{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:13:56Z","timestamp":1790475236814,"version":"4.1.0"},"reference-count":47,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngologic Clinics of North America"],"published-print":{"date-parts":[[2023,10]]},"DOI":"10.1016\/j.otc.2023.05.013","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T16:14:31Z","timestamp":1688487271000},"page":"977-985","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["Radiotherapy-induced Pathology of the Ear"],"prefix":"10.1016","volume":"56","author":[{"given":"Kaitlyn A.","family":"Brooks","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Gross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"9149","key":"10.1016\/j.otc.2023.05.013_bib1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0140-6736(98)05180-0","article-title":"Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer: a randomised trial","volume":"353","author":"Dearnaley","year":"1999","journal-title":"Lancet"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib2","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1102\/1470-7330.2004.0003","article-title":"Intensity-modulated radiotherapy--what is it?","volume":"4","author":"Taylor","year":"2004","journal-title":"Cancer Imag"},{"key":"10.1016\/j.otc.2023.05.013_bib3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.oraloncology.2018.11.015","article-title":"Intensity modulated proton therapy (IMPT) - The future of IMRT for head and neck cancer","volume":"88","author":"Moreno","year":"2019","journal-title":"Oral Oncol"},{"issue":"4","key":"10.1016\/j.otc.2023.05.013_bib4","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.ijrobp.2016.02.044","article-title":"Intensity modulated proton therapy versus intensity modulated photon radiation therapy for oropharyngeal cancer: first comparative results of patient-reported outcomes","volume":"95","author":"Sio","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.otc.2023.05.013_bib5","doi-asserted-by":"crossref","first-page":"305","DOI":"10.3109\/00016926109172825","article-title":"Dose factors and morphology of delayed radiation lesions of the internal and middle ear in rabbits","volume":"56","author":"Berg","year":"1961","journal-title":"Acta Radiol"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib6","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1742-4801.2005.00079.x","article-title":"Radiotherapy and wound healing","volume":"2","author":"Dormand","year":"2005","journal-title":"Int Wound J"},{"issue":"9","key":"10.1016\/j.otc.2023.05.013_bib7","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1038\/nrc1950","article-title":"Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology","volume":"6","author":"Bentzen","year":"2006","journal-title":"Nat Rev Cancer"},{"issue":"4S Suppl 1","key":"10.1016\/j.otc.2023.05.013_bib8","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1097\/SAP.0000000000002098","article-title":"Radiation-Induced Skin Fibrosis: Pathogenesis, Current Treatment Options, and Emerging Therapeutics","volume":"83","author":"Borrelli","year":"2019","journal-title":"Ann Plast Surg"},{"issue":"3","key":"10.1016\/j.otc.2023.05.013_bib9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/09553009514551231","article-title":"Expression of transforming growth factor-beta 1 in mouse skin during the acute phase of radiation damage","volume":"68","author":"Randall","year":"1995","journal-title":"Int J Radiat Biol"},{"issue":"6","key":"10.1016\/j.otc.2023.05.013_bib10","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1006\/jsre.1995.1226","article-title":"The effect of interleukin-1 beta or transforming growth factor-beta on radiation-impaired murine skin wound healing","volume":"59","author":"Vegesna","year":"1995","journal-title":"J\u00a0Surg Res"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib11","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0360-3016(00)00435-1","article-title":"TGF-beta1 and radiation fibrosis: a master switch and a specific therapeutic target?","volume":"47","author":"Martin","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"10.1016\/j.otc.2023.05.013_bib12","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.oooo.2013.11.497","article-title":"Can tissue spectrophotometry and laser Doppler flowmetry help to identify patients at risk for wound healing disorders after neck dissection?","volume":"117","author":"Rohleder","year":"2014","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"10.1016\/j.otc.2023.05.013_bib13","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s13014-015-0508-3","article-title":"An expression analysis of markers of radiation-induced skin fibrosis and angiogenesis in wound healing disorders of the head and neck","volume":"10","author":"Koerdt","year":"2015","journal-title":"Radiat Oncol"},{"issue":"6","key":"10.1016\/j.otc.2023.05.013_bib14","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1007\/s10029-006-0150-y","article-title":"Radiation responses in skin and connective tissues: effect on wound healing and surgical outcome","volume":"10","author":"Wang","year":"2006","journal-title":"Hernia"},{"issue":"4","key":"10.1016\/j.otc.2023.05.013_bib15","first-page":"185","article-title":"Management of radiation skin reactions: literature review and clinical application","volume":"19","author":"Porock","year":"1999","journal-title":"Plast Surg Nurs. Winter"},{"issue":"1","key":"10.1016\/j.otc.2023.05.013_bib16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jaad.2005.08.054","article-title":"Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006","volume":"54","author":"Hymes","year":"2006","journal-title":"J\u00a0Am Acad Dermatol"},{"issue":"3","key":"10.1016\/j.otc.2023.05.013_bib17","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.radonc.2014.11.031","article-title":"Treatment outcomes of particle radiotherapy using protons or carbon ions as a single-modality therapy for adenoid cystic carcinoma of the head and neck","volume":"113","author":"Takagi","year":"2014","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.otc.2023.05.013_bib18","unstructured":"National Cancer Institute: Division of Cancer Treatment and Diagnosis. Common Terminology Criteria for Adverse Events (CTCAE) Version 2. In: Cancer Therapy and Evaluation Program. 1999. Available at: https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/ctcv20_4-30-992.pdf. Accessed March 6, 2023."},{"key":"10.1016\/j.otc.2023.05.013_bib19","unstructured":"Ansari A, Tariq MA, Sadiq NM. Histology, Ear. In: StatPearls. 2023. Available at: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK545170\/. Accessed February 23, 2023."},{"issue":"5","key":"10.1016\/j.otc.2023.05.013_bib20","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/01.moo.0000172821.04946.30","article-title":"Acquired external auditory canal stenosis: assessment and management","volume":"13","author":"Luong","year":"2005","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"5","key":"10.1016\/j.otc.2023.05.013_bib21","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0305-7372(03)00066-5","article-title":"Radiotherapy-induced ear toxicity","volume":"29","author":"Jereczek-Fossa","year":"2003","journal-title":"Cancer Treat Rev"},{"issue":"1 Suppl","key":"10.1016\/j.otc.2023.05.013_bib22","doi-asserted-by":"crossref","first-page":"15S","DOI":"10.1016\/j.jvs.2010.06.175","article-title":"Acute and chronic radiation injury","volume":"53","author":"Brown","year":"2011","journal-title":"J\u00a0Vasc Surg"},{"issue":"6","key":"10.1016\/j.otc.2023.05.013_bib23","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1017\/S0022215100112873","article-title":"Management of radiation-induced otitis externa","volume":"104","author":"Robinson","year":"1990","journal-title":"J\u00a0Laryngol Otol"},{"key":"10.1016\/j.otc.2023.05.013_bib24","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1159\/000416586","article-title":"Effect of radiation on normal tissues in the head and neck. Bone, cartilage, and soft tissue","volume":"23","author":"Million","year":"1989","journal-title":"Front Radiat Ther Oncol"},{"issue":"4","key":"10.1016\/j.otc.2023.05.013_bib25","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/S0936-6555(05)81059-3","article-title":"Irradiation of the pinna with superficial kilovoltage radiotherapy","volume":"4","author":"Lim","year":"1992","journal-title":"Clin Oncol"},{"key":"10.1016\/j.otc.2023.05.013_bib26","unstructured":"National Cancer Institute: Division of Cancer Treatment and Diagnosis. Common Terminology Criteria for Adverse Events (CTCAE) Version 5. In: Cancer Therapy and Evaluation Program. 2017. Available at: https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_8.5x11.pdf. Accessed March 6, 2023."},{"issue":"11","key":"10.1016\/j.otc.2023.05.013_bib27","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1097\/00005537-200211000-00012","article-title":"External auditory canal stenosis after radiation therapy","volume":"112","author":"Carls","year":"2002","journal-title":"Laryngoscope"},{"issue":"4","key":"10.1016\/j.otc.2023.05.013_bib28","first-page":"226","article-title":"Radiation effects on the external auditory canal","volume":"14","author":"Adler","year":"1985","journal-title":"J\u00a0Otolaryngol"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib29","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/S0360-3016(00)00410-7","article-title":"Results of radiotherapy for epithelial skin cancer of the pinna: the Princess Margaret Hospital experience, 1982-1993","volume":"47","author":"Silva","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"10.1016\/j.otc.2023.05.013_bib30","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0360-3016(96)00447-6","article-title":"Necrosis following radiotherapy for carcinoma of the pinna","volume":"36","author":"Hayter","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"9","key":"10.1016\/j.otc.2023.05.013_bib31","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1097\/MAO.0000000000001925","article-title":"Osteoradionecrosis of the temporal bone: an evidence-based approach","volume":"39","author":"Yuhan","year":"2018","journal-title":"Otol Neurotol"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib32","first-page":"223","article-title":"Intracranial complications of temporal bone osteoradionecrosis","volume":"18","author":"Leonetti","year":"1997","journal-title":"Am J Otol"},{"issue":"1 Suppl","key":"10.1016\/j.otc.2023.05.013_bib33","first-page":"S1","article-title":"Clinical practice guideline: acute otitis externa","volume":"150","author":"Rosenfeld","year":"2014","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"10","key":"10.1016\/j.otc.2023.05.013_bib34","first-page":"2933","article-title":"Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC skin toxicity study group","volume":"21","author":"Wong","year":"2013","journal-title":"Support Care Cancer"},{"issue":"10","key":"10.1016\/j.otc.2023.05.013_bib35","first-page":"5343","article-title":"Topical management of acute radiation dermatitis in breast cancer patients: a systematic review and meta-analysis","volume":"37","author":"Haruna","year":"2017","journal-title":"Anticancer Res"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib36","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.ijrobp.2018.02.006","article-title":"A\u00a0randomized trial of mometasone furoate 0.1% to reduce high-grade acute radiation dermatitis in breast cancer patients receiving postmastectomy radiation","volume":"101","author":"Ho","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"10.1016\/j.otc.2023.05.013_bib37","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.ijrobp.2021.05.133","article-title":"Phase 3 randomized trial of topical steroid versus placebo for prevention of radiation dermatitis in patients with head and neck cancer receiving chemoradiation","volume":"111","author":"Yokota","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"14","key":"10.1016\/j.otc.2023.05.013_bib38","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1016\/j.ejca.2009.05.015","article-title":"Pentoxifylline and vitamin E treatment for prevention of radiation-induced side-effects in women with breast cancer: a phase two, double-blind, placebo-controlled randomised clinical trial (Ptx-5)","volume":"45","author":"Magnusson","year":"2009","journal-title":"Eur J Cancer"},{"issue":"13","key":"10.1016\/j.otc.2023.05.013_bib39","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1200\/JCO.2003.06.064","article-title":"Randomized, placebo-controlled trial of combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis","volume":"21","author":"Delanian","year":"2003","journal-title":"J\u00a0Clin Oncol"},{"issue":"10","key":"10.1016\/j.otc.2023.05.013_bib40","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1097\/MAO.0000000000002781","article-title":"Pentoxifylline and tocopherol in the management of temporal bone osteoradionecrosis: a case series","volume":"41","author":"Lovin","year":"2020","journal-title":"Otol Neurotol"},{"key":"10.1016\/j.otc.2023.05.013_bib41","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.radonc.2021.11.021","article-title":"Hyperbaric oxygen treatment of mandibular osteoradionecrosis: combined data from the two randomized clinical trials DAHANCA-21 and NWHHT2009-1","volume":"166","author":"Forner","year":"2022","journal-title":"Radiother Oncol"},{"issue":"7","key":"10.1016\/j.otc.2023.05.013_bib42","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1097\/MAO.0000000000000321","article-title":"Osteoradionecrosis of the temporal bone: a case series","volume":"35","author":"Sharon","year":"2014","journal-title":"Otol Neurotol"},{"issue":"10","key":"10.1016\/j.otc.2023.05.013_bib43","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1017\/S0022215109990612","article-title":"Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients","volume":"123","author":"Metselaar","year":"2009","journal-title":"J\u00a0Laryngol Otol"},{"issue":"11","key":"10.1016\/j.otc.2023.05.013_bib44","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1002\/(SICI)1097-0142(19960601)77:11<2407::AID-CNCR33>3.0.CO;2-Z","article-title":"Hyperbaric oxygen therapy for the treatment of radiation-induced sequelae in children. The University of Pennsylvania experience","volume":"77","author":"Ashamalla","year":"1996","journal-title":"Cancer"},{"issue":"9","key":"10.1016\/j.otc.2023.05.013_bib45","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1002\/hed.24267","article-title":"Effects of radiation on the temporal bone in patients with head and neck cancer","volume":"38","author":"Lambert","year":"2016","journal-title":"Head Neck"},{"issue":"2","key":"10.1016\/j.otc.2023.05.013_bib46","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1055\/s-0039-1677865","article-title":"Challenges of Hearing rehabilitation after radiation and chemotherapy","volume":"80","author":"Nader","year":"2019","journal-title":"J\u00a0Neurol Surg B Skull Base"},{"issue":"4","key":"10.1016\/j.otc.2023.05.013_bib47","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1097\/MAO.0b013e31819d34ab","article-title":"The BAHA hearing system for hearing-impaired postirradiated nasopharyngeal cancer patients: a new indication","volume":"30","author":"Soo","year":"2009","journal-title":"Otol Neurotol"}],"container-title":["Otolaryngologic Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0030666523000919?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0030666523000919?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T14:55:23Z","timestamp":1758466523000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0030666523000919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["S0030666523000919"],"URL":"https:\/\/doi.org\/10.1016\/j.otc.2023.05.013","relation":{},"ISSN":["0030-6665"],"issn-type":[{"value":"0030-6665","type":"print"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Radiotherapy-induced Pathology of the Ear","name":"articletitle","label":"Article Title"},{"value":"Otolaryngologic Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.otc.2023.05.013","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}