{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:06:54Z","timestamp":1740107214849,"version":"3.37.3"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Osteoradionecrosis (ORN) of the skull base is a rare complication after head and neck radiation with a broad variety of subsequent complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A 68-year-old woman with a complex oncological history (right-sided sphenoid meningioma; left-sided neck metastasis of a Cancer of Unknown Primary\u2014CUP) was admitted with a right-sided epi\u2014\/ oropharyngeal mass and severe pain exacerbations for further evaluation. CT scan revealed an advanced ORN of the skull base with subsequent abruption of the ventral part of the clivus. This dislocated part of the clivus wedged in the oropharynx for 48\u00a0h and then moved towards the larynx, resulting in dyspnea and almost complete airway obstruction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Due to the dangerous airway situation, an urgent exploration and removal of the dislocated clivus was necessary. After a potential cervical spine instability was ruled out, the patient\u2019s airway was initially secured with an awake tracheotomy and the clivus was removed transorally. The tracheostomy tube was removed during the ongoing inpatient stay, and the patient was discharged with significant pain relief.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The present case illustrates an orphan complication of skull base ORN resulting in a major airway emergency situation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00405-024-08507-1","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T16:02:20Z","timestamp":1708531340000},"page":"2755-2759","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Unknown Foreign laryngeal Object: an exotic complication of skull base osteoradionecrosis"],"prefix":"10.1007","volume":"281","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9523-7489","authenticated-orcid":false,"given":"Stefan","family":"Grasl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Wassipaul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Arnoldner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Janik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"issue":"1\u20136","key":"8507_CR1","doi-asserted-by":"publisher","first-page":"399","DOI":"10.3109\/00016922609139503","volume":"6","author":"J Eiving","year":"1926","unstructured":"Eiving J (1926) Radiation osteitis. Acta Radiol 6(1\u20136):399\u2013412","journal-title":"Acta Radiol"},{"issue":"4","key":"8507_CR2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1097\/01.moo.0000170527.59017.ff","volume":"13","author":"MS Teng","year":"2005","unstructured":"Teng MS, Futran ND (2005) Osteoradionecrosis of the mandible. Curr Opin Otolaryngol Head Neck Surg 13(4):217\u2013221","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"4","key":"8507_CR3","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/0030-4220(87)90136-8","volume":"64","author":"RE Marx","year":"1987","unstructured":"Marx RE, Johnson RP (1987) Studies in the radiobiology of osteoradionecrosis and their clinical significance. Oral Surg Oral Med Oral Pathol 64(4):379\u2013390","journal-title":"Oral Surg Oral Med Oral Pathol"},{"issue":"1","key":"8507_CR4","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.mehy.2011.03.024","volume":"77","author":"Q Zhuang","year":"2011","unstructured":"Zhuang Q, Zhang Z, Fu H, He J, He Y (2011) Does radiation-induced fibrosis have an important role in pathophysiology of the osteoradionecrosis of jaw? Med Hypotheses 77(1):63\u201365","journal-title":"Med Hypotheses"},{"issue":"02","key":"8507_CR5","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.radonc.2004.08.021","volume":"73","author":"S Delanian","year":"2004","unstructured":"Delanian S, Lefaix JL (2004) The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol 73(02):119\u2013131","journal-title":"Radiother Oncol"},{"issue":"1","key":"8507_CR6","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/j.1749-6632.2010.05771.x","volume":"1218","author":"AO Hoff","year":"2011","unstructured":"Hoff AO, Toth B, Hu M, Hortobagyi GN, Gagel RF (2011) Epidemiology and risk factors for osteonecrosis of the jaw in cancer patients. Ann N Y Acad Sci 1218(1):47\u201354","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"8507_CR7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/0167-8140(95)01583-3","volume":"36","author":"C Glanzmann","year":"1995","unstructured":"Glanzmann C, Gratz KW (1995) Radionecrosis of the mandibula: a retrospective analysis of the incidence and risk factors. Radiother Oncol 36(2):94\u2013100","journal-title":"Radiother Oncol"},{"issue":"11","key":"8507_CR8","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.1016\/j.joms.2007.05.021","volume":"65","author":"BR Goldwaser","year":"2007","unstructured":"Goldwaser BR, Chuang SK, Kaban LB, August M (2007) Risk factor assessment for the development of osteoradionecrosis. J Oral Maxillofac Surg 65(11):2311\u20132316","journal-title":"J Oral Maxillofac Surg"},{"issue":"1","key":"8507_CR9","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.tripleo.2011.07.042","volume":"113","author":"S Nabil","year":"2012","unstructured":"Nabil S, Samman N (2012) Risk factors for osteoradionecrosis after head and neck radiation: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 113(1):54\u201369","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"02","key":"8507_CR10","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/0030-4220(80)90299-6","volume":"49","author":"CG Murray","year":"1980","unstructured":"Murray CG, Daly TE, Zimmerman SO (1980) The relationship between dental disease and radiation necrosis of the mandible. Oral Surg Oral Med Oral Pathol 49(02):99\u2013104","journal-title":"Oral Surg Oral Med Oral Pathol"},{"issue":"03","key":"8507_CR11","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1054\/ijom.2002.0332","volume":"32","author":"T Reuther","year":"2003","unstructured":"Reuther T, Schuster T, Mende U, K\u00fcbler A (2003) Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients\u2013a report of a thirty year retrospective review. Int J Oral Maxillofac Surg 32(03):289\u2013295","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"Suppl 2","key":"8507_CR12","first-page":"e521","volume":"83","author":"N Shaikh","year":"2021","unstructured":"Shaikh N, Makary CA, Ryan L, Reyes C (2021) Treatment outcomes for osteoradionecrosis of the central skull base: a systematic review. J Neurol Surg B Skull Base 83(Suppl 2):e521\u2013e529","journal-title":"J Neurol Surg B Skull Base"},{"issue":"3","key":"8507_CR13","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1016\/j.ijrobp.2010.03.029","volume":"80","author":"S Delanian","year":"2011","unstructured":"Delanian S, Chatel C, Porcher R, Depondt J, Lefaix JL (2011) 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\u2013839","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"8507_CR14","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1002\/hed.20121","volume":"27","author":"S Delanian","year":"2005","unstructured":"Delanian S, Depondt J, Lefaix JL (2005) Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: a phase II trial. Head Neck 27(2):114\u2013123","journal-title":"Head Neck"},{"issue":"11","key":"8507_CR15","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.oraloncology.2010.08.007","volume":"46","author":"AS Jacobson","year":"2010","unstructured":"Jacobson AS, Buchbinder D, Hu K, Urken ML (2010) Paradigm shifts in the management of osteoradionecrosis of the mandible. Oral Oncol 46(11):795\u2013801","journal-title":"Oral Oncol"},{"issue":"1","key":"8507_CR16","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/idj.12318","volume":"68","author":"A Chronopoulos","year":"2018","unstructured":"Chronopoulos A, Zarra T, Ehrenfeld M, Otto S (2018) Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review Int Dent J 68(1):22\u201330","journal-title":"A concise review Int Dent J"},{"issue":"12","key":"8507_CR17","doi-asserted-by":"publisher","first-page":"2545","DOI":"10.1016\/j.joms.2007.08.041","volume":"66","author":"DL Hirsch","year":"2008","unstructured":"Hirsch DL, Bell RB, Dierks EJ, Potter JK, Potter BE (2008) Analysis of microvascular free flaps for reconstruction of advanced mandibular osteoradionecrosis: a retrospective cohort study. J Oral Maxillofac Surg 66(12):2545\u20132556","journal-title":"J Oral Maxillofac Surg"},{"issue":"5","key":"8507_CR18","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1002\/(SICI)1097-0347(199708)19:5<406::AID-HED7>3.0.CO;2-3","volume":"19","author":"AR Shaha","year":"1997","unstructured":"Shaha AR, Cordeiro PG, Hidalgo DA et al (1997) Resection and immediate microvascular reconstruction in the management of osteoradionecrosis of the mandible. Head Neck 19(5):406\u2013411","journal-title":"Head Neck"},{"key":"8507_CR19","doi-asserted-by":"crossref","unstructured":"Huang WB, Wong STS, Chan JYW. Role of surgery in the treatment of osteoradionecrosis and its complications after radiotherapy for nasopharyngeal carcinoma. Head Neck 2018;40(02):369\u2013376 23","DOI":"10.1002\/hed.24973"},{"issue":"01","key":"8507_CR20","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1002\/lio2.345","volume":"5","author":"H Daoudi","year":"2020","unstructured":"Daoudi H, Labeyrie MA, Guillerm S et al (2020) Multimodal strategy for the management of sphenoid osteoradionecrosis: preliminary results. Laryngoscope Investig Otolaryngol 5(01):19\u201323","journal-title":"Laryngoscope Investig Otolaryngol"},{"issue":"12","key":"8507_CR21","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1017\/S0022215115002601","volume":"129","author":"Y Brand","year":"2015","unstructured":"Brand Y, Lim E, Waran V, Prepageran N (2015) Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note. J Laryngol Otol 129(12):1243\u20131247","journal-title":"J Laryngol Otol"},{"issue":"03","key":"8507_CR22","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/j.ijrobp.2018.06.027","volume":"102","author":"P Han","year":"2018","unstructured":"Han P, Wang X, Liang F et al (2018) Osteoradionecrosis of the skull base in nasopharyngeal carcinoma: incidence and risk factors. Int J Radiat Oncol Biol Phys 102(03):552\u2013555","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"8507_CR23","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. 2016;V1.2016. https:\/\/www.nccn.org\/professionals\/physician_glsf_guidelines.asp.Accessed August 1 2017."},{"key":"8507_CR24","doi-asserted-by":"publisher","unstructured":"Eskander A, Ghanem T, Agrawal A; Education Committee of American Head and Neck Society (AHNS). AHNS Series: Do you know your guidelines? Guideline recommendations for head and neck cancer of unknown primary site. Head Neck. 2018 Mar;40(3):614\u2013621. https:\/\/doi.org\/10.1002\/hed.25026. Epub 2017 Nov 21. PMID: 29159978.","DOI":"10.1002\/hed.25026"},{"key":"8507_CR25","doi-asserted-by":"publisher","unstructured":"S. Nabil, N. Samman Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review Int J Oral Maxillofac Surg, 40 (2011), pp. 229\u2013243, https:\/\/doi.org\/10.1016\/j.ijom.2010.10.005","DOI":"10.1016\/j.ijom.2010.10.005"},{"key":"8507_CR26","doi-asserted-by":"publisher","unstructured":"A.A. Owosho, C.J. Tsai, R.S. Lee, H. Freymiller, A. Kadempour, S. Varthis, et al.The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): The Memorial Sloan Kettering Cancer Center experience Oral Oncol, 64 (2017), pp. 44\u201351, https:\/\/doi.org\/10.1016\/j.oraloncology.2016.11.015","DOI":"10.1016\/j.oraloncology.2016.11.015"},{"issue":"4","key":"8507_CR27","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1002\/hed.25522","volume":"41","author":"P Di Maio","year":"2019","unstructured":"Di Maio P, Iocca O, De Virgilio A et al (2019) Role of palatine tonsillectomy in the diagnostic workup of head and neck squamous cell carcinoma of unknown primary origin: a systematic review and meta-analysis. Head Neck 41(4):1112\u20131121","journal-title":"Head Neck"},{"key":"8507_CR28","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2022.105748","volume":"126","author":"A Al-Lami","year":"2022","unstructured":"Al-Lami A, Gao C, Saddiq M et al (2022) Reducing the unknowns: A systematic review & meta-analysis of the effectiveness of trans-oral surgical techniques in identifying head and neck primary cancer in carcinoma unknown primary. Oral Oncol 126:105748","journal-title":"Oral Oncol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-024-08507-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-024-08507-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-024-08507-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T07:07:13Z","timestamp":1713337633000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-024-08507-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,21]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["8507"],"URL":"https:\/\/doi.org\/10.1007\/s00405-024-08507-1","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"type":"print","value":"0937-4477"},{"type":"electronic","value":"1434-4726"}],"subject":[],"published":{"date-parts":[[2024,2,21]]},"assertion":[{"value":"3 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no funding, financial relationships or conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This was obtained from the ethical review boards of the Medical University of Vienna (EK No.1758\/2017-with annual extensions).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}