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Mucositis Case Studies

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Oral mucositis is an inflammatory reaction of the mucosa lining the oral cavity and oropharynx and is a very common complication of head and neck radiotherapy (RT). Mucositis occurs because of damage by radiation, to the epithelial cells lining the mucosa resulting in loss of epithelial cells. Damage to the basal layers of mucosa, the layer where stem cells are located, results in reduced regeneration as well. The oral mucosa has a very high cell turnover, renewal of total mucosa occurring in 3-5 days, making them very vulnerable to cellular damage. There can be a direct DNA damage by radiation resulting in death of cells. The DNA damage can also be indirectly caused by reactive free radicals generated by the action of ionizing radiation on water molecules. This results in release of multiple cytokines like IL 1, IL 6, TNF beta etc., resulting in mucosal erythema and edema. Eventually the mucosal ulcers get covered by thick exudates forming a fragile pseudomembrane. RT also affects the salivary gland functions reducing and altering the salivary composition. The reduced glycoprotein content in saliva result in loss of protection to mucosa, making them vulnerable to mechanical and chemical irritants, thereby aggravating the mucositis. Mucositis has a clear dose response curve, with erythema starting around second week of RT. The following …show more content…

During RT it may result in pain, distress, nutritional compromise, weight loss and may interfere with execution and completion of planned treatment compromising oncological outcomes. Consequentially, severe grades of mucositis may cause long term complications like prolonged feeding tube dependence, oral fibrosis, mucosal infections/ bleeding, trismus, thereby severely reducing the patient’s wellbeing. This makes prevention, timely recognition and appropriate management of mucositis very

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