The use of hyperbaric oxygen therapy in bony reconstruction of the irradiated and tissue-deficient patient

MultiModality Surgical and Hyperbaric Management of Mandibular Osteoradionecrosis

“…At the time of follow-up, 82% of the observed wounds were resolved (n = 24) or improved (n = 13) by Epstein criteria; and, when lesion size was taken into account, 82% were healed (n = 28) or improved (n = 4) ( Table 6). These findings agree well with earlier data of Marx and Ames (13), and the benefits were sustained for a mean of 86 months provided that the patients were cancer recurrence free and abstained from tobacco. Unfortunately, more than one third of the patients continued to smoke after therapy despite encouragement to cease, and their wound survival time averaged only 16 months.…”

“…The absence of uniform use of surgical debridment in that study deviates from the usual clinical protocols for the use of HBO in the treatment of ORN. The use of HBO as a solo modality for the treatment ORN is not the standard of the Undersea and Hyperbaric Medical Society (10, 16), which recommends surgical removal of all nonviable bone after HBO has improved the vascularity of the radiation-damaged soft tissues (13,19,20). This position is supported even by literature critical of the use of HBO.…”

MultiModality Surgical and Hyperbaric Management of Mandibular Osteoradionecrosis

“…At the time of follow-up, 82% of the observed wounds were resolved (n = 24) or improved (n = 13) by Epstein criteria; and, when lesion size was taken into account, 82% were healed (n = 28) or improved (n = 4) ( Table 6). These findings agree well with earlier data of Marx and Ames (13), and the benefits were sustained for a mean of 86 months provided that the patients were cancer recurrence free and abstained from tobacco. Unfortunately, more than one third of the patients continued to smoke after therapy despite encouragement to cease, and their wound survival time averaged only 16 months.…”

“…The absence of uniform use of surgical debridment in that study deviates from the usual clinical protocols for the use of HBO in the treatment of ORN. The use of HBO as a solo modality for the treatment ORN is not the standard of the Undersea and Hyperbaric Medical Society (10, 16), which recommends surgical removal of all nonviable bone after HBO has improved the vascularity of the radiation-damaged soft tissues (13,19,20). This position is supported even by literature critical of the use of HBO.…”

Impact of perioperative hyperbaric oxygen therapy on the quality of life of maxillofacial patients who undergo surgery in irradiated fields

“…Comprehensive literature reviews in 2002 and 2004 9,10 indicated that HBO 2 is an effective treatment for established radiation tissue damage at multiple anatomical sites. The research of Marx and others [9][10][11]17,18 supports the theory that HBO 2 acts as an adjunct to healing in irradiated tissue by stimulating angiogenesis and fibroplasia. Data from a randomised clinical trial 18 supports the use of HBO 2 as a prophylactic measure when tooth removal is performed in an irradiated area.…”

Management of spontaneous osteoradionecrosis: A case report

“…Although healing may be complicated by the poor quality of irradiated soft tissues, surgical reconstruction with iliac crest or rib bone grafts should be considered in some cases.zz Surgical reconstruction with HBO therapy has been supported as an optimal treatment for ORpJ. 15,22,27 Treatment of ORN can extend from weeks to years without resolution, as evidenced in this case report. Although adjunctive measures may be effective, when high-dose radiation results in spontaneous breakdown of large areas of bone and mucosa, surgical resection is inevitable.…”

MultiModality Surgical and Hyperbaric Management of Mandibular Osteoradionecrosis

“…At the time of follow-up, 82% of the observed wounds were resolved (n = 24) or improved (n = 13) by Epstein criteria; and, when lesion size was taken into account, 82% were healed (n = 28) or improved (n = 4) ( Table 6). These findings agree well with earlier data of Marx and Ames (13), and the benefits were sustained for a mean of 86 months provided that the patients were cancer recurrence free and abstained from tobacco. Unfortunately, more than one third of the patients continued to smoke after therapy despite encouragement to cease, and their wound survival time averaged only 16 months.…”

“…The absence of uniform use of surgical debridment in that study deviates from the usual clinical protocols for the use of HBO in the treatment of ORN. The use of HBO as a solo modality for the treatment ORN is not the standard of the Undersea and Hyperbaric Medical Society (10, 16), which recommends surgical removal of all nonviable bone after HBO has improved the vascularity of the radiation-damaged soft tissues (13,19,20). This position is supported even by literature critical of the use of HBO.…”

Impact of perioperative hyperbaric oxygen therapy on the quality of life of maxillofacial patients who undergo surgery in irradiated fields

“…Comprehensive literature reviews in 2002 and 2004 9,10 indicated that HBO 2 is an effective treatment for established radiation tissue damage at multiple anatomical sites. The research of Marx and others [9][10][11]17,18 supports the theory that HBO 2 acts as an adjunct to healing in irradiated tissue by stimulating angiogenesis and fibroplasia. Data from a randomised clinical trial 18 supports the use of HBO 2 as a prophylactic measure when tooth removal is performed in an irradiated area.…”

Management of spontaneous osteoradionecrosis: A case report

“…Although healing may be complicated by the poor quality of irradiated soft tissues, surgical reconstruction with iliac crest or rib bone grafts should be considered in some cases.zz Surgical reconstruction with HBO therapy has been supported as an optimal treatment for ORpJ. 15,22,27 Treatment of ORN can extend from weeks to years without resolution, as evidenced in this case report. Although adjunctive measures may be effective, when high-dose radiation results in spontaneous breakdown of large areas of bone and mucosa, surgical resection is inevitable.…”

MultiModality Surgical and Hyperbaric Management of Mandibular Osteoradionecrosis

“…At the time of follow-up, 82% of the observed wounds were resolved (n = 24) or improved (n = 13) by Epstein criteria; and, when lesion size was taken into account, 82% were healed (n = 28) or improved (n = 4) ( Table 6). These findings agree well with earlier data of Marx and Ames (13), and the benefits were sustained for a mean of 86 months provided that the patients were cancer recurrence free and abstained from tobacco. Unfortunately, more than one third of the patients continued to smoke after therapy despite encouragement to cease, and their wound survival time averaged only 16 months.…”

“…The absence of uniform use of surgical debridment in that study deviates from the usual clinical protocols for the use of HBO in the treatment of ORN. The use of HBO as a solo modality for the treatment ORN is not the standard of the Undersea and Hyperbaric Medical Society (10, 16), which recommends surgical removal of all nonviable bone after HBO has improved the vascularity of the radiation-damaged soft tissues (13,19,20). This position is supported even by literature critical of the use of HBO.…”

Impact of perioperative hyperbaric oxygen therapy on the quality of life of maxillofacial patients who undergo surgery in irradiated fields

“…Comprehensive literature reviews in 2002 and 2004 9,10 indicated that HBO 2 is an effective treatment for established radiation tissue damage at multiple anatomical sites. The research of Marx and others [9][10][11]17,18 supports the theory that HBO 2 acts as an adjunct to healing in irradiated tissue by stimulating angiogenesis and fibroplasia. Data from a randomised clinical trial 18 supports the use of HBO 2 as a prophylactic measure when tooth removal is performed in an irradiated area.…”

Management of spontaneous osteoradionecrosis: A case report

“…Although healing may be complicated by the poor quality of irradiated soft tissues, surgical reconstruction with iliac crest or rib bone grafts should be considered in some cases.zz Surgical reconstruction with HBO therapy has been supported as an optimal treatment for ORpJ. 15,22,27 Treatment of ORN can extend from weeks to years without resolution, as evidenced in this case report. Although adjunctive measures may be effective, when high-dose radiation results in spontaneous breakdown of large areas of bone and mucosa, surgical resection is inevitable.…”