Abstract
Complications attendant on the use of irradiation in the head and neck occurred in 72 of 128 patients at the M. D. Anderson Hospital. The author outlines a rational approach to the patient with head and neck cancer that can help in preventing undesirable sequelae. Dental status, tumor location, and patient compliance are major factors that bear on incidence of major complications of radiation. Recent advances in reconstructive surgery now permit safe transfer of tissue with its intrinsic blood supply-not dependent, as in the past, on the local radiated area for its vascularity. When complications of radiation therapy occur, they are usually late and in some instances no treatment is indicated or desired. Clinical examples are used to identify specific areas of concern.
Résumé
L'irradiation de la tÊte et du cou peut provoquer des complications au niveau des tissus situés au-dessus de la clavicule. Pour les prévenir l'auteur insiste sur les précautions qu'il convient d'adopter chez le malade qui présente un cancer de la région céphalocervicale en fonction de l'état de sa dentition, du siège de la tumeur et de sa volonté de collaboration. Les progrès récents de la chirurgie réparatrice permettent de recouvrir efficacement la surface irradiée qui a été excisée grâce à des tissus qui ont une bonne vascularisation. Quand des complications se manifestent elles sont souvent tardives et aucun traitement est ni indiqué, ni souhaitable. Quelques complications particulières et les solutions thérapeutiques à leur apporter sont prises en considération.
Resumen
La irradiación de la cabeza y del cuello puede afectar cualquier tejido ubicado por encima de la clavícula y resultar en complicaciones indeseables. El autor presenta un aproche racional en el paciente con cáncer de cabeza y cuello, el cual puede prevenir el desarrollo de secuelas indeseables, con atención particular hacia el estado dental, la localización del tumor y la tolerancia del paciente. Gracias a los recientes avances en cirugía reconstructiva, nos encontramos hoy en capacidad de realizar coberturas adecuadas con tejidos provistos de su irrigación propia y no dependientes, como ocurría en el pasado, de la región irradiada para su vascularidad. Cuando se presentan complicaciones, estas generalmente son tardías y en algunos casos no requieren tratamiento. Se utilizan ejemplos clínicos ilustrativos de situaciones específicas.
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Larson, D.L. Repair of radiation complications in the head and neck. World J. Surg. 10, 195–205 (1986). https://doi.org/10.1007/BF01658136
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DOI: https://doi.org/10.1007/BF01658136