Heterogeneity of Necrotic Changes between Cortical and Cancellous Bone in Mandibular Osteoradionecrosis: A Histopathological Analysis of Resection Margin after Segmental Mandibulectomy

Figure 1

Clinical and histopathological images of a representative case (patient number 10). (a) A resected bone specimen. The anterior and posterior specimens were prepared apart from the true resection margin to avoid heat artifacts caused by the surgical saw (black lines). Mental foramen (). (b) A sagittal section. The most advanced area of bone destruction (white box). Mandibular canal (). Color change was found along the cortical bone of the inferior border of the mandible (arrows). (c) Anterior margin. Mental nerve (). (d) Viable cancellous bone in anterior margin. (e) Viable cortical bone at the middle level of the mandible at the anterior margin. (f) Necrotic cortical bone near the inferior border of the mandible. (d′–f′) Enlarged views. Viable bone evident with blood vessels within Haversian canals (d′ and e′) and necrotic bone evident with empty Haversian canal (f′). (g) Posterior margin. (h) Cancellous bone, (i) cortical bone at the middle level of the mandible, and (j) cortical bone near the inferior border of the mandible. (h′–j′) Enlarged views showing viable bone evident with blood vessels within Haversian canals. (k) Cancellous bone near the most advanced area of bone destruction shown in white box in (b). (k′) Enlarged view showing viable bone evident with osteocyte nuclei within lacunae. All specimens were stained with hematoxylin and eosin, original magnification ×4.