Rapid Progression of Head and Neck Squamous Carcinoma after Hyperbaric Oxygenation

Abstract

ILlMyperbaric oxygen (HBO) therapy is sometimes indicated in the course of treatment of head and neck cancer patients for the treatment of persistent infection 1 or bone or cartilage necrosis after radiation therapy 2-4 or as an adjunct to reconstructive proced~ares/ Recurrent or residual tumor may be present in patients undergoing HBO. Previous experimental studies have been inconclusive regarding the effect of HBO on tumor cells. Concerns have been raised regarding whether HBO leads to tumor activation. Some evidence suggests that HBO may have two independent effects on carcinogenesisinhibiting the development of new tumors while enhancing the growth of existing lesions. 6 Others dispute these findings. 7 Further, some studies suggest an increased metastasis rate in patients irradiated in a hyperbaric field, s,9 but others disagree with these conclusions.l°-12 An actual mechanism by which HBO influences tumor growth remains to be elucidated. CASE REPORTSCase ~!. A 30-year-old male tobacco chewer was treated for a T4N0 lateral tongue and tongue base lesion with wide excision, partial mandibulectomy, and right modified radical neck dissection. A radial forearm flap was used for