(3):832-9, 2011
- Morrissey D et al: Incidence of osteoradionecrosis of the temporal bone. ANZ J Surg. 81(12):876-9, 2011
- Leonetti JP et al: Temporal bone osteoradionecrosis after surgery and radiotherapy for malignant parotid tumors. Otol Neurotol. 31(4):656-9, 2010
- Benlier E et al: Massive osteoradionecrosis of facial bones and soft tissues. J BUON. 14(3):523-7, 2009
- Metselaar M et al: Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients. J Laryngol Otol. 123(10):1114-9, 2009
- Xu YD et al: Surgical treatment of osteoradionecrosis of the temporal bone in patients with nasopharyngeal carcinoma. J Laryngol Otol. 122(11):1175-9, 2008
- Nason R et al: Bacterial biofilms may explain chronicity in osteoradionecrosis of the temporal bone. Otol Neurotol. 28(8):1026-8, 2007
- Ang E et al: Reconstructive options in the treatment of osteoradionecrosis of the craniomaxillofacial skeleton. Br J Plast Surg. 56(2):92-9, 2003
- Linskey ME et al: Radiation exposure of normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas. J Neurosurg. 98(4):800-6, 2003
- Linskey ME et al: Radiation tolerance of normal temporal bone structures: implications for gamma knife stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 57(1):196-200, 2003
- Armour A et al: Late radiation side-effects in three patients undergoing parotid irradiation for benign disease. Clin Oncol (R Coll Radiol). 12(6):403-8, 2000
- Pathak I et al: Temporal bone necrosis: diagnosis, classification, and management. Otolaryngol Head Neck Surg. 123(3):252-7, 2000
- Tsang WS et al: Osteoradionecrosis of the temporal bone in nasopharyngeal carcinoma after radiotherapy: a case report. Ear Nose Throat J. 79(2):94-5, 2000
- Vudiniabola S et al: Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones. Int J Oral Maxillofac Surg. 29(6):435-8, 2000
- Hao SP et al: Systematic management of osteoradionecrosis in the head and neck. Laryngoscope. 109(8):1324-7; discussion 1327-8, 1999
- Pfreundner L et al: Carcinoma of the external auditory canal and middle ear. Int J Radiat Oncol Biol Phys. 44(4):777-88, 1999
- Meiteles L et al: Osteoradionecrosis of the temporal bone. Ear Nose Throat J. 77(1):56-7, 1998
- Lustig LR et al: Radiation-induced tumors of the temporal bone. Am J Otol. 18(2):230-5, 1997
- Nishimura R et al: MR evaluation of radiation otomastoiditis. Int J Radiat Oncol Biol Phys. 39(1):155-60, 1997
- Fong RS et al: Pediatric sensorineural hearing loss after temporal bone radiation. Am J Otol. 16(6):793-6, 1995
- Rudge FW: Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen therapy. Mil Med. 158(3):196-8, 1993
- Thornley GD et al: Osteoradionecrosis of the temporal bone. J Otolaryngol. 8(5):396-400, 1979
- Ramsden RT et al: Osteoradionecrosis of the temporal bone. J Laryngol Otol. 89(9):941-55, 1975
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Osteoradionecrosis (ORN)
Synonyms
- Radiation osteitis, radiation necrosis, irradiation osteomyelitis, avascular bone necrosis
Definitions
- Radiation-induced injury to temporal bone
- Localized (more common): Limited to external auditory canal (EAC)
- Diffuse: Involves mastoid septations and middle ear cavity (MEC), possibly skull base
- Radiation-induced injury to temporal bone
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Herr MW et al: Radiation necrosis of the lateral skull base and temporal bone. Semin Plast Surg. 34(4):265-71, 2020
- Yuhan BT et al: Osteoradionecrosis of the temporal bone: an evidence-based approach. Otol Neurotol. 39(9):1172-83, 2018
- Lambert EM et al: Effects of radiation on the temporal bone in patients with head and neck cancer. Head Neck. 38(9):1428-35, 2016
- Glicksman JT et al: Pentoxifylline-tocopherol-clodronate combination: a novel treatment for osteoradionecrosis of the temporal bone. Head Neck. 37(12):E191-3, 2015
- Kammeijer Q et al: Treatment outcomes of temporal bone osteoradionecrosis. Otolaryngol Head Neck Surg. 152(4):718-23, 2015
- Lee EW et al: Osteoradionecrosis of the temporal bone. Ear Nose Throat J. 94(1):18-9, 2015
- Phillips DJ et al: Radiation-induced necrosis of the temporal bone: diagnosis and Management. Otol Neurotol. 36(8):1374-7, 2015
- Ahmed S et al: CT findings in temporal bone osteoradionecrosis. J Comput Assist Tomogr. 38(5):662-6, 2014
- Sharon JD et al: Osteoradionecrosis of the temporal bone: a case series. Otol Neurotol. 35(7):1207-17, 2014
- Delanian S et al: Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO): a phase II trial. Int J Radiat Oncol Biol Phys. 80(3):832-9, 2011
- Morrissey D et al: Incidence of osteoradionecrosis of the temporal bone. ANZ J Surg. 81(12):876-9, 2011
- Leonetti JP et al: Temporal bone osteoradionecrosis after surgery and radiotherapy for malignant parotid tumors. Otol Neurotol. 31(4):656-9, 2010
- Benlier E et al: Massive osteoradionecrosis of facial bones and soft tissues. J BUON. 14(3):523-7, 2009
- Metselaar M et al: Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients. J Laryngol Otol. 123(10):1114-9, 2009
- Xu YD et al: Surgical treatment of osteoradionecrosis of the temporal bone in patients with nasopharyngeal carcinoma. J Laryngol Otol. 122(11):1175-9, 2008
- Nason R et al: Bacterial biofilms may explain chronicity in osteoradionecrosis of the temporal bone. Otol Neurotol. 28(8):1026-8, 2007
- Ang E et al: Reconstructive options in the treatment of osteoradionecrosis of the craniomaxillofacial skeleton. Br J Plast Surg. 56(2):92-9, 2003
- Linskey ME et al: Radiation exposure of normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas. J Neurosurg. 98(4):800-6, 2003
- Linskey ME et al: Radiation tolerance of normal temporal bone structures: implications for gamma knife stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 57(1):196-200, 2003
- Armour A et al: Late radiation side-effects in three patients undergoing parotid irradiation for benign disease. Clin Oncol (R Coll Radiol). 12(6):403-8, 2000
- Pathak I et al: Temporal bone necrosis: diagnosis, classification, and management. Otolaryngol Head Neck Surg. 123(3):252-7, 2000
- Tsang WS et al: Osteoradionecrosis of the temporal bone in nasopharyngeal carcinoma after radiotherapy: a case report. Ear Nose Throat J. 79(2):94-5, 2000
- Vudiniabola S et al: Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones. Int J Oral Maxillofac Surg. 29(6):435-8, 2000
- Hao SP et al: Systematic management of osteoradionecrosis in the head and neck. Laryngoscope. 109(8):1324-7; discussion 1327-8, 1999
- Pfreundner L et al: Carcinoma of the external auditory canal and middle ear. Int J Radiat Oncol Biol Phys. 44(4):777-88, 1999
- Meiteles L et al: Osteoradionecrosis of the temporal bone. Ear Nose Throat J. 77(1):56-7, 1998
- Lustig LR et al: Radiation-induced tumors of the temporal bone. Am J Otol. 18(2):230-5, 1997
- Nishimura R et al: MR evaluation of radiation otomastoiditis. Int J Radiat Oncol Biol Phys. 39(1):155-60, 1997
- Fong RS et al: Pediatric sensorineural hearing loss after temporal bone radiation. Am J Otol. 16(6):793-6, 1995
- Rudge FW: Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen therapy. Mil Med. 158(3):196-8, 1993
- Thornley GD et al: Osteoradionecrosis of the temporal bone. J Otolaryngol. 8(5):396-400, 1979
- Ramsden RT et al: Osteoradionecrosis of the temporal bone. J Laryngol Otol. 89(9):941-55, 1975
