Summary:

Radiation therapy for head and neck cancers has been shown to be an effective adjuvant intervention for reduction of cancer cells. When radiation therapy is used in addition to surgical resection of head and neck tumors, the short-term and long-term effects on tissue healing and stability must be considered when assessing and planning for effective, safe, and comfortable retention of a facial prosthesis. The potential for radiation-related complications and their severity can vary depending on which parts of the anatomy receive radiation, the dose delivered, and the timing and duration of delivery. Conditions that may arise during or after radiation, including but not limited to osteoradionecrosis, fibrosis, poor wound healing, skin sensitivity, or lymphedema, can significantly impact a patient’s comfort and capacity to resume many activities of daily living. We must also be mindful of the effects of radiation therapy on intraoral health and functionality, especially for design of midfacial prostheses, as management of intraoral complications like loss of saliva, edentulism, or trismus may have a direct impact on the fit, retention, and manageability of the prosthesis. It is crucial that the design of a facial prosthesis accounts for how radiation-related symptoms present and impact what a patient experiences beyond the perimeter of one’s prosthesis margins. Disruptions to a patient’s ability to eat, swallow, speak, breathe, hear, and see effectively can present barriers to communication and participation in treatment. Our awareness of how radiation therapy may compromise these functions can help us to more thoughtfully design prostheses and deliver care to our patients. This presentation will explore the effects of radiation therapy soft tissue, bone and teeth, with an emphasis on the skin, nasal, and oral mucosa, as well as patient assessment and considerations for prosthesis retention design.