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October 1987

Oral Tetracycline in Surgical Management of Osteoradionecrosis

Author Affiliations

Tampa, Fla

Arch Otolaryngol Head Neck Surg. 1987;113(10):1047. doi:10.1001/archotol.1987.01860100025015

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John F. Kveton, MD, Lahey Clinic, Burlington, Mass, presented a case report to the American Neurotologic Society meeting in Denver that detailed successful management of a child with osteoradionecrosis of the temporal bone. A 10-year-old child had had osteoradionecrosis of the temporal bone with otorrhea for approximately six years as a complication of combined therapy for a rhabdomyosarcoma of the infratemporal fossa. Computed tomography revealed extensive lytic changes in the temporal bone consistent with a diffuse pattern of bone necrosis. Forty-five preoperative hyperbaric oxygen treatments were administered. Ten days prior to surgical débridement of the necrotic temporal bone, tetracycline was administered orally. Tetracycline binds to calcium ions in bone and fluoresces on exposure to ultraviolet light. Fluorescence was used as an indicator of viable bone, and the absence of fluorescence suggested the need for further bone removal. The resulting defect was obliterated with fat.

Literature review suggested that failure of

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